[1][2] This fall is believed to result from the employment of the ABC approach, especially reduction in the number of sex partners, called "zero grazing" in Uganda.
Advocating this ideal, whilst pragmatically dealing with the fact that abstinence only sex education is ineffective by itself, has made the ABC approach popular with many African governments and relief agencies.
The program understood that it would not be possible to stop all teenagers from having sex, but still stressed that abstinence is the only guaranteed way of avoiding unwanted pregnancies and contraction of STIs.
[7] The most important message to teens from the program comes from Joycelyn Elders, President Clinton's first Surgeon General, that "if they have a baby there is an 80% likelihood they'll be poor, ignorant, and slaves for the rest of their lives.
[9] For those who would reject abstinence, or have early sex forced upon them, abstinence-only messages provided little to no hope to prevent pregnancy and spread of disease.
[11] In 1996, the federal government increased funding for state abstinence education as an inclusion of the Welfare Reform Act, creating Title V, and the abstinence-only-until-marriage program.
In 2006 and 2007, $176 million was given annually to abstinence-only programs, whose central message was to delay sexual activity until marriage, preventing the inclusion of information about safe-sex practices or contraception.
[2] Uganda's HIV/AIDS and sex education program has a greater focus on the use of condoms in preventing HIV/AIDS, however, religious institutions emphasize abstinence.
[21] However, donor funding has always been allocated overwhelmingly to condoms, reflecting clear US and European policy priorities, including under George W Bush.
[22] Condoms, needles, and negotiation is a proposed alternative approach among high-risk groups as is SAVE (Safer practices, Available medication, Voluntary testing & counseling and Empowerment through education).
[13] Abstinence-only sex education programs have been proven to be ineffective and there is little evidence showing that abstinence-only, or abstinence-only-until-marriage programs lower risky sexual behavior in teens[28] There is also evidence to support a parental push for earlier sex education for students, starting in elementary school rather than middle school.
[29] Parents in this study also supported a greater emphasis on sex education in middle schools and an increase in the teaching of the same topics from elementary school as well as a greater emphasis on birth control and condom use[29] Pope Benedict XVI has criticized some harm reduction policies with regards to HIV/AIDS, saying that "if the soul is lacking, if Africans do not help one another, the scourge [of HIV] cannot be resolved by distributing condoms; quite the contrary, we risk worsening the problem".
[32] Archbishop Gabriel Charles Palmer-Buckle of Accra has stated that "the Catholic Church [offers] three methods to help solve this problem of AIDS in Africa: "A", abstain; "B", be faithful; "C", chastity, which is in consonance with traditional African values.
[34] A major proponent of the ABC approach, author and member of Presidential Advisory Council on HIV and Aids in 2003–2007, Harvard University's Edward C. Green, said "Advocates of the ABCs often use the term to mean a primary emphasis on abstinence/delay of sexual debut and faithfulness/partner reduction, with condom use being a secondary but necessary strategy for those who do not or cannot practice abstinence or fidelity."
Furthermore, Green in his seminal book Rethinking AIDS Prevention (Praeger 2003)[citation needed] argued that the success in Uganda, where prevalence fell 21% to 6% between 1989 and 2003 was largely due to the "B" of the ABC approach, fidelity or reduction in multiple partners.