The original PEPFAR law contains a provision that enables organizations receiving U.S. funding to pick and choose the prevention and treatment services they wish to provide. The new law takes this bad policy and makes it worse by extending this refusal to provide services—dubbed a "conscience clause"—to organizations that provide care and support to people living with HIV/AIDS, their families, and their communities.  So, for example, if a faith based organization did not want to provide care to someone of a different faith they could refuse—and still receive U.S. tax dollars. If they don’t like how a person became infected or are put off by the realities in a person’s life, they can again refuse services, under the protection of PEPFAR law.

Millions of dollars go to organizations to provide prevention services, even though they refuse to discuss the potential of male or female condoms or other contraceptives in preventing the spread of HIV. Stand-alone abstinence and partner reduction programs have outpaced other programs providing individuals with a full range of information needed to prevent sexual transmission of HIV, underscoring that this law stands in the way of effective use of resources.  This is neither fiscally nor morally responsible.

Enabling organizations that receive U.S. funds to choose among those groups and individuals to whom they are "morally" comfortable providing care, permits the denial of services to those whose behavior, identity, religion or other attributes may be deemed unacceptable.

During the nearly three decades of the HIV and AIDS epidemic, efforts to reduce and eliminate stigmatization of those infected and those at risk have been a critical factor in successful approaches to prevention. Yet, this provision actually codifies stigmatization and discrimination into law and allows the use of U.S. taxpayer funds to perpetuate such discrimination.