Thursday, November 30, 2006

WPost Fails to Reveal Reporter Met w/Iraq Study Group

[Sent today via email.]

Deborah Howell
The Washington Post

Dear Ms. Howell:

The front-page of today's Post has an article, written by Thomas E. Ricks and Robin Wright, on the Iraq Study Group and how it is wrapping up months of interviews and deliberations, as it prepares to deliver recommendations to the President and the American public.

This is what the Post reported on who the panel has spoken with:

"Forty experts from fields such as warfare, the Middle East, reconstruction and Islamic militancy were asked to put together options for the group but did not take part in the policy debates."

If you look at the Iraq Study Group's nine-page paper listing all of the experts they consulted, you will see on page 9 that Ricks was among the chosen few to give advice to the group.

Unfortunately, the fact Ricks consulted with members of the group was not disclosed by the Post today and I believe in the interest of full media transparency, it should have been mentioned.

Do you think the Post had an ethical responsibility to inform readers that one of the writers of today's article has consulted with the group he was writing about?

A prompt reply would be appreciated.

Sincerely yours,
Michael Petrelis


On the one hand, I must apologize to Thomas Ricks and the Post for not being aware that the paper had indeed disclosed his appearance before the study group.

But on the other hand, the disclosure ran in the Post on November 12, appended to a piece I had not read.

So maybe the Post owes me an apology for not again disclosing Ricks' talk with the Baker-Hamilton panel?

Actually, what responsibility does the Post owe all readers on this journalistic transparency matter? Is it enough they told readers about Ricks' talk to the panel, in just one of his pieces on the study group, its inner workings and eventual recommendations? Should the Post be required to inform readers of this link Ricks has to the panel, every time he writes about it?

Frankly, I think the paper must disclose the link every time, as suggested by the ombudsman Deborah Howell. The burden to know about Ricks' link should not be on me, as the reader, to somehow know when reading a Nov 30 story that he disclosed the link in a Nov 12 article. The onus should be on the Post.

After all, Ricks himself, in his suggestion to me that I change my headline, that the problem is the Post's failure to repeat the disclosure.

And let's not overlook the other journalists who have spoken with the panel, such as Tom Friedman of the NY Times, George Will of the Post, George Packer of the New Yorker, Mark Danner of the NY Review of Books and William Kristol of the Weakly Standard. (Check out my previous post on them and click here.)

As far as I know, none of them have disclosed how and why they advised the Baker-Hamilton commission. If they have, and I've missed the disclosures they've made, make me aware of where and when the disclosure took place and I'll again update this post.

Finally, even though this episode started with me thinking the Post hadn't disclosed, they actually had, only I didn't know it, and now that I do, I must applaud the Post for setting a fine media example of how to make such a disclosure. May we soon have Friedman, NY Times, et al, doing the same as Ricks and the Post.

Here the reply I received from the paper's ombudsman:

Mr. Petrelis, On Nov. 12, the last time Ricks was involved in a story on
the Iraq Study Group, the paper put this tagline at the end of the story::

"Ricks, the author of "Fiasco," a book on the Bush administration's policy in Iraq, appeared before the study group at its members' request to answer questions about his book."

Perhaps it needs to be done every time.

Deborah Howell
Washington Post Ombudsman

And this came from Thomas Ricks:

Actually, my appearance before the Iraq Study Group was disclosed in the Washington Post in a tagline at the end of a story on Nov. 12:

"Ricks, the author of "Fiasco," a book on the Bush administration's policy in Iraq, appeared before the study group at its members' request to answer questions about his book."

So maybe you could fix your headline to more accurately state that:

WPost Fails to Repeat Its Note That Reporter Met w/Iraq Study Group


AP: Taxpayers Paying for Cheney's Idaho Visit; Where's the Veep?

The last update on the White House's web page for the Vice President was more than a week ago, November 22,when Dick Cheney's office announced he would visit his pals in Saudi Arabia.

Since then, not a peep out of the Veep, at least in terms of any official statements from him, according to his web page.

So is Cheney still in the Middle East, back in the USA or traveling somewhere else in his official capacity as Veep? If Google and Yahoo news searches are any indication, no one knows where he is these days. Perhaps on another hunting trip?

Even though Cheney's not been in the public eye lately, he still generates news. Have a glance at excerpts from an AP wire story today on yet another broken promise to taxpayers from GOP leaders, related to Cheney and his political travels:

COEUR D'ALENE — Local taxpayers will pay $3,500 for Vice President Dick Cheney's Nov. 2 visit to this northern Idaho city to campaign for Republican candidates, despite GOP promises taxpayers wouldn't get the bill.

