In an effort to implement an “anti-prostitution” provision included in the Lantos-Hyde Act, the law that reauthorized PEPFAR, the Administration may do more harm than good.

In a letter to Health and Human Services Secretary Kathleen Sebelius, leading HIV/AIDS physician-scientists expressed serious concern that a proposed rule requiring PEPFAR-funded organizations to declare their opposition to prostitution and sex trafficking could have a chilling effect on efforts to reach “extremely vulnerable population at high risk for HIV infection” with treatment, education, and other vital assistance.

“The regulation fails to outline with any clarity what being ‘opposed to prostitution’ might entail, while restricting what organizations can do with their private funding and placing limits on their ability to forge affiliations with other organizations,” states the letter, signed by Drs. Carol Dukes Hamilton, Kenneth H. Mayer, and Michael Saag. Drs. Hamilton and Mayer serve as co-chairs of IDSA’s Center for Global Health Policy; Dr. Saag is chairman of the board of the HIV Medicine Association.

“Sound public health principles dictate that individuals and vulnerable groups be approached with non-judgmental, evidence-based prevention and treatment interventions aimed at reducing infection risk, or in the case of already established infection, reducing morbidity and mortality and preventing further transmission,” the physicians wrote to Secretary Sebelius. “At best, the opinions of PEPFAR grantees on the subjects of prostitution and sex trafficking are irrelevant to the task at hand; at worst, a so-called anti-prostitution pledge serves to stigmatize an already marginalized population, which may translate into discouraging individuals from seeking prevention and care services or discouraging PEPFAR implementers from providing services to this population.”