Improving U.S. Global AIDS Policy for Young People

Naina Dhingra

Advocates for Youth releases a new policy report today which presents findings from programs in Kenya and South Africa that are funded by the President's Emergency Plan for AIDS Relief (PEPFAR).

New Policy Report from Advocates for Youth

Last December, I traveled to South Africa and Kenya to get a handle on what programs funded by the President's Emergency Plan for AIDS Relief (PEPFAR) looked like on the ground. Specifically, I wanted to talk to youth themselves to get their perception of PEPFAR and to examine program responses to young people's needs.

Overwhelmingly, I learned that the common sentiment on the ground was that PEPFAR has, so far, largely ignored the realities of young people's lives and the state of the epidemic among youth. It's no surprise, considering the policies that strangle an effective response like the ideological abstinence-until-marriage earmark and the un-scientifically based guidance from the Office of the Global AIDS Coordinator (OGAC).

One Kenyan PEPFAR implementing partner told me, "PEPFAR requires you to present everything about condoms very negatively. You … shoot yourself in the foot before you start."

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There was common agreement that PEPFAR HIV prevention programs for youth also lacked sufficient links to reproductive health care. One recipient stated that PEPFAR's current youth prevention policy has resulted in "an absence of condoms and aggressive inattention to STI education and clinical services [for youth] … this inattention is unethical and disgusting."

I also found a widespread belief that PEPFAR's one-size-fits-all approach to youth HIV prevention ignores the social and cultural factors that contribute to the spread of HIV. One South African PEPFAR implementing partner said,

"PEPFAR prevention programs that target youth ignore the context. At home, a teenage girl is hearing from her mother and aunty that she has to have a baby to prove she is a woman. … Post-apartheid democratization has created tensions for youth. They have their family and cultural obligations on the one hand, and on the other, they see the opportunity for a different world. Basically, they are stuck between two worlds. Society and the family expect different things of the young person."

Another PEPFAR implementing partner told me to be successful in positive behavior change for an individual, "You have to target the community to change attitudes. A young person may want to change behavior, but the environment might not allow them to." I even found some research funded by USAID in Namibia that found that most youth did not understand the concepts of abstinence or faithfulness for HIV prevention. Namibian youth believed that "abstinence" meant "to be absent" and "faithfulness" meant faith in religion; 75 percent of the study population had never heard the word "monogamy."

The findings from my travels to South Africa and Kenya along with several months of research are documented in a new Advocates for Youth publication, Improving U.S. Global AIDS Policy for Young People: Assessing the President's Emergency Plan for AIDS Relief. The report makes a number of recommendations to Congress, including the immediate repeal of the abstinence-until-marriage earmark from PEPFAR and an increase in appropriations for international family planning.

The report also critiques PEPFAR's response to HIV-positive youth which will be featured in a new blog tomorrow.

Commentary Politics

Milwaukee Officials: Black Youth, Single Mothers Are Not Responsible for Systemic Failings—You Are

Charmaine Lang

Milwaukee has multiple problems: poverty, a school system that throws out Black children at high rates, and lack of investment in all citizens' quality of life. But there's another challenge: politicians and law enforcement who act as if Black youth, single mothers, and families are the "real" reasons for the recent uprising and say so publicly.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

On the day 23-year-old Sylville Smith was killed by a Milwaukee police officer, the city’s mayor, Tom Barrett, pleaded publicly with parents to tell their children to come home and leave protests erupting in the city.

In a August 13 press conference, Barrett said: “If you love your son, if you love your daughter, text them, call them, pull them by the ears, and get them home. Get them home right now before more damage is done. Because we don’t want to see more loss of life, we don’t want to see any more injuries.”

Barrett’s statement suggests that parents are not on the side of their sons and daughters. That parents, too, are not tired of the inequality they experience and witness in Milwaukee, and that youth are not capable of having their own political ideologies or moving their values into action.

It also suggests how much work Milwaukee’s elected officials and law enforcement need to do before they open their mouths.

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Barrett’s comments came after Smith fled a traffic stop and was shot by authorities on Milwaukee’s northwest side. The young Black man’s death sparked an urban uprising in the Sherman Park neighborhood, an area known for its racial and religious diversity. Businesses were burnt down, and the National Guard was activated in a city plagued by racism and poverty.

But Milwaukee parents and families need more than a directive thinly disguised as a plea. And Mayor Barrett, who was re-elected to a fourth term in April, should know well that Milwaukee, the nation’s most racially stratified city, needs racial equity in order for there to be peace and prosperity.

I live in Milwaukee, so I know that its residents, especially its Black parents, do love their children. We want more for them than city-enforced curfews and a simplistic solution of returning to their homes as a way to restore calm. We will have calm when we have greater investment in the public school system and youth services; easy access to healthy food; and green spaces, parks, and neighborhoods that are free from police harassment.