Officials with the city, as well as Kootenai County, say they will not ask the Republican Party of Idaho to reimburse them for expenses generated by the event, which was not open to the public. [...]

"Not to simplify it, but we weren't doing it for the Republicans," Watson told The Spokesman-Review. "We were doing it because we were asked by the Secret Service."

State GOP Executive Director Jayson Ronk said the vice president's visit wouldn't cost Idaho taxpayers a penny. Now Ronk is declining to comment and instead referred questions about the costs to the White House. "That's just our policy," he said. [...]

"I would think that the Republican Party can come up with $3,500 dollars to pay for a campaign visit by the vice president," Democratic Party spokesman Chuck Oxley told The Associated Press on Wednesday. "If they don't, it just shows the extent of their arrogance, which we've come to expect." [...]

According to public records obtained by the newspaper, sheriff's department employees worked about 60 hours of overtime for the visit, at a cost of $2,014. That doesn't include the regular pay of 26 employees who spent time at the airport where Cheney spoke.

The Coeur d'Alene Police Department reported it spent $1,506 on the visit and would not seek reimbursement. "For $1,500 to have a vice president in this city, I don't think they would find that a huge expense," police spokeswoman Sgt. Christie Wood said.

Wednesday, November 29, 2006

SF DPH Releases HIV Serosorting Slides Showing ...

Earlier this month a representative from the SF health department made a presentation on serosorting at a forum hosted by the Stop AIDS Project, in which he basically approved the practice of HIV poz guys having sex only with other poz men, as an effective means of preventing the virus from being spread to an HIV negative man.

The DPH expert used thirteen slides in his presentation, and after I filed a Sunshine Act request for them, the department shared the slides with me. All of them are posted here, in the hope they will add to the community-wide discussion about serosorting. Neither the health department nor the Stop AIDS Project post the slides on their site, and I'm not sure why they think gay and HIV activists shouldn't have easy access to the slides.

For me, the most important slide to consider is number 7, which shows new HIV infections between 1996 and 2003 of people getting tested at clinics, where the bulk of SF's HIV tests are administered, and the peak happened in 1999. The rate since then has pretty much continued on a downward trend and it is very likely due to serosorting.

Slide 7 also shows a red line representing new syphilis infections starting to climb in 1999 and reaching skyward. What's not footnoted by DPH is the fact that in 1999 the CDC launched a national syphilis elimination effort, one that significantly drove up the number of syphilis tests performed and also enhanced surveillance.

I must further note that even though SF health officials and AIDS groups were citing the surging syphilis rate and equating it with a supposed jump in HIV infections, that clearly was not the case.

Another fascinating aspect to the data in slide 7 is that the HIV incidence flattening/dropping in recent years occurred even though those same SF HIV experts were sounding alarm after alarm about barebacking, an outbreak of adult male shigellosis, bug chasing, the emergence of Lymphogranuloma venereum (LGV), gift giving parties, the spread of a nasty multi-drug resistant staph infection, an explosion of meth use, a rise in male rectal gonorrhea (due to increased testing and surveillance), the climbing syphilis numbers, and a few other scary things I'm forgetting at the moment.

One thing the DPH presenter did not address in his talk is how the heck HIV in SF could stabilize and fall, at a time when the health department saw a new burgeoning gay male sexual health crisis around every corner.

One last point, serosorting, which many HIV control expert agree is curbing new infections, has not been developed, endorsed or actively promoted by HIV prevention groups, the CDC and local health departments. Kind of says something; that if HIV poz gays are left alone to create safer ways of loving, without the interference of the prevention groups and their hostile social marketing campaigns, HIV pozzies do just fine, thank you very much, at reducing HIV rates.

Here are the slides from DPH:

No. 1

No. 2

No. 3

No. 4

No. 5

No. 6

No. 7

(See my comments above on this slide.)

No. 8

No. 9

No. 10

No. 11

No. 12

No. 13

VA Sen.-elect Webb "Tempted to Slug" Bush Over Iraq

Dear Mr. Webb, I'm no psychic, but something tells me you're channeling the wishes and deepest desires of millions of people, not just in the USA, but around the planet.

From the November 29 edition of The Hill, emphasis added:

President Bush has pledged to work with the new Democratic majorities in Congress, but he has already gotten off on the wrong foot with Jim Webb, whose surprise victory over Sen. George Allen (R-Va.) tipped the Senate to the Democrats.

