I 
108TH CONGRESS 
2D SESSION 
H. R. 4792 
To require the President to establish a comprehensive, integrated, and cul-
turally appropriate HIV prevention strategy that emphasizes the needs 
of women and girls for each country for which the United States provides 
assistance to combat HIV/AIDS, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 9, 2004 
Ms. LEE (for herself, Mr. LANTOS, Mr. WEXLER, Mr. PAYNE, Mr. MCGOV-
ERN, Mr. GRIJALVA, Ms. CORRINE BROWN of Florida, Mr. OWENS, Mr. 
RUSH, Ms. WATERS, Ms. NORTON, Mr. CONYERS, Mr. BROWN of Ohio, 
Mr. BELL, Mr. MCDERMOTT, Mr. CROWLEY, Mr. GUTIERREZ, Ms. CAR-
SON of Indiana, Mr. PALLONE, Mr. DAVIS of Illinois, Mrs. MALONEY, Mr. 
DELAHUNT, Mrs. CHRISTENSEN, Mr. CUMMINGS, Mr. DOGGETT, Mr. 
OLVER, Mr. FRANK of Massachusetts, Ms. JACKSON-LEE of Texas, Mr. 
WAXMAN, Ms. WATSON, Ms. KILPATRICK, Ms. EDDIE BERNICE JOHN-
SON of Texas, Mr. THOMPSON of Mississippi, Mr. JACKSON of Illinois, 
Mr. SCOTT of Virginia, Mr. SCOTT of Georgia, Mr. LEWIS of Georgia, 
Mr. CLYBURN, Ms. MILLENDER-MCDONALD, Mr. BISHOP of Georgia, 
Ms. MCCOLLUM, Mr. WYNN, Mr. KUCINICH, Mr. RANGEL, Ms. SOLIS, 
Mr. DICKS, Ms. SCHAKOWSKY, Mrs. MCCARTHY of New York, Mr. 
MEEKS of New York, Mr. DINGELL, Mr. BERMAN, Ms. DELAURO, Mrs. 
JONES of Ohio, Mr. MORAN of Virginia, and Mr. SERRANO) introduced 
the following bill; which was referred to the Committee on International 
Relations 
A BILL 
To require the President to establish a comprehensive, inte-
grated, and culturally appropriate HIV prevention strat-
egy that emphasizes the needs of women and girls for 
each country for which the United States provides assist-
ance to combat HIV/AIDS, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘New United States 
Global HIV Prevention Strategy to Address the Needs of 
Women and Girls Act of 2004’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Globally, the United Nations Joint Pro-
gramme on HIV/AIDS (UNAIDS) estimates that 
there are more than 40,000,000 people infected with 
HIV/AIDS, the vast majority of whom live in the de-
veloping world. For a number of reasons, women 
and girls are biologically, socially, and economically 
more vulnerable to HIV infection, and today they 
represent more than half of all individuals who are 
infected with HIV worldwide. 
(2) In sub-Saharan Africa, women and girls 
make up 60 percent of those individuals infected 
with HIV. Data from several countries in Africa in-
dicate that women ages 15 to 24 are from two and 
a half to thirteen times more likely to be infected 
with HIV as their male counterparts.
(3) Gender disparities in the rates of HIV in-
fection are the result of a number of factors, includ-
ing— 
(A) inadequate knowledge about how HIV 
is transmitted; 
(B) lack of access to basic HIV prevention 
and reproductive health services; 
(C) an inability to negotiate safer sex with 
regular partners; 
(D) social norms that prevent frank and 
open discussions about sex; 
(E) a lack of access to female-controlled 
HIV prevention methods, such as the female 
condom and, when available, microbicides; and 
(F) social and economic inequalities based 
largely on gender. 
(4) Current HIV prevention programs designed 
to support the ABC model: ‘‘Abstain, Be faithful, 
use Condoms’’, are not always effective at address-
ing the central fact that women and girls are often 
powerless to abstain from sex, ensure their partner’s 
faithfulness, or to insist on condom use even within 
marriage, and especially in the case of early- or 
child-marriages. Women may also be coerced into 
unprotected sex and they often run the risk of being
infected by husbands or male partners in societies 
where it is common or accepted for men to have 
more than one partner. 
(5) Recognizing that current international HIV 
prevention and protection efforts are failing women 
and girls, UNAIDS officially launched the Global 
Coalition on Women and AIDS on February 2, 
2004, to focus on preventing new HIV infections 
among women and girls, promoting equal access to 
HIV care and treatment, increasing access to fe-
male-controlled prevention methods such as female 
condoms, accelerating microbicides research, pro-
tecting women’s property and inheritance rights, 
supporting ongoing efforts toward reaching universal 
primary education for girls, and reducing violence 
against women. 
(6) Violence against women, perpetuated by 
their intimate partners, is a major human rights and 
public health problem throughout the world and it is 
also a major contributing factor to the spread of 
HIV. According to the World Health Organization 
(WHO), one-fifth to one-third of women ages 15 to 
49 have experienced some form of physical abuse or 
sexual coercion in their lifetimes, the vast majority 
within marriage.
(7) Unfortunately, current HIV prevention pro-
grams do not place enough importance on respond-
ing to violence against women, changing the social 
norms that shape the attitudes and behaviors of men 
and boys toward women and girls, or using strate-
gies to promote effective communication among cou-
ples on matters of sex and reproduction. 
(8) The fear of domestic violence and the con-
tinuing stigma and discrimination associated with 
HIV/AIDS prevents many women from accessing in-
formation about HIV/AIDS, getting tested, dis-
closing their HIV status, accessing services to pre-
vent mother-to-child transmission, or receiving treat-
ment and counseling even when they already know 
they have been infected with HIV. 
(9) Economic and social disparities between 
men and women amplify the effects of stigma and 
discrimination, the fear of domestic violence, and 
other risks of HIV infection faced by women and 
girls. Unequal access to education, income, land, and 
other productive resources leaves many women and 
girls dependent on men for income, housing, suste-
nance and social security. 
(10) For women and girls, gender discrimina-
tion in the ownership and retention of property also