In fact, according to staggering statistics about Milwaukee and Wisconsin as a whole, Black people have been consistently denied their basic human rights and health. Wisconsin has the highest rate of incarceration of Black men nationwide; the Annie E. Casey Foundation has found it is the worst state for racial disparities affecting Black childrenand infant mortality rates are highest among Black women in the state.

What we absolutely don’t need are public officials whitewashing the facts: that Milwaukee’s young people have much to protest, including Wisconsin’s suspending Black high-school students more than any other state in the country.

Nor do we need incendiary comments like those coming from Milwaukee County Sheriff David Clarke, who drew national attention for his “blue lives matter” speech at the Republican National Convention and who is a regular guest on CNN and Fox News. In an August 15 op-ed published by the Hill, Clarke has called the civil unrest “the rule of the jungle,” “tribalism,” and a byproduct of “bullies on the left.”

He went even further, citing “father-absent homes” as a source of what he calls “urban pathologies”—leaning on old tropes used to stigmatize Black women, families, and the poor.

Single mothers are not to be blamed for young people’s responses to a city that ignores or criminalizes them. They should not be shamed for having children, their family structure, or for public policy that has made the city unsafe for parenting.

Creating justice—including reproductive justice—in Milwaukee will take much more than parents texting their teens to come home. The National Guard must leave immediately. Our leaders must identify anti-Black racism as a root cause of the uprisings. And, lastly, creating justice must start with an end to harmful rhetoric from officials who lead the way in ignoring and dehumanizing Milwaukee residents.

Sheriff Clarke has continued his outrageous comments. In another interview, he added he wouldn’t “be satisfied until these creeps crawl back into their holes so that the good law-abiding people that live in the Milwaukee ghetto can return to at least a calm quality of life.”

Many of Milwaukee’s Black families have never experienced calm. They have not experienced a city that centers their needs and voices. Black youth fed up with their treatment are not creeps.

And what hole do you think they should crawl back into? The hole where they face unemployment, underemployment, police brutality, and racism—and face it without complaint? If that’s the case, you may never be satisfied again, Sheriff.

Our leaders shouldn’t be content with Milwaukee’s status quo. And asking the citizens you serve to be quiet in the ghetto is an insidious expectation.

News Law and Policy

Seattle Becomes Fourth U.S. City to Outlaw ‘Conversion Therapy’

Nicole Knight

The American Psychological Association has warned of risks from the so-called treatment, including depression, anxiety, self hatred, and self-destructive behavior. Major medical organizations have rejected the harmful practice.

The Seattle City Council this week banned so-called conversion therapy for LGBTQ youth, making it the latest in a string of cities and states to outlaw the harmful and unscientific practice.

The “conversion therapy” ban passed Monday in a unanimous vote.

“Being gay, lesbian, bisexual, queer or transgender is not an illness,” said Lorena González, the councilperson who sponsored the new ordinance, as the Stranger reported. “Nor is it something that needs a cure.”

“Conversion therapy” attempts to change a young LGBTQ person’s sexual orientation or gender identity to cisgender or “straight.” Major medical and health-care organizations, such as the American Medical Association, the American Academy of Pediatrics, and the American Academy of Child and Adolescent Psychiatry have rejected the controversial practice.

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The American Psychological Association has warned of risks from the so-called treatment, including depression, anxiety, self hatred, and self-destructive behavior.

Cincinnati, Miami Beach, and Washington, D.C. already ban “conversion therapy,” as do states including California, New Jersey, Oregon, Illinois, New York, and Vermont, Seattle officials said in a statement.

The Seattle ordinance applies to licensed providers treating youths younger than 18. Violators face fines of up to $1,000.

The city “has taken a bold step to save children’s lives, and its children have received a clear message that they were born perfect,” said Carolyn Reyes, youth policy counsel with the National Center for Lesbian Rights (NCLR). The NCLR’s #BornPerfect campaign seeks to end “conversion therapy” nationwide by 2019 through new laws, court action, and awareness campaigns.

Although LGBTQ rights groups in Washington state had pushed for statewide legislation to outlaw “conversion therapy,” Monisha Harrell, with the LGBTQ advocacy group Equal Rights Washington, cheered the city ordinance. She said the group would redouble its efforts to enact a statewide ban.

The Obama administration last year called for an end to “conversion therapy,” throwing its support behind national legislation named for Leelah Alcorn. Alcorn, a 17-year-old transgender woman who killed herself in 2014, wrote in a suicide note that religious therapists tried to force her identify as a boy, as Rewire reported.

The Republican Party this summer nearly made support for the harmful practice part of its party platform, as Time reported.

The Family Research Council’s Tony Perkins had advocated for strong language backing “conversion therapy,” but watered down his amendment after conferring Republican National Committee officials. The party finally agreed to: “We support the right of parents to determine the proper treatment or therapy, for their minor children.”

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