Webb, a decorated former Marine officer, hammered Allen and Bush over the unpopular war in Iraq while wearing his son’s old combat boots on the campaign trail. It seems the president may have some lingering resentment.

At a private reception held at the White House with newly elected lawmakers shortly after the election, Bush asked Webb how his son, a Marine lance corporal serving in Iraq, was doing.

Webb responded that he really wanted to see his son brought back home, said a person who heard about the exchange from Webb.

“I didn’t ask you that, I asked how he’s doing,” Bush retorted, according to the source.

Webb confessed that he was so angered by this that he was tempted to slug the commander-in-chief, reported the source, but of course didn’t. It’s safe to say, however, that Bush and Webb won’t be taking any overseas trips together anytime soon. [...]

Monday, November 27, 2006

Trying to Follow Hillary Clinton's Iowa & NH Money

I'm the kind of activist who thinks there are many batches of political tea leaves to read when looking at the 2008 presidential race, such as FEC filings, funds raised, pundit chatter about setting up exploratory committees, opinion polls, blog accounts of which advisors have signed on with a given candidate and stories in the mainstream press, from the "it's a horse-race" perspective.

One batch of tea leaves not yet thoroughly gone over, at least online, are the Iowa and New Hampshire secretary of state's campaign financial disclosure records for their state's respective political parties, statewide advocacy groups and candidates for state offices.

This is because both of these crucial states on the 2008 primary calendar have lousy web sites, compared to other states' sites with voluminous and easy-to-search data, according to an analysis and rankings by the helpful folks at the Campaign Disclosure Project site.

Check out this incredible portal to follow the political money at the state level, and learn if your state is in modern web age with records online and searchable, or if your state ranks at caveman level. All is clearly explained by the disclosure project leaders.

I wanted to see if Hillary Rodham Clinton or any of her campaign and political associates and close advisors gave money this year to any candidates, or otherwise spread some dough, say, at a county dinner, in Iowa, home of the nation's first presidential caucuses, so I visited the Iowa page on the disclosure project's site as my first step.

Excerpts from their analysis:

Grade: D

Iowa has shown significant improvement this year, raising its overall grade from an F to a D, and its overall rank from 38th to 31st, with most of the gains coming in the Online Contextual and Technical Usability category.

Iowa’s disclosure law can be described as average, and requires candidates to report detailed information about almost all contributions received and expenditures made. [...]

Though the state’s grade and rank for Disclosure Content Accessibility has not changed since 2004, there has been one small measurable improvement in this area, which is that the agency reduced the price of paper copies of campaign finance reports. Otherwise, there have been few changes in data accessibility and the main deficiency is still a lack of any searchable—or even sortable—data, even though approximately one-third of the candidates are filing electronically. [...]

What a disappointment it was to read this, then link over to Iowa's lame campaign disclosure site, with an incredible dearth of public records. Never mind looking for a Hillary donation, or by any other individual for that matter, because no such basic campaign finance transparency is provided by Iowa. To compound the problem of not having easy access to the Hawkeye State's donations records, New Hampshire campaign finance transparency is even worse.

Take a look at the New Hampshire analysis and ranking from the disclosure project:

Grade: F

New Hampshire’s rank in the study dropped for the second year in a row and its disclosure program is still among the bottom ten in the nation, with poor performance in the areas of electronic filing, data accessibility, and web site usability.

New Hampshire performs best in the area of the law, and it received a B- in the Campaign Disclosure Law category. Candidates are required to report details about contributors giving $25 or more, including occupation and employer for those contributing more than $100. [...] The Secretary of State’s office previously stated it offered candidates the option of filing electronically, but clarified in 2005 that what it actually offers is downloadable forms that candidates must print, complete and return via traditional filing methods (i.e. mail or in-person delivery).

Access to campaign filings in New Hampshire is poor, as reflected in the state’s F for Disclosure Content Accessibility. [...]

Speaking of the Granite State, that nickname is totally appropriate and related to my earlier contention that states not making simple campaign finance records available on the net live in a prehistoric stone age time.

Should be a no-brainer, as 2007 approaches, that America can follow the Iowa and New Hampshire political money, and how it influences the 2008 race for the White House, in my opinion. But that just won't happen for this presidential election.

Sydney Herald: Gay HIV Infections = Sub-Saharan Rates

The November 26 edition of the Sydney Morning Herald used this scary headline, HIV infection rate rises to epidemic levels in gay community, for its alarming story on new stats released in anticipation of local AIDS groups marking 25 years of the HIV epidemic. Here's some of what the paper reported:

Last year in NSW, 954 people were diagnosed with HIV and nearly three-quarters of them caught the disease through homosexual contact. [...] "For gay men, HIV is a massive epidemic," Dr Prestage said. "If you are a gay man living in central Sydney, you are living with rates of HIV that are equivalent to sub-Saharan Africa."

