HIV/AIDS Legal And Policy Requirements

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U.S. Government foreign assistance activities, including HIV/AIDS-prevention, care, and treatment activities, are subject to a number of U.S. statutory and policy requirements.

U.S. Agency for International Development (USAID) and implementing partner staff must understand the key components of the requirements in order for the requirements to be implemented correctly.

Requirements Applicable to All U.S. Government Foreign Assistance

USAID, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), and implementing partner staff must be familiar with the requirements that apply to all U.S. Government foreign assistance:

  • Abortion Restrictions: There are several statutory requirements related to abortion, including the Helms, Leahy, Siljander, and Biden Amendments.

Resource: See Abortion-Related Restrictions for more information.

  • Working with faith-based organizations (FBOs) and in faith-related contexts: U.S. government funds may only be used for secular purposes, but staff of the U.S. government and implementing partners often work with or may be FBOs. See the resources below for additional information. Establishment Clause of the First Amendment

Resources: See Automated Directive System (ADS) Chapter 303.3.28 [PDF, 1.1MB] and USAID Rule for Participation by Religious Organizations for additional information.

  • Working with military, police, prisons, and other law enforcement personnel: Generally, USAID is prohibited by statute and general principles of appropriation law from providing assistance to military forces, police, prison, and other law enforcement personnel. However, there are situations where it is appropriate to include these populations in your HIV/AIDS programs.

Resource: Guidance on the Definition and Use of the Global Health Programs (GHP) Account (see ADS 201mau)

Requirements Applicable to HIV/AIDS Activities

USAID HIV/AIDS programs are subject to a set of legal and policy requirements, and USAID, PEPFAR, and implementing partner staff must be familiar with them. These requirements include:

Resource: The current standard provisions for HIV/AIDS activities are contained in Acquisition & Assistance Policy Directive (AAPD) 14-04.

  • Legalization of prostitution and sex trafficking
    • Use of Funds: No U.S. Government funds for HIV/AIDS activities may be used to promote or advocate the legalization or practice of prostitution or sex trafficking.
    • For certain non-U.S. organizations, the Policy Requirement: Organizations receiving U.S. Government funds for HIV/AIDS and AIDS activities must sign a statement in their award agreeing that their organization is opposed to the practices of prostitution and sex trafficking.

Resource: The current standard provisions for HIV/AIDS activities are contained in Acquisition & Assistance Policy Directive (AAPD) 14-04.

  • Conscience Clause: An organization, including a faith-based organization, that is otherwise eligible to receive funds for HIV/AIDS prevention, treatment, or care –
    1. Shall not be required, as a condition of receiving such assistance –
      (i) to endorse or utilize a multisectoral or comprehensive approach to combating HIV/AIDS; or
      (ii) to endorse, utilize, make a referral to, become integrated with, or otherwise participate in any program or activity to which the organization has a religious or moral objection; and
    2. Shall not be discriminated against in the solicitation or issuance of grants, contracts, or cooperative agreements for refusing to meet any requirement described in (1) above.

Resource: The current standard language for HIV/AIDS solicitations are contained in Acquisition & Assistance Policy Directive (AAPD) 14-04.

  • Voluntary medical male circumcision (VMMC) – Voluntarism, Informed Consent, and Reimbursement: All PEPFAR VMMC programs must ensure that VMMC services are carried out safely, under conditions of informed consent and without coercion.

Resource: PEPFAR's Best Practices for Voluntary Medical Male Circumcision Site Operations [PDF, 3.6MB]: See Chapter 12: Voluntarism and Informed Consent.

Resources for USAID and PEPFAR Staff and Implementing Partners

There are many resources available to USAID and PEPFAR staff and implementing partners to facilitate compliance with these requirements.

HIV/AIDS Compliance Resources

HIV/AIDS Legal and Policy Requirements eLearning Course (available in Arabic,English, French, Portuguese, and Spanish): The purpose of this course is to provide an overview of the legislative and policy requirements that govern HIV/AIDS activities. The primary audience for this course is people who manage and/or implement USAID-supported HIV/AIDS activities.

Acquisition & Assistance Policy Directive (AAPD) 14-04 [PDF, 338KB]: AAPD 14-04 provides information on the standard provisions for all awards that include HIV/AIDS activities. The AAPD implements a 2013 U.S. Supreme Court decision and makes explicit that the prostitution and sex trafficking policy requirement does not apply to U.S. nongovernmental organizations (NGOs) but does apply to non-U.S. NGOs and certain public international organizations (PIOs). Some of the other HIV/AIDS standard provisions were also updated.

Last updated: June 01, 2021

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