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The local debate on abstinence-only education is international in flavour. On one end is a non-directive comprehensive approach that provides information on all effective methods of HIV prevention, including consistent and correct condom use. Such programmes are guided by the human rights to information and health. The abstinence model, on the other hand, is anchored by a model of morality. Premarital abstinence and post-marital fidelity are its sole life-saving strategies. Local bodies like the FPA, RapPort and YMCA, as well as international ones like UNAIDS, UNFPA and the WHO, endorse the comprehensive approach. The abstinence model gets a nod from US President George W Bush.

Bush proposes to increase the US domestic budget for abstinence education to US$270 million next year. The scheme is also being vigorously vended to developing countries that accept American aid and its conditions. Bush's involvement with the abstinence movement dates from his governor years in Texas. Texas, incidentally, has the United States' third highest teen birth rate. Louisiana comes in seventh. Both states' rates are above the country's incredibly high (by wealthy western standards) national average of 53 births per 1,000 teenagers.

"President Bush's faith-based initiative is alive and well in Louisiana," said Dan Richey, coordinator of the Louisiana Governor's Programme on Abstinence (GPA). Our Abstinence Committee has drawn heavily from the six-year-old GPA. Because this programme and others like it are so young, there has been little conclusive research about their effectiveness. But here is one statistic on which everyone agrees: the US Census reports that there has been a 50 per cent surge in the number of married teens during the 1990s. Many attribute the increase to abstinence-until-marriage programmes. The US Centre for Law and Social Policy (CLASP) advises that teen marriages are more unstable than those among older adults and that teen mothers who marry are less likely to continue their education.

In 2004, the Union of Concerned Scientists released "Scientific Integrity in Policymaking", a report in which it claims the Bush administration distorts science for political expediency. The report accuses the administration of planting its sympathisers on scientific advisory committees, of censoring and repressing reports that conflict with its political goals, and of failing to seek independent scientific advice. Notably, Bush's friend and abstinence advocate, Dr Joe McIlhaney, has been appointed to government advisory panels. This despite (or, perhaps, because of) the fact that in 1995 the obstetrician and gynaecologist was reprimanded by the Texas Department of Health "for spreading false information about STDs and condoms' ineffectiveness".

One debate is of critical political and medical significance. How did Uganda accomplish a reduction from 30 to ten per cent in its HIV prevalence rate during the 1990s? One side insists that Uganda's success was due to abstinence and behaviour change, not condoms. Uganda's First Lady, Janet Museveni, corroborates. She says the country targeted condom messages to adults with high-risk lifestyles only.

"There is no 'safe sex' outside of the situation of faithfulness to a partner," she has said. Studies from conservative think tanks like the Heritage Foundation conclude that condoms played a secondary role in Uganda and that the country's policy in favour of abstinence and fidelity won out. Ironically, this is disproved by the Uganda AIDS Commission's draft policy on abstinence and being faithful.

"The ABC strategy has played a major role in prevention of HIV in Uganda. However, in recent years the AB strategies have not been fully developed... Of all three approaches, condom use has received more organised, strategic and results-oriented efforts and resources," the report reads. So why the fudging about the role of condoms in Uganda's experience? The answer is Bush.

In 2001, the Ugandan Government launched a US-funded programme to expand HIV prevention education to all the country's primary and secondary schools. And this year, the US government budgeted about US$8 million on Uganda's abstinence-only programmes. The National Youth Forum, a body headed by Museveni, has also received money under the plan. A Human Rights Watch report, "The Less They Know the Better: Abstinence-only HIV/AIDS Programmes in Uganda", comes to a scathing conclusion: "Ultimately it is not just Ugandans who will pay the price for the country's back-steps in HIV prevention."

Brazil is determined not to take the fall. Last month, the Latin American country's government rejected US$40 million in US aid for its AIDS programmes. The country opted to maintain autonomy over its HIV policy, resisting US pressure to "focus on promoting abstinence and fidelity rather than condoms". Brazil's bold anti-AIDS policies include the promotion of safe sex among high-risk and vulnerable groups, including prostitutes and adolescents.

Many of Brazil's liberal strategies resemble those of Sweden, one of the few countries that boasts long-standing and wildly successful STI-prevention and sex education strategies. Sweden couples early and comprehensive sex education with widespread access to contraception and other sexual health services. The result is a teen pregnancy rate of seven per 1,000 teens and a 40 per cent decline in the rates of STDs during the 1990s.

In a 2004 speech at the UN General Assembly, Mona Sahlin, the Swedish Minister for Democracy, Integration and Gender Equality Issues, explained the Swedes' starting point.

"Discussions about sexuality and sexual relations are sensitive and it means that we place the most private in the public eye. We, especially the states, must take our responsibility to speak openly about these issues." Sahlin stressed that "abstinence-only programmes exclude necessary information needed when the person in question at some point chooses to have sex".