In my web searches to verify that 954 HIV figure for New South Wales, I came across and read the Australian Bureau of Statistics' latest annual report, and the section on communicable diseases, provides these figures for recent annual new HIV infections for the entire country:

1996 / 900
1997 / 821
1998 / 753
1999 / 714
2000 / 755
2001 / 765
2002 / 848
2003 / 861
2004 / 886

I don't know how just New South Wales can be reporting 954 new HIV infections when the stats bureau is claiming a far lower number of new infection for all of Australia.

The report also contains important caveats about the HIV stats:
"Not adjusted for multiple reporting [...] The number of HIV/AIDS diagnoses for each year may be revised over time due to late reports, updated information on exposure and testing history for reported cases, and removal of previously unrecognised duplicate diagnoses."

In other words, some of the HIV diagnoses may initially be counted two or more times, but later reduced due to better surveillance by health officials.

Furthermore, the HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report for 2005, makes the following claim, on page 17:

Following a long-term decline, the annual number of new HIV infections in Australia has gradually increased over the past five years, from 656 in 2000 to around 930 in 2005.

Now for the HIV infections for New South Wales, as reported in the 2005 NSW Department of Health's annual report, page 146:

1996 / 447
1997 / 421
1998 / 402
1999 / 373
2000 / 352
2001 / 338
2002 / 389
2003 / 415
2004 / 404

Clearly, HIV is rising slightly in NSW, and across Australia, but I'm not sure the 954 stat for only NSW claimed by the Sydney Morning Herald, is accurate.

As many AIDS activists in San Francisco and across the USA know, we've had our HIV experts in the past make claims of sub-Saharan rates of new HIV infections, only to have the officials backtrack on the claim, not to mention data showing HIV in San Francisco was not surging upward.

This was the original scary allegation, as printed in the June 30, 2000, San Francisco Chronicle:

``We are very concerned, and we are very worried,'' said San Francisco Department of Public Health epidemiologist Dr. Willi McFarland. ``These are sub-Saharan African levels of transmission.''

And this Bay Area Reporter story from July 9, 2000, shows the backtracking:

"The 900 number is not an official DPH number. The comparison to sub-Saharan Africa is unfortunate," Dr. Willi McFarland, an epidemiologist with DPH told the Bay Area Reporter, referring to a quote he gave to the Chronicle: "These are sub-Saharan African levels of transmission."

Six years later, McFarland gave the following quote the science journal Nature, which I blogged about last month:

"Many of us in the field have suspected that the standard methods of estimation have resulted in overestimates," says Willi McFarland, director of HIV/AIDS Statistics and Epidemiology for the San Francisco Department of Public Health.

Whenever an HIV/AIDS expert invokes sub-Saharan rates of new HIV infections among gay men, deep skepticism, and lots of verifiable HIV stats, are needed as we debate such an alarming claim.

Saturday, November 25, 2006

AP: Kolbe's Travel Tab; Barney #2 Traveler in Congress; Tammy Travels w/Spouse

Gay Democratic Representative Barney Frank is the PoliticalMoneyLine's number two in rankings of top Congressional travelers' whose tabs were picked up, in whole or part, by private non-government groups. With 71 trips under his belt, I guess congratulations are due to the gentleman from Newton who's been on the road quite a bit since 2000, according to Barney's travel records, as analyzed and made available by the PoliticalMoneyLine site.

Looking over Barney's itineraries, it's clear when he travels, it's for causes of importance to him. He's spoken to statewide gay groups fighting restrictive ballot initiatives, a Jewish AIDS nonprofit, unions, advocates for immigrants rights, and he attended the late lesbian leader and therapist Betty Berzon's memorial service. Barney's travels primarily are for liberal social issues and on behalf of organizations working for tolerance and social diversity.

How does Barney's traveling stack up against his GOP counterpart, Jim Kolbe? Just between us gay guys, Barney puts Kolbe to shame, by my liberal political standards, in terms of giving back and being there for your community and diverse constituencies, judging by their respective travel files. I can't find anything gay-specific in Kolbe's file, and I'd be hard pressed to say he's spent much time on the road talking to grassroots groups or advocacy organizations working for tolerance.

Okay, it's probably unfair to compare a liberal gay Democrat's travel records with those of a moderate gay Republican, because, after all, one would expect their travels to reflect their political leanings. But it's still interesting to examine such files, if only from a transparency in government perspective, right?.

