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Clara Barton founded the American Red Cross (ARC) in 1881, out of a desire to offer neutral humanitarian care to Americans “in peace and in war, during times of disaster and national calamity,” according to the organization’s Web site. Over the years, it has extended its services at home and abroad.

The American Red Cross is one of 66 organizations that have directly received funding from the U.S. government to implement abstinence-until-marriage and fidelity programs overseas. Those are two components of a wider prevention plan implemented by the Bush administration to fight HIV/AIDS, called “ABC” — which is short for “Abstinence, Be faithful and correct and consistent use of Condoms.” The $15 billion President’s Emergency Plan for Aids Relief (PEPFAR) is a five-year program focusing in the 15 countries with some of the highest HIV prevalence rates in the world, the majority of which are located in Africa. Besides prevention, PEPFAR also includes funding for treatment and care programs.

Funded by a $7 million award since February 2004, ARC has worked in HIV prevention, implementing the “Together We Can” (TWC) program in partnership with national Red Cross societies and Ministries of Health in Guyana, Haiti and Tanzania.

Together for a decade

The original TWC program was developed in the 1990s for use in Jamaica by consultants to the ARC and the International Federation of Red Cross and Crescent Societies, an umbrella organization for all national Red Cross societies. Field staff, peer educators and beneficiaries in Jamaica also collaborated. The peer-education curriculum first implemented there from 1993 to 1997 under a U.S. Agency for International Development grant is based on the premise that youths feel a greater comfort and openness when talking to others their age.

The program has been adapted a number of times over the years and replicated in 14 countries since then. ARC officials said that revisions or updates to the curriculum are driven by the needs of each national Red Cross society. The PEPFAR project was tailored specifically for Guyana, Haiti and Tanzania. In Haiti, the curriculum was revised in 2005 to reflect local needs, while in Guyana, it has not required major updates. Regardless of the adjustments, ARC officials said, PEPFAR did not change the core of its program.

“The TWC curriculum has always been ‘AB’ [abstinence and be faithful] focused from its inception in 1993,” said Lance Leverenz, the American Red Cross’ international services regional director for the Americas.

Besides abstinence until marriage, the program emphasizes delaying youths’ start of sexual activity, secondary abstinence for those who have already had sex, being faithful to one’s partner and reduction of sexual partners among sexually active unmarried people.

In Haiti, Guyana and Tanzania, the TWC curriculum strives to change behavior among those ages 10 to 24 through peer education both in and out of school, according to an ARC document describing the program’s overview and impact. In each of these countries, Red Cross facilitators and health ministry officials recruit and train youths ages 13 to 19 from Red Cross clubs and schools to take part in workshops.

Each workshop participant is asked to share HIV prevention messages with 10 peers, a tactic called the “multiplier effect.” A message might reach siblings, schoolmates and friends.

Those messages address the consequences of high-risk behavior, facts about HIV transmission and prevention, and also identify myths and misconceptions about the virus and the ways discrimination affects the lives and families of people living with HIV/AIDS.

The correct and consistent use of condoms is part of the message when it is directed to sexually active youths or those who have a high probability to engage in risky sexual behaviors, but is not limited to those circumstances.

“Complete information has been and continues to be provided on condoms, including how to use them correctly and how to negotiate their use with partners,” said Leverenz. “PEPFAR funding has not changed this approach for youth over the age of 14. At-risk youth 14 and under also benefit from the same condom information.”

Organizers also use concerts, street theater, film screenings and sports events as vehicles to reinforce their prevention message. School-based clubs are also targeted for specific HIV/AIDS educational exercises.

Religious leaders also play a role, as do parents, teachers, host-country government officials, non-governmental organizations and community leaders.

At the end of the five-year TWC program in Guyana, Haiti and Tanzania, the ARC expects to reach more than 766,000 youth, age 10 to 24, the majority in Tanzania.

AIDS experience

The American Red Cross first responded to the HIV/AIDS crisis in the United States in 1985. In the last 21 years, the organization says to have trained more than 30,000 people in the U.S. to become HIV/AIDS instructors.

An HIV-prevention curriculum targeting youth is in use in 30 states through ARC chapters. The U.S. programs include curricula tailored to reach specific audiences, such as African-Americans and Hispanics.

In addition to its PEPFAR-funded programs abroad, the organization is presently involved with HIV/AIDS projects in Russia, Nigeria and Honduras.

For the year beginning July 1, 2004, and ending June 30, 2005, the American Red Cross reported revenue of $3.9 billion, a 26.8 percent increase from the previous year. The organizations direct public contributions almost tripled over that period, possibly boosted by the 2004 tsunami disaster in Asia.

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