HIV and AIDS Legal and Policy Requirements

photo of the U.S. Capitol steps

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

U.S. Agency for International Development (USAID) staff and implementing partners 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

In addition to requirements that apply specifically to HIV and AIDS and Family Planning-HIV (FP/HIV) integrated activities, U.S. President's Emergency Plan for AIDS Relief (PEPFAR) staff and partners should be familiar with the requirements that apply to all U.S. Government foreign assistance:

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

Resource: See Restrictions on Support for Abortion for more information.

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 and AIDS programs.

Resource: Guidance on the Definition and Use of the Global Health Programs (GHP) Account (see section III(6)(C)(b)(ii)) [PDF, 1.6MB]

Requirements Applicable to HIV and AIDS Activities

USAID HIV and AIDS programs are subject to certain requirements, and PEPFAR staff and partners should be familiar with the following:

  • Prostitution and sex trafficking
    • Use of Funds (Leadership Act Section 301(e)): No U.S. Government funds for HIV and 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 (Leadership Act Section 301(f)): Organizations receiving U.S. Government funds for HIV 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 and AIDS activities are contained in Acquisition & Assistance Policy Directive (AAPD) 14-04.

  • Conscience Clause (Leadership Act Section 301(d)): An organization, including a faith-based organization, that is otherwise eligible to receive funds for HIV and 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 and 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 provisions for HIV and AIDS activities are contained in Acquisition & Assistance Policy Directive (AAPD) 14-04.

  • Voluntary medical male circumcision (VMMC) – voluntarism and informed choice: All PEPFAR VMMC programs must ensure that VMMC services are carried out safely, with informed consent, and without coercion.

Resource: PEPFAR's Best Practices for Voluntary Medical Male Circumcision Site Operations [PDF, 3.6MB]: See "Section 14: Voluntarism, Informed Consent, and Reimbursement" for additional guidance.

Resources for USAID Staff and Partners

There are many resources available to USAID staff and partners to help them become familiar with and ensure compliance with these requirements.

HIV and 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 and AIDS activities. The primary audience for this course is people who manage and/or implement USAID-supported HIV and 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 and 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. non-governmental organizations (NGOs) but does apply to non-U.S. NGOs and certain public international organizations (PIOs). Some of the other HIV and AIDS standard provisions were also updated.

Special Consideration: Family Planning and HIV and AIDS (FP/HIV) Integration


Related Sectors of Work