Falling somewhere between the two gay congressman is Democratic Rep. Tammy Baldwin, and her travel documents show she's spoken before a few gay groups, like Barney Frank, and attended a forum sponsored by the Aspen Institute, just like Jim Kolbe has. Plus, Baldwin lists her partner, Laura Azar, as her spouse on her disclosure forms.

Kolbe made one trip connected to AIDS when he went to Geneva to interview for a job with the Global Fund for AIDS. Click here for Kolbe's travel info.

And as he ends his congressional tenure, Kolbe faces scrutiny from the mainstream media over his travels. The Associated Press ran this story on the wires Wednesday, when many gays were traveling or shopping. It needs some extra attention:

WASHINGTON -- Arizona Rep. Jim Kolbe may be retiring at the end of the year, but that hasn't kept him from racking up free trips abroad.

Kolbe, a Tucson Republican who announced his retirement plans a year ago, reported visiting Turkey, Italy, Poland, England, Canada, Spain and Belgium since June _ all on the dime of private groups including the Aspen Institute and the German Marshall Fund.

Kolbe took more privately paid trips in 2006 than anyone else in Arizona's congressional delegation, according to a list compiled by the independent Web site, which tracks political spending.

The value of the trips totaled almost $40,000. Most were for three to five days to participate in international summits such as the Bellagio Conference on Migration in Bellagio, Italy, in July.

One, to Geneva, was to a job interview with the Global Fund to Fight AIDS, Tuberculosis and Malaria. [...]

But Kolbe took the trips after his committee approved the foreign operations bill on May 25, which is one of his key responsibilities. His first privately paid trip of the year was to Istanbul, Turkey, between May 29 and June 4. [...]

Kolbe's travel stands out in a year in which many lawmakers cut back on their privately funded trips in the wake of scandals involving congressional travel. [...]

But Kolbe took far more trips than others in the Arizona delegation. The 22-year veteran of the House ranks 39th in number of trips on PoliticalMoneyLine's list of lawmakers' privately funded travel, which covers 2000 to the present. In another ranking, only two other members of Congress took more government-paid trips between 1994 and 2006, according to the group. [...]

Other than merely getting mentioned in the press as a gay GOP representative, I don't think Kolbe did anything of much substance for us gays while he served in the House. Maybe we should just wish him luck in finding a new cushy position and be glad he's gone from the House. Even though I've certainly had my differences and spats with the gentleman from Massachusetts, I'll take a Barney Frank over a Jim Kolbe any day of the week.

(Kolbe measuring his accomplishments on behalf of gay and lesbian people while in the House?)

Gay Group Inflates SF AIDS Deaths to Raise Cash

Many, if not all, AIDS activists, science reporters and policymakers accept the San Francisco health department's quarterly AIDS surveillance reports and the death stats contained therein as the most accurate numbers of people who have died of AIDS.

Here are a few annual death figures to consider, from the September 30, 2006, AIDS report, page 8, column 4:

2002 / 319
2003 / 298
2004 / 231
2005 / 242
2006 / 138 (Jan - Sept only)

But those DPH death stats, which have thankfully really declined since their height in the early 1990s when the city saw more than 2,000 die annually from AIDS, apparently aren't good enough for the gay men at the community-based Stop AIDS Project organization. Nice to see that at least for the past 2-3 years, deaths have NOT been more than the number claimed by the project.

In an effort to do was is their top priority these days, raise cash, the Stop AIDS Project's web site's opening page features an enormous dark-blue three-hundred figure and this claim:
"More than 300 San Franciscans die of AIDS-related illness every year."

And as the group has so often done in the past when manipulating HIV/AIDS numbers to either sow alarm or raise money, Stop AIDS Project officials offer no source for their 300 deaths allegation. Click on the 300 figure and you'll be whisked away to a page where you can donate money to the project.

If it's not too much trouble, this group should tell the community, and the epi experts at DPH, where they're getting their 300 stat from.

I'm sure there will be some "AIDS alarm queens" who dismiss my objections to this group exploiting, and inflating, the demise of our brothers and sisters because they believe fear and terror are good public health and HIV prevention tools. And you can be sure such alarm queens work in AIDS Inc and they need to justify their careers and salaries, most crucially at this holiday time of the year.

If a homophobic, desperate rightwing group were artificially increasing AIDS deaths in San Francisco, the better to get donations, and in effect killing more people with AIDS than are actually, and sadly, dying these days, there would be an uproar.

