PEPFAR is governed by legislation which mandates funding for abstinence and fidelity programs, although PEPFAR's operational guidelines for organizations have been ambiguous at best. This apparently is changing. The Baltimore Sun reports that new internal guidelines at PEPFAR establish at 66% the minimum level of AIDS prevention funding that is to be used for abstinence and fidelity programs. This focus on abstinence and fidelity, and lessening of support for other prevention measures, has raised concern in the public health community. Duff Gillespie, former head of AIDS programs at USAID, comments:

It's outrageous and stupid. From a public health point of view, it's irresponsible.

PEPFAR has not yet posted the new guidelines.