Under current federal funding guidelines, international HIV/AIDS programs have to adopt anti-prostitution policies if they want U.S. money. But the Supreme Court is about to put that mandate to the First Amendment test. Today the Roberts Court took up a case from 2011 that left the 2nd U.S. Circuit Court of Appeals in New York divided. The lower court ruled against the requirement 2-to-1, claiming that the mandate violates HIV/AIDS workers' free speech rights. The Obama administration wasn't happy with the ruling, and their appeal found a home today.

The mandate to oppose sex work grew out of the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003. The Bush administration ushered in the "anti-prostitution pledge," keeping any organization getting money through the President's emergency plan for Aids relief (PEPFAR) from engaging in any behavior that might be seen as endorsing sex trafficking or prostitution. Activists around the world have claimed this damages their ability to address the HIV/AIDS crisis, considering that sex workers. Last summer, The Guardian's Claire Provost reported on global protests against the pledge: 

Around 200 organisations and individuals have signed a petition demanding that the US government repeals the pledge. The petition says the pledge has led to "the reduction or complete elimination of HIV prevention and treatment services for sex workers in numerous countries". "The US is preventing the delivery of successful health programmes and important resources to sex workers worldwide," it says.

A Public Library of Science study from 2007 found that, "A substantial body of peer-reviewed published studies suggests that the empowerment, organization, and unionization of sex workers can be an effective HIV prevention strategy."