But because the Stop AIDS Project is viewed as part of the gay community and based in the Castro neighborhood, it is not held accountable for its shameless exploitation and deception of death figures. The project, which can't be bothered to acknowledge and praise gay men for significantly reducing and controlling new HIV infections in the past decade, in using the bogus 300-deaths stat is showing us their "death wish" for people with AIDS. Leaders of the project likely long for the bad old days when thousands of new infections and deaths were occurring annually, because it would help their fundraising efforts.

Maybe bringing some attention to their holiday "death wish" plea for money will persuade community leaders and the San Francisco media to question the Stop AIDS Project on where they get their unique stats from.

Thursday, November 23, 2006

(An un-elected nanny for public health, Jeffrey Klausner, MD)

SF DPH Wrong: NIH Conference and Study Show No HIV, Gays & Viagra Link

Among the more nutty ideas proposed by San Francisco's STD control chief Dr. Jeffrey Klausner was a proposal in 2002 to force the maker of Viagra to add a stronger warning on the drug's warning label about a possible link between HIV and other STDs and use of the erectile dysfunction medication. Citing his own study of people seeking HIV/STD testing at his own city-run STD clinic, Klausner, as is his media-whoring custom, generated lots of news, including a story in the Los Angeles Times, in March 2002:

[Dr. Klausner is] making an unusual appeal to federal regulators to warn consumers that use of the sexual impotence drug Viagra is linked to gonorrhea transmission.
"The data's clear, the evidence is strong," said Dr. Jeffrey Klausner, director of sexually transmitted disease control for the city, who has conducted a study on the issue. "There's really at this point no excuse for inaction by the FDA or the manufacturer."

But Food and Drug Administration spokeswoman Laura Bradbard said Thursday that her agency wants to wait for more studies before deciding if changes to Viagra's warning label are necessary. Klausner is not suggesting that Viagra causes gonorrhea. Rather, he contends that Viagra leads to risky sexual behavior, which is associated with higher rates of STD transmission. [...]

He said young gay and bisexual men often use Viagra recreationally, along with ecstasy and other illegal drugs, lessening their resolve to use condoms. In fact, Viagra's manufacturer, Pfizer Inc., has warned doctors about the danger of mixing amyl nitrate (a street drug known as "poppers") with Viagra, which can cause a sharp drop in blood pressure. [...]

[Pfizer spokesman] Cook said the company is satisfied that Viagra's consumer label adequately addresses the issue of STD transmission. It reads: "Viagra does not protect you or your partner from getting sexually transmitted diseases, including HIV--the virus that causes AIDS." [...]

Klausner said the label doesn't address his concerns. [...]

A few points need to be made here. First, some Klausner critics scoffed at his study because it only looked at just one population -- clients at his STD clinic. Critics said he designed the study to support his hypothesis of a link between HIV/STD transmission and Viagra, with a population very likely to show at least a casual connection of infections and the ED drug. Kind of like studying people at cocktail bars and finding some of them have liver conditions.

Second, Viagra's warning label, which, like all such labels, is about 24 -28 inches long, double-sided and printed in 8 point type, already included an explicit messages about the drug and HIV.

Third, many men, in the throes of lust and love, do not stop and take an hour or so to read such labels in their entirety.

Why was Klausner going all-out in his crusade? Was it just to cast himself in the media limelight, again, as the lone, brave STD control chief doing everything in his power to prevent new infections? I can't answer those questions, and Klausner never addressed the issue of how many men were likely to all of sudden read a newer warning label, when they didn't previously, and that the warning would aid in halting new STDs.

A few months later, in July 2002, Klausner published his study and results Journal of AIDS. These were some of the highlights:

The potential role of sildenafil (Viagra) in the risk of HIV and sexually transmitted disease (STD) transmission was evaluated among gay or bisexual men seeking public STD services in San Francisco. Viagra users reported greater numbers of recent sex partners, higher levels of unprotected anal sex with an HIV-positive partner, and higher rates of prevalent STD than non-users. [...]

Despite these limitations, our data highlight a significant relationship between Viagra use and sexual risk behaviors, drug use, and new STD among a sample of gay or bisexual men in San Francisco. These findings are consistent with other studies of STD, HIV, and drug-related risk behaviors among gay men using Viagra [2,4], and provide compelling information on the potential role that Viagra may play in the transmission of new HIV infections and STD among gay or bisexual men in San Francisco [5]. [...]

