AIDS is an epidemic of astronomical proportions. It has orphaned an estimated 14.5 million children so far, and the number is expected to more than double by 2010.

Millions are spent every year on research to find a cure, but until one is found, programs are emphasizing prevention. A consensus has emerged that most prevention programs should promote the ABCs of AIDS prevention — Abstinence, Be faithful, and consistent and correct Condom use. But much debate has developed over the weight that each of these three elements should be given.

One unusual nonprofit organization has been practicing all three methods for nearly 20 years and, where appropriate, joining hands with religious organizations. “We have long promoted all of the "ABCs" along with voluntary counseling and testing with a great deal of success,” says Richard A. Frank, president of Population Services International. PSI is a Washington, D.C.-based nonprofit agency founded in 1970 to use social marketing to improve the health of poor and vulnerable people in more than 70 developing countries.

“Experience shows that the best approach is a comprehensive one. We can’t rely on one or two methods. We must use every tool at our disposal to deal with AIDS,” adds Frank.

One of the main tools PSI uses is social marketing, which combines education to motivate healthy behavior with the provision of needed health products and services at subsidized prices. PSI is unique among non-profit organizations working in HIV/AIDS in that it works through the private, commercial sector, which is financially motivated to stock and sell products.

Frank says people who are poor and at risk appreciate the value of the products and services they receive more because they have a personal stake in them. In 2002 alone, sales of PSI products and services are estimated to have averted 500,000 cases of HIV around the world. That is equivalent to 10 percent of all new infections in the world in 2002.

PSI has learned that a cookie cutter approach to AIDS prevention does not work. “Every country is different, and requires an AIDS prevention strategy appropriate for that country and that culture,” says Frank. “Sometimes that requires more emphasis on abstinence, sometimes a bit more emphasis on condoms is in order."

Cambodia and Zambia are two examples of PSI programs that have been successful with different approaches. In Zambia, PSI emphasizes abstinence for youth and condoms for those who are already sexually active. Research shows that youth who saw PSI’s mass media campaign promoting the idea that “abstinence is cool” were 1.7 times more likely to report abstinence. In Cambodia, where commercial sex is common, PSI supported the government’s policy of 100 percent condom use in brothels. Since PSI started those two programs in the early 1990s, HIV prevalence has either stabilized or declined in both countries.

One of the PSI Zambia program’s strongest supporters is former Zambian President Kenneth Kaunda,. He lost a son to AIDS in 1986 and is now appearing in PSI public service announcements (PSAs) that urge Zambians to get tested, be compassionate with people infected with HIV and use condoms. President Bush applauded Kaunda’s efforts the day he signed the HIV/AIDS bill into law.

“There were some who thought I should remain silent about the death my son, but Mrs. Kaunda and I decided to make this public… if we are to win the battle, we must confront this problem openly,” he says in one of the ten PSAs. Kaunda is one of the first heads of state or former heads of state to make a direct appeal to his people to use condoms. He also helped PSI sit down with Christian leaders to map out a strategy for fighting AIDS.

In Cambodia, PSI recently launched a new HIV/AIDS prevention campaign with blessings from His Royal Highness King Norodom Sihanouk, who praised PSI for its “many achievements extremely beneficial to the health of the Cambodian people.” PSI has worked with Buddhist monks to promote AIDS prevention in Cambodia for several years.

Nearly 60 percent of those infected by HIV in sub-Sahara Africa are women. Three million African children under 15 have AIDS.

Courtesy of ARA Content