Kati Marton

Protect women, stop a disease

More money to fight AIDS is both welcome and necessary. But its effectiveness depends on how well it helps the primary victims of AIDS in the most highly affected areas: women and teenage girls.

Fifty percent of those infected worldwide, and 58 percent of AIDS victims in sub-Saharan Africa, are women. If we are serious about combating this plague, women must be empowered so that they can defend themselves against the men who are infecting and abandoning them. The administration has failed to do anything significant in this critical area.

In much of sub-Saharan Africa, girls under 18 are four times to seven times more likely than boys the same age to become infected. Why? The answer is sexual coercion and violence against women, child marriage, polygamy and the widespread belief that having sex with a virgin will cure AIDS. Girls are frequently forced into sex with older men in exchange for food for their families or money for school — or for nothing.

These cycles of abuse and exploitation will not disappear by making AIDS medication more readily available. A huge — and forthright — education campaign and the strengthening of public health programs in the developing world are also essential. But on these critical issues, the Bush administration's policy has been worse than disappointing. Most recently, it proposed extending the so-called Mexico City policy, or "global gag rule," to its AIDS initiative, effectively barring any organization that receives funds from performing abortions, or even discussing them. Driven by ideology rather than concern for public health, the policy would deny money to organizations already well positioned to provide women with the full range of services they need. The administration also opposes the distribution of condoms in refugee camps, where rape is endemic. Its proposed budget would cut more than $20 million from international family planning. The administration has already blocked a $34 million contribution to the United Nations Population Fund, the largest provider of family-planning services, because of claims that it supported forced abortions and sterilizations in China. (A subsequent State Department investigation found no evidence for this claim.)

In a mind-boggling alliance with Iran, Libya, Sudan, Syria and Iraq, the Bush administration tried to block a consensus at the United Nations General Assembly Special Session on Children last year in support of better education on how to avoid sexually transmitted diseases. The countries stood together in asserting that sex education promotes promiscuity. Not surprisingly, the administration's new budget calls for a $33 million increase in financing programs whose version of sex education is "abstinence only until marriage."

Of course, abstinence is one important way to avoid AIDS. To maintain that it's the only way, however, is not only delusional but also dangerous. Women must have access to free female condoms and effective microbicides, as well as to programs that can teach them to resist sexual predators. So while we should support the president's initiative, let us look carefully at the not-so-fine print. Congress should authorize the funds to fight H.I.V. and AIDS — but only if girls' and women's needs are central.

Kati Marton, a member of the board of the International Woman's Health Coalition, is author of "Hidden Power: Presidential Marriages That Shaped Our Recent History."