The religious right’s pernicious influence in Africa isn’t limited to Uganda’s persecution of homosexuals; the Bush administration’s much-praised anti-AIDS program had a decidedly less altruistic side.

SIRAKANO, Uganda — At age 45, after giving birth to 13 children in her village of thatch roofs and bare feet, Beatrice Adongo made a discovery that startled her: birth control.

“I delivered all these children because I didn’t know there was another way,” said Adongo, who started on a free quarterly contraceptive injection last year. Surrounded by her weary-faced brood, her 21-month-old boy clutching at her faded blue dress, she added glumly: “I fear we are already too many in this family.”

On a continent where fewer than one in five married women use modern contraception, an explosion of unplanned pregnancies is threatening to bury Adongo’s family and a generation of Africans under a mountain of poverty. Promoting birth control in Africa faces a host of obstacles — patriarchal customs, religious taboos, ill-equipped public health systems — but experts also blame a powerful, more distant force: the U.S. government.

Under President George W. Bush , the United States withdrew from its decades-long role as a global leader in supporting family planning, driven by a conservative ideology that favored abstinence and shied away from providing contraceptive devices in developing countries, even to married women.

Bush’s mammoth global anti-AIDS initiative, the President’s Emergency Plan for AIDS Relief, poured billions of dollars into Africa but prohibited groups from spending any of it on family planning services or counseling programs, whose budgets flat-lined.

The restrictions flew in the face of research by international aid agencies, the U.N. World Health Organization and the U.S. government’s own experts, all of whom touted contraception as a crucial method of preventing births of babies being infected with HIV, the virus that causes AIDS.

The Bush program is widely hailed as a success, having supplied lifesaving anti-retroviral drugs to more than 2 million HIV patients worldwide.

However, researchers, Africa experts and veteran U.S. health officials now think that PEPFAR also contributed to Africa’s epidemic population growth by undermining efforts to help women in some of the world’s poorest countries exercise greater control over their fertility.

“It was a huge missed opportunity to integrate HIV/AIDS and reproductive health in ways that made sense,” said Jotham Musinguzi, a Ugandan physician who heads the Africa office of Partners in Population and Development, an intergovernmental group that promotes sexual health in developing countries.