A massive study has found no evidence that U.S. efforts to promote sexual abstinence and marriage fidelity abroad have had any impact on individuals’ sexual behavior. Publishing their findings in Health Affairs, researchers reviewed records from the Demographic and Health Surveys about nearly 500,000 men and women younger than 30. These individuals lived either in 14 countries in sub-Saharan Africa that received funds for abstinence and fidelity programs from the U.S. President’s Emergency Fund for AIDS Relief (PEPFAR) or in eight nations in the region that did not receive PEPFAR funds. The investigators examined data from 1998 through 2013.

PEPFAR, a signature international aid program of the George W. Bush administration, began in 2004. At the time, one third of prevention funds were required to go toward abstinence and “be faithful” endeavors. After Barack Obama assumed the presidency, the one-third requirement was eliminated. However, funding has continued to back these programs in recent years. In 2008, the last year of Bush’s presidency, $260 million in funds supported the initiatives; that figure declined to $45 million in 2013. The researchers found that, among the 345,000 women and the 132,000 men included in the study, there was no difference in the number of reported sexual partners among those living in countries receiving PEPFAR funding compared with those living in non-PEPFAR-sponsored nations.