Petrelis Files

CDC TO EVALUATE HIV PREVENTION GROUPS


June, Gay Pride Month, is the perfect time of year for the Centers for Disease Control and Prevention to publicly commit to assessing its myriad HIV prevention programs, especially those targeting gay men.

Atlanta’s Southern Voice newspaper on June 20 ran a balanced story by reporter Christopher Seely about CDC’s recent letter to Rep. Mark Souder spelling out the agency’s development of “plans to periodically review all grantees to assess their effectiveness,” and continuing complaints the Congressman and I have raised about the Stop AIDS Project.

One quote in Seely’s excellent article, from Jimmy Loyce, the head of the San Francisco Department of Public Health’s AIDS Office, reveals how for many people who work in AIDS Inc, the issue foremost on their minds is increased funding.

Loyce, in response to my demands for proof of effectiveness from the Stop AIDS Project to actually halt new HIV infections and other sexually transmitted diseases, said: “Until the federal government – without reducing the dollars to prevention services – is willing to pay for long term studies to determine the impact of HIV incidence and prevalence as a result of our prevention strategies, it is an unfounded mandate for them to say we need to do some long term studies of our own.”

I must point out that the University of California at San Francisco’s Centers for AIDS Prevention Studies receives millions of federal dollars annually to design, implement and assess HIV prevention programs and messages. But even with millions in government grants, UCSF’s CAPS is unable to produce hard, verifiable evidence showing the effectiveness not only of the Stop AIDS Project, but also of the other HIV prevention efforts in CAPS’s own backyard.

In my opinion, it should be a relative snap for the SF DPH and CAPS to whip out tons of documentation proving the effectiveness of Geezer Balls, HIV bowling leagues, trips to the zoo, flirting classes, etc., but they can’t, so Loyce and his ilk try to divert attention from current HIV and STD epidemiologic reports showing increasing rates and instead call for additional dollars for more studies.

Why no one in the SF DPH AIDS Office or at UCSF CAPS has thought to prove the effectiveness of the Stop AIDS Project and similar groups illustrates how little thought they have given to determining the efficacy of HIV prevention programs.

There is nothing objectionable to Souder and I calling on the CDC and its grantees to prove their HIV prevention workshops and messages are working.

Gay men in San Francisco should have been asking the CDC a long time ago for honest, scientific evaluations of the Stop AIDS Project and all such groups that target us.

Here’s Seely’s article from Southern Voice.
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http://www.sovo.com/2003/6-20/news/national/

June 20, 2003
Southern Voice
Atlanta, GA


CDC threatens funding for Calif. AIDS program
Activist, congressman question effectiveness of Stop AIDS in San Francisco

By CHRISTOPHER SEELY



In an apparent about-face, the Centers for Disease Control & Prevention in Atlanta sent a letter June 13 to San Francisco’s Stop AIDS Project cautioning the group to comply with federal funding guidelines that do not permit recipients to promote sexual activity.

If the group does not comply, CDC will pull its funding, according to the letter.

The letter Stop AIDS received provided three specific examples of programs targeted at gay men that violated the federal Public Health Service Act, which does not allow funding to “be used to provide education or information designed to promote or encourage, directly, homosexual or heterosexual activity.”

Separate letters also went to the San Francisco Department of Public Health, which oversees activities at Stop AIDS, and to Rep. Mark Souder (R-Ind.), who since 2001 has funneled a steady stream of complaints filed by a gay AIDS activist about Stop AIDS through his office to the CDC.

“We are very pleased that the CDC will finally begin routinely assessing federal HIV prevention programs to ensure that they are effective in preventing HIV and STDs and comply with federal laws,” Roland Foster, an aide to Souder, said this week.

But the letter to Souder, signed by CDC Director Dr. Julie Gerberding, contradicts a letter she sent to him four months ago that supported the programs at Stop AIDS. The letter sent in February stated that Stop AIDS prevention techniques were “in compliance” with current guidelines.

Souder and Michael Petrelis, the controversial AIDS activist who alerted Souder to Stop AIDS’ programs, believe the effectiveness of current HIV prevention methods need to be assessed.

But Stop AIDS and the San Francisco Public Health Department contend that the CDC fell prey to pressure from a heightened conservative political environment that is taking aim at HIV and STD prevention organizations that frankly address gay sex.

“It is clear that this is not a political climate that supports an honest, open, and realistic discussion of sex, particularly sex between gay men, and it is having a chilling effect on the kind of research and grassroots organizing that is being done,” said Shana Krochmal, spokesperson for Stop AIDS.


Too sexy for the feds
The CDC letters cited workshops titled “In Our Prime: Men for Hire,” for older men to learn safety tips when dealing with escorts, “Bootylicious,” a discussion on ways to improve anal sex and be safe, and “Oral Sex = Safe Sex?” for men to acquire new information on oral sex.

