I think it's the exact opposite. This is not a single policy advocated separately from the lifestyle changes advocated and expected to function well within the current cultures in Africa. It is part of a larger call to change the culture. But I suspect we're in agreement regarding the likelihood of that occurring.
I wonder if that is related to calls from the Catholic Church or if it is simply a division of efforts. For example, PEPFAR has a focus on treatment of pregnant mothers to prevent transmission of HIV to their children, efforts to safeguard the blood supply, etc. It seems like a medical approach. The USAID disease prevention seems more akin to a field sanitation or social work type of effort that can occur with significantly less (or different) specialized skills.
The taboo on advocating birth control might also be part of an image adjustment. Condoms as a birth control measure can fairly easily be construed as, "America doesn't want black people to have kids." It sounds dumb, but some people would believe it. Some people (in this country!) believe that we created HIV to kill black people. When I was an undergrad in 2002, taking an upper-level course in immunology, a student actually gave a presentation that assumed we were using HIV and various birth control drugs as weapons to kill or sterilize black people. Thankfully the professor had some words to say in response - the rest of us were speechless.
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