BY PAUL SCHINDLER | A letter from three Republican members of Congress to the Centers for Disease Control and Prevention (CDC) is prompting the second federal investigation in less than a year into the HIV prevention programs of the Stop AIDS Project of San Francisco.
The July 30 letter from members of the House Government Reform Subcommittee on Criminal Justice, Drug Policy and Human Resources, a copy of which Gay City News was unable to obtain as of press time, alleged that the agency was using federal dollars to “promote sexual activity,” according to an August 7 report in the Washington Times.
In response to the Congressional letter, CDC’s newly installed director, Julie Gerberding sent a letter to Darlene Weise, Stop AIDS executive director, stating that a team of CDC representatives would begin a two-day inquiry on August 12 “to assess whether these [AIDS Project] programs [funded by the CDC] are not only scientifically sound but also consistent with [federal program guidelines].”
Under Congressional pressure initiated by North Carolina Republican Jesse Helms, the CDC in 1992 adopted regulations that programs funded by the agency cannot include “education or information designed to promote or encourage, directly, homosexual or heterosexual sexual activity or intravenous substance abuse.”
Stop AIDS receives approximately $700,000 a year from the CDC out of a total budget of approximately $1.8 million.
Stop AIDS is unambiguous in denying the central thrust of the Congressional criticism.
“We don’t promote sex at all,” said Shana Krochmal, the group’s communications director. “We target our prevention efforts at gay and bi men who have chosen to be sexually active. We’re not here to discourage them from their choices.”
Though Helms undoubtedly hoped that he could stifle federal funding of any discussion of sexuality when he launched the push that led to the CDC’s 1992 regulation, the fact of the matter is that AIDS prevention has been able to co-exist with the rules for most of the past decade.
Ronald Johnson, the associate executive director of Gay Men’s Health Crisis, articulated the logic that has allowed for such coexistence, but also explained that some G.O.P critics of AIDS prevention hope to undermine that logic.
“When you’re trying to prevent sexually transmitted diseases, you have to talk about sex,” Johnson told Gay City News in response to questions about the new inquiry into Stop AIDS. “The congressmen seem to be making the assumption that when you are talking about sex, you are promoting sex. That’s a spurious correlation. That is what is disturbing.”
The fraying of a widespread, decade-long consensus on this issue first began to appear late last year.
The first signs that HIV prevention programs were coming under special scrutiny came when Indiana Republican Mark Souder, chair of the House Criminal Justice, Drug Policy and Human Resources Subcommittee, and Montana Democrat Max Baucus and Iowa Republican Charles Grassley, both of the Senate Finance Committee, began to raise questions about the financial management of CDC and other federal grantees.
Curiously, the politicians were alerted to their concerns by two gay men long identified as AIDS activists. Baucus and Grassley had read an April, 2001 Washington Monthly article by Wayne Turner of ACT UP/DC which alleged fraud by six recipients of federal Ryan White funds. Souder had been contacted by Michael Petrelis, an outspoken San Francisco activist harshly critical of mainstream AIDS organizations, scientists, and public health officials who he charges exaggerate the risks gay men currently face from HIV as part of an effort to stigmatize queer sexuality. (Late last year, Petrelis faced felony harassment charges stemming from activities he engaged in targeting San Francisco public health officials with whom he disagreed that were later dropped on a technicality, but which the local district attorney vowed to re-file.)
By the fall of 2001, Congressional questions went beyond matters of financial management into areas of HIV prevention program content. A November 8 letter from three G.O.P. members of Congress–– John Shadegg of Arizona, Joseph Pitts of Pennsylvania, and Chris Smith of New Jersey –– to Tommy Thompson, the Secretary of Health and Human Services (HHS), referred to “activities that are highly controversial in nature,” and billboards that were “sexually explicit.” As Duncan Osborne reported late last year in LGNY, Gay City News’ predecessor, all of the objectionable material cited in the congressmembers’ letter appeared to come from literature put out by the conservative Family Research Council.
In response to Congressional pressure from certain quarters, Janet Rehnquist, the HHS inspector general, launched investigations of several AIDS prevention programs. Her report on the Stop AIDS Project concluded that its ‘Great Sex’ workshop “appears to directly promote sexual activity” and that the ‘Booty Call’ workshop “appears to focus equally on, and possibly to promote, sexual activity.” Rehnquist also found that “sexually explicit workshop advertisements” might meet “the legal definition of obscene material.”
In the wake of Rehnquist’s report, the Contra Costa Times in California reported that officials at Stop AIDS and the San Francisco Department of Public Health pledged to make sure that their programs were in line with all federal guidelines. This week, Krochmal said that the group is in compliance with all federal laws and regulations and that Stop AIDS was not asked to make any specific changes in the wake of last year’s report.
In fact, Krochmal said that next week’s visit by the CDC was not all that unusual, that the two agencies frequently meet to go over programs, and that CDC is well-acquainted with Stop AIDS’ programs.
“The CDC has long been an ally and a supporter of the Stop AIDS Project,” she said. “And it’s not been unusual for the CDC to recommend our programs as models for other groups around the country.”
At the same time, Krochmal conceded that the scrutiny out of Washington during the past year has been unusual and argued that it was ideologically based.
“The vast majority of criticism comes down to politics, which is not unexpected,” she said. “We are a community organization doing work by and for gay and bi men in San Francisco. What it takes to catch the eye of a gay man in San Francisco might raise an eyebrow in Washington. We do what our community tells us to do.”
Krochmal argued that community input is key to the success of prevention efforts which must be tailored to specific populations.
“That’s the reason the CDC allows for local control, and that’s something that Republicans generally are for too,” she said. “In fact, it’s a CDC requirement that the control is local, because community standards vary greatly around the nation.”
Others in the prevention field share Krochmal’s concern about the political motivations behind the scrutiny of Stop AIDS.
In a telephone interview from last month’s International AIDS Conference in Barcelona, GMHC’s Johnson tied recent audits of Stop AIDS and the Helping Us program in Washington that targets African American gay and bisexual men to a trend among key Bush administration officials to champion abstinence-only HIV prevention efforts.
“There is a seeming intent to audit HIV prevention programs, and that’s of particular concern given the number of administration officials talking about an abstinence-only approach,” Johnson said. “There is an attempt to muzzle the kind of content that is very, very important to prevention efforts, specifically the sexually explicit content that targets men who have sex with men.”
Another AIDS prevention professional who has worked in the field since the earliest days of the epidemic also saw bigger picture political forces at work.
“This can’t be about whether there’s anyone in San Francisco who could remotely find [Stop AIDS’ programs] offensive,” the prevention professional told Gay City News on condition of anonymity.
That source also suggested that CDC was only acting under extreme pressure, both from Congressional Republicans and from the Bush administration HHS leadership, perhaps explaining how Krochmal’s upbeat assessment of Stop AIDS’ relationship with the CDC can be squared with the investigation just announced.
“This is clearly not something CDC would be doing on its own,” the source told Gay City News. “This is HHS’ way of slapping the shit out of CDC.”
The prevention professional also suggested why others in the HIV field, like Johnson, might be concerned––Stop AIDS has some of the best programs around and if they can be attacked, any group is vulnerable.
“Stop AIDS has one of the most talented prevention organizations there is,” according to this source. “Their programs are incredibly well-grounded in what the community wants, needs, and will do.”
But the Republican view from Washington is considerably different. Several weeks before the Congressmembers’ letter arrived at the CDC, Roland Foster, a key staff assistant to Criminal Justice, Drug Policy and Human Resources Subcommittee chair Souder and a leading behind the scenes figure in the unfolding controversy, wrote the following to a CDC staffer: “It has come to the subcommittee''s attention that the Stop AIDS Project is once again sponsoring the ‘Great Sex’ workshop. As you will recall, several months ago the Inspector General concluded that this program violated federal laws and regulations. Could you provide the subcommittee with evidence that Stop AIDS Project''s ‘Great Sex’ is now fully complying with federal laws?”
By the end of the month, Foster’s boss had initiated a formal inquiry to the CDC.
And although the congressmembers’ letter is not publicly available, the perspective of at least one subcommittee member was reflected in the Washington Times reporting.
“The CDC''s policies in San Francisco are a dismal failure,” said Rep. Dave Weldon, a Florida Republican, who said that as a physician he treated AIDS patients prior to going to Congress in 1986. “We''ve seen a doubling of new HIV infections [in San Francisco] over the past four years; new syphilis infections have grown from under 30 to over 400 per year, and the CDC says three-quarters of those infected with HIV don''t know it. And this in a city that gets twice the amount of AIDS money as any other community.”