“We don’t think we are promoting sex,” said Krochmal, spokesperson for Stop AIDS. “We are providing a forum for men who have already chosen to be sexually active.”

But the CDC did not object to the content of the workshops, just the way Stop AIDS marketed the programs with titles that promote sexual activity, said Kathy Harben, CDC spokesperson.

“We’re not saying it can’t be discussed at all, but it can’t be designed to promote sexual activity,” Harben said.
Harben declined to go into specifics about how the titles appeared to violate the law.

Souder’s office did not comment directly on the three controversial programs, instead saying that Stop AIDS has not proven its effectiveness because HIV infection rates are increasising despite the increased amount of funding for HIV prevention.

The San Francisco Department of Public Health stands by Stop AIDS’ marketing strategies and claims the sexy titles encourage participation from a younger generation being infected with HIV at higher rates.

The CDC should not consider the racy programs when applying federal law because none of the three workshops in question are funded with CDC money, according to Krochmal and Jimmy Loyce, deputy director of health for AIDS programs in San Francisco’s public health department.

City and state funds pay for the three programs that cost about $1,500, Loyce said.

The CDC grants an estimated $600,000 both directly and through the city to Stop AIDS for HIV prevention every year, Krochmal said.


Politics at play?
The current funding threat to Stop AIDS follows an investigation launched last summer to evaluate the scientific merit of Stop AIDS, and a 2001 report by the U.S. Department of Health & Human Services that said Stop AIDS’ programs could be construed to encourage sexual activity and to be “obscene.”

Gerberding launched the investigation last year partly in response to complaints received about Stop AIDS’ HIV educational sessions, she wrote in a letter to Stop AIDS then.

At the time, Petrelis, who lives in San Francisco and is HIV-positive, had been lodging complaints about Stop AIDS for years with HHS, CDC, and the U.S. House of Representatives’ Subcommittee On Criminal Justice, Drug Policy & Human Resources. Souder chairs the subcommittee, according to Foster, his spokesperson.

Souder, named by critics as a leader in the conservative movement against Stop AIDS, followed procedure and began forwarding Petrelis’ complaints to HHS and CDC when Petrelis grabbed Souder’s attention in 2001, according to Foster.

The investigation last year, though, found Stop AIDS to be compliant with federal guidelines and the programs “based on current accepted behavioral science theories in the area of health promotion,” Gerberding wrote in a Feb. 13 letter to Souder.

But Stop AIDS contends officials at the CDC buckled under political pressure and compromised scientific integrity because of the repeated requests by Souder’s office to demand further proof of the group’s effectiveness even after Gerberding’s initial analysis.

“The science in question is being subjected to a number of political tests,” Krochmal said. “We don’t want to be in a position to choose between federal funding and being true to the community and what they need out of an HIV prevention agency.”

CDC remains committed to ensuring the efficacy and compliance of federally funded HIV programs, but politics do come into play when making decisions, Harben said.

“It’s a fact that elected officials are also an audience of ours,” she said. “We consider their concerns as we consider other concerns brought to our attention, but the CDC remains committed to science.”


Effective measure?
The day Souder received his letter from Gerberding was a landmark in the history of HIV prevention because it shows the federal government questioning the effectiveness of HIV prevention organizations, according to Petrelis, an activist known for his frequent criticisms of AIDS organizations.

“It’s year 22 of the AIDS epidemic and the CDC is finally developing plans to measure effectiveness,” he said.

The most recent letter to Souder assured him that the CDC is “developing plans to periodically review all grantees to assess their effectiveness.”

Petrelis looks at the steps being taken by CDC as a way to hold AIDS groups accountable for the funds they receive, and not as a threat.

“I don’t believe asking the CDC for proof of effectiveness with these groups should be in any way detrimental to them,” he said. “Gay men should be asking the CDC for proof since so many of their programs affect us.”

The federal government, not Stop AIDS, is responsible for providing the in-depth analysis that Souder and Petrelis demand, Loyce said.

“Until the federal government — without reducing the dollars to prevention services — is willing to pay for long term studies to determine the impact of HIV incidence and prevalence as a result of our prevention strategies, it is an unfunded mandate for them to say we need to do some long term studies of our own,” he said.


‘Whisper campaign’
Federal grants to research HIV prevention efforts might be hindered by a recent government “whisper campaign” to weed out grant proposals that use “key words” identified by scientists in the New York Times in April, according to Dr. Kenneth Haller, president of the Gay & Lesbian Medical Association.

The New York Times article reported that several researchers who would not reveal their names received instructions from officials with the CDC and the National Institutes of Health to avoid “key words” on grant applications that include “men who sleep with men” and “anal sex.”

“There is no paper trail, no e-mails or directives from government agencies,” Haller said. “It is purely a whisper campaign, which makes it much more dangerous.”

HHS denies the allegations made by the scientists.

“There is no such effort,” said Bill Pierce, spokesperson for the federal agency.