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As the world marks 25 years since HIV and AIDS first appeared, a clash among high-profile evangelical leaders over an international relief foundation threatens to take center stage.

The dispute also lays bare a faultline among American evangelicals, who have been divided over the treatment and prevention of AIDS because of the disease's perceived connections to homosexuality and sexual promiscuity.

The clash, which centers on the Global Fund to Fight AIDS, Tuberculosis, and Malaria, may have long-term ramifications, both for those suffering with diseases and for the reputation of American evangelicals, activists said.

If the U.S. fails to extend help because of objections from conservative Christians, "we will look on this as a very mistaken time," said Tony Campolo, a prominent sociologist and Christian activist.

Since its founding in 2001, the Swiss-based Global Fund has spent $2 billion on programs that offer medical treatment and education in 130 countries, according to a spokesperson. The U.S. government has provided 30 percent of the public-private foundation's finances through 2005, and appropriated $445 million for 2006.

Some of the programs bankrolled through the Global Fund—such as those that distribute condoms to prostitutes or provide clean needles to drug addicts—have drawn fire from conservative evangelicals. Hardline conservatives favor President Bush's policy of abstinence and emphasis on fidelity in marriage. Others take a more pragmatic approach, and say that exporting Western morality to foreign countries is ineffective at best and calamitous at worst.

After the Senate passed a non-binding budget amendment last March to increase the U.S. contribution to the Global Fund to $866 million in 2007, Dobson ...

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