The Bush administration is requiring that U.S. HIV/AIDS organizations seeking funding to provide services in other countries make a pledge opposing commercial sex work, and some Republican lawmakers and administration officials are pushing for a similar policy for needle-exchange programs, the Wall Street Journal reports. Under the new policy, even groups whose HIV/AIDS work in other countries has "nothing to do" with commercial sex workers will have to make a written pledge opposing commercial sex work or risk losing federal funding, according to the Journal. In addition, the Bush administration might refuse to fund HIV/AIDS groups that do not accept Bush's "social agenda" on issues such as sexual abstinence and drug use, according to the Journal. The new policy stems from two 2003 laws, one involving HIV/AIDS funding and another regarding sex trafficking (Phillips, Wall Street Journal, 2/28). One measure was included as an amendment, sponsored by Rep. Christopher Smith (R-N.J.), in the legislation (HR 1298) that authorized the President's Emergency Plan for AIDS Relief, the five-year, $15 billion program that directs funding for HIV/AIDS, tuberculosis and malaria to 15 focus countries. The measure prohibits funds from going to any group or organization that does not have a policy "explicitly opposing prostitution and sex trafficking" (Kaiser Daily HIV/AIDS Report, 4/3/03). The U.S. Department of Justice initially told the administration that the requirement should be applied to overseas groups only because of constitutional free speech concerns in applying it to U.S. organizations, according to the Journal. However, DOJ in 2004 "reversed itself" and said that the administration could apply the rule to U.S. groups, according to the Journal.

Harm Reduction
Sen. Sam Brownback (R-Kan.) said that although there is "conservative support" for U.S. HIV/AIDS programs overseas, "there are areas of concern ... that risk the continued support from a number of conservative members and conservative groups." Many U.S. HIV/AIDS organizations providing services in other countries are "reluctant" to make a pledge opposing commercial sex work because the groups often work with commercial sex workers to distribute condoms and say that such pledges could lead to "official stigmatization" of commercial sex workers that could lead to their further isolation, according to the Journal. Some HIV/AIDS groups favor a strategy of "harm reduction" that acknowledges that some people will engage in high-risk behaviors -- including commercial sex work and injection drug use -- and that the best way to prevent the spread of HIV is to make those behaviors less dangerous. U.S. officials said that some HIV/AIDS groups that have applied for grants have agreed to sign the pledge, but they would not identify the groups by name, according to the Journal. Janice Crouse, a senior fellow at Concerned Women for America, said that federal funding for international aid programs often has gone to "left-leaning groups" and that the new Bush administration policy would "redress that imbalance," according to the Journal. Susan Cohen, director of government affairs for the Alan Guttmacher Institute, said that the Bush administration's new policy is "another salvo in the campaign that the administration and its fellow conservatives are undertaking to create more and more litmus tests and blacklists of those they're willing to do business with."

Needle Exchange
Some congressional Republicans have been working to prevent federal funding from going to groups that advocate needle-exchange programs to reduce the spread of HIV among injection drug users, with Reps. Mark Souder (R-Ind.) and Tom Davis (R-Va.) leading the effort, according to the Journal. Brownback earlier this month in a memo to his political allies outlined a strategy seeking a ban on USAID grants going to any organizations that do not "fully support" Bush's views on issues, including drug use and sexual abstinence, the Journal reports. A "major target" of the congressional Republican attempts to ban funding from going to groups supporting needle exchange is the Open Society Institute, which was founded by billionaire financier George Soros, according to the Journal. OSI supports needle-exchange programs to reduce the spread of HIV in former Soviet Union countries. Although Soros' aides say that no federal funding goes to OSI's needle-exchange programs, Souder began investigating OSI after Soros spent "millions of dollars" during the 2004 election campaign to oppose Bush's re-election, the Journal reports. USAID policy prohibits federal funding from going to needle-exchange efforts, according to the Journal (Wall Street Journal, 2/28).

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