Getting nowhere with his study and alarmist claims, in terms of persuading Pfizer to change its warning label more to his satisfaction, Klausner in July 2004 sent an eleven-page petition to the FDA, asking the federal government to force Pfizer to do what he wanted. He also demanded Viagra be reclassified as a Schedule III controlled substance, and under such a classification, anyone caught with the drug without a prescription, could be charged by prosecutors and be given up to five years in jail and slapped with a fine of $250,000. Click here to read Klausner's lengthy submission.

Then in November 2005, Matthew S. Bajko of the Bay Area Reporter wrote an excellent story about a serious setback in Klausner's campaign:

Fifteen months after requesting federal officials increase the penalties for illegal use of erectile dysfunction drugs, a San Francisco health official is changing course and withdrawing his controversial proposal. But he still is sounding alarms about how the drugs are marketed and labeled because of the role they play in the transmission of HIV and other sexually transmitted diseases. [...]

The move met with fierce opposition from the companies as well as gay health advocates and other medical professionals, who argued changing the classification would make it harder for those who legitimately needed the drugs to obtain them. San Francisco AIDS czar Jeff Sheehy went even further, calling Klausner's petition "AIDSphobic and homophobic," and in August of this year asked the city's Human Rights Commission to investigate the matter.

At a national conference in September to discuss the health concerns surrounding PDE-5 inhibitors, the class of drugs to which erectile dysfunction medications belong, Klausner's proposal once again met with opposition. One cardiologist warned if the FDA placed the drugs under Schedule III it would only increase the black market sale of the medications. Others argued that the move was unneeded because the drugs are already illegal to use without a prescription. [...]

However, Klausner said he has no regrets about filing the petition because data continues to show a connection between new HIV infections and use of Viagra.

And just to show what a "public health nanny" he really is, with national concerns, whether anyone wants him to serves in that role or not, the BAR noted Klausner had other kvetches to make about Viagra:

Klausner also continues to criticize how the makers of the drugs market their products, especially television commercials and the use of professional athletes as spokespeople for the drugs, such as the Viagra-sponsored NASCAR team.

So in November 2005 Nanny Klausner is still claiming data continues to show demonstrated a connected between HIV transmissions and Viagra, and the entire matter fades into the background, seemingly over, right? No, this issue still had another act to play out.

Earlier this week, findings from a National Institutes of Health-sponsored conference, with many analyses, medical journal citations and sexual health surveys and studies, found no link between HIV transmissions and use of Viagra. From the news release put out by Blackwell Publishing Ltd., publisher of the Journal of Sexual Medicine:

A comprehensive, multi-disciplinary conference funded by the National Institutes of Health sought to determine whether the drug class of PDE-5 inhibitors was contributing to an overall increase in HIV infection. The results of this conference appear in the latest issue of The Journal of Sexual Medicine. [Click here for the full article.]

Convincing evidence was not found to support the conclusion that PDE-5 inhibitor use is a risk factor for HIV infection. For the large majority of men, PDE-5 inhibitor use is conducted in a stable, committed partner relationship. Under such circumstances, the risk of HIV infection is relatively small. Clinicians and educators did emphasize, however, the importance of safe sex practices for those engaging in risky sexual relations. [...]

Irwin Goldstein, Editor-in-Chief of The Journal of Sexual Medicine , noted that this paper is especially important to the field. "Health care providers should be reminded that individuals infected with HIV frequently have ED from their disease or from pharmacologic agents commonly used in its treatment. Positive clinical benefits have been reported in the HIV population when using PDE-5 inhibitor drugs as indicated."

Well, don't tell Klausner there's a reported positive effect for HIV positive men, if they use ED drugs! It might alter his sex panic ways of thinking. And don't expect him to offer any apology for his years-long crusade, in which he needlessly and shamelessly demonized gay men in general and gay men living with HIV/AIDS. He's an unelected STD nanny who rarely acknowledges a mistake and continues in his busybody role at San Francisco health department.

(Hat tip: Bob R.)

Wednesday, November 22, 2006

Anti-Pork Group: Pelosi Must Answer $1.5M HIV Earmark Questions

I didn't realize there were time limits on attending the questioning earmarks party, but I am finally there! ;-)

Seriously, I am grateful to Mr. Allison and his Sunlight Foundation web site for adding his voice to the small, but growing, chorus of government transparency and AIDS activists asking for some answers from Madame Speaker-elect Pelosi about a $1.5 million HIV/AIDS earmark for the San Francisco health department.

From the Sunlight Foundation:

Still Exposing Earmarks
Written by Bill Allison on November 21, 2006

Michael Petrelis may be a little late to the exposing earmarks party that we at Sunlight were part of last summer, but he asks exactly the kinds of thoughtful questions that any constituent, as part of his citizen oversight duties, should get answered from a representative in Congress. Petrelis is asking them of Rep. Nancy Pelosi, the soon-to-be House Speaker--it will be interesting to see how quickly, and thoroughly, she responds.

Tuesday, November 21, 2006

Questions for Pelosi on $1.5 Million HIV/AIDS Earmark for San Francisco DPH

[This letter has been emailed and snail mailed today.]

The Honorable Nancy Pelosi
Speaker-elect of the U.S. House of Representatives
Washington, DC

Dear Congresswoman Pelosi:

I am a person with AIDS, a government transparency advocate and one of your constituents, and as such write to you today about a $1.5 million HIV/AIDS demonstration project to improve federally-funded treatment and prevention programs administered by the San Francisco Department of Public Health, which was covered recently by the SF Examiner.

As you know, House Report 109-515, which accompanies H.R. 5647, on page 144, explains the $1.5 million earmark for fiscal year 2007 in the Labor/HHS/Education appropriations bill.

After speaking with several other people with AIDS, who may be the targets of the demonstration and share my concerns, several questions have come up and we hope you and your staff can address them.

1. Is this HIV/AIDS demonstration project an earmark that you placed in the appropriations bill?

2. Where can I find a copy of the proposal for the project, or does your office have a the proposal and can you simply forward it to me?

3. Which federal agencies are the overseers of the project and who are the personnel at those agencies responsible for carrying out this project?

4. Who at the San Francisco health department is the point-person for the project?

5. What are the specific, achievable goals of the project and how can people with AIDS be involved in the design, implementation and evaluation of it?

6. What is the duration of the project and will it began before the end of 2006?

7. Considering that San Francisco already receives a substantial pot of federal HIV money, why does the city need this additional $1.5 million, especially since we are blessed with falling new HIV infections?

8. Can you provide me with any of the documents that the health department provided to your staff that demonstrated the need for this new funding?

Even if you are not responsible for this $1.5 million earmark, I'm sure you will agree that these important questions need answers, and quickly too, to better insure all federal funds allocated to San Francisco for improving services of every kind targeting PWAs are used wisely.

In the name of fiscal transparency at the federal level, let's crack the whip!

A prompt reply is requested and appreciated.

Best regards,
Michael Petrelis

Sunday, November 19, 2006

SF Chron, AmFAR Gala: AIDS is a Cabaret!

Almost as if to counter the CDC's well-funded social marketing campaigns of recent years lecturing gays that HIV is no picnic and not fabulous, the Sunday "Style" section of the San Francisco Chronicle today features a simply marvelous report on Liza Minnelli's glamorous appearance at a recent AmFAR fundraiser, darlings.

The Chron's gushing story was standard fare in terms of covering yet another "celebs and moneyed people use HIV to get their names and photos in the paper, while the needs of actual people with AIDS go unmet" event. Not one PWA is in the piece and the incredible good news about San Francisco's HIV infection rate, on the decline for many years according to epi data from the DPH, is ignored.

Instead, a close to washed-up gay icon, who knows all about being the beard for closeted white men on the down low, tries to scare the glitzy gathering with frightening numbers:

"I worry people aren't maintaining vigilance in preventing this disease," Minnelli said, dashing off the latest stats for women and children in the poorest countries, who are contracting AIDS at an alarming rate.

In no way do I wish to minimize the very real problem faced by at-risk women and girls in developing nations, but would it be so un-fab of Liza and AmFAR to cite the stunning drop in new HIV infections in this hard-hit city?

And I'm also not suggesting we don't need beautiful people with money pitching in to fight and cure AIDS, but speaking for myself and my circle of friends, we're more than saturated, and fed up, with patronizing and exploitive social marketing campaigns constantly telling us there's something we doing wrong over HIV, while AIDS organizations trot out celebs in designer clothes to raise money for people with HIV, many of whom struggle to live on limited budgets in SRO hotels mere blocks from the AmFAR shindig.

One day, I'd like to see the images from the AmFAR party mingled with the CDC-funded ads exploiting PWAs, just for the sake of balance and to give the public a more-rounded picture of all aspects related to AIDS. I guess that day is today.

From the Chron today:

Life is a cabaret: At the amfAR Fall Dinner, Denise Hale finally got the chance to introduce her "two children." [...]

The Ritz-Carlton was rockin' as a record crowd gathered for a gala and auction, raising $430K. [...]

As dazzling and passionate about AIDS activism? Liza with a "z," who gamely sang for her supper (created by Delfina chef-owner Craig Stoll).

Shimmