Bush’s faith based initiatives have sparked a debate over the four years of this administration as to whether it is ethically proper to combine church and state in development assistance. This combination has life and death implications for developing countries, specifically concerning African organizations that implement HIV/AIDS policies that deal with methods of birth control. This paper examines how PEPFAR (President’s Emergency Plan for AIDS Relief), a fast track disease program, is playing out in Ethiopia by examining the AIDS program of the Ethiopian Orthodox Church (EOC) which recently received US$5 million to implement abstinence and faith based education programs through USAID. Because the EOC has a strong history in the country, widespread linkages exist for the education by the clergy. Certain gaps, however, also exist between the clergy and community members, and these must be bridged if the full potential of the church is to be realized. Research I conducted in the country in 2004 offers a foundation in assessing these gaps: why they are occurring, how they can be eradicated to ensure the EOC does not promote stigma, why some individuals do not participate in HIV/AIDS education, which program activities are deemed most successful, and how community members view religion (abstinence and faithfulness) as a positive tool in reducing infection rates. Certain key themes appear from the community perspective: the problems of centralized control, the relationship between patriarchy in the church and in society, female inequality, and a lack of collaboration leading to clergy suspicions. Two difficulties that arise include stagnant views concerning female genital mutilation, and the dangerous rhetoric concerning wrath and punishment employed by many of the clergy that is potentially promoting stigma rather than eliminating it. These have important implications for how the initiatives are unfolding not only in Africa but also in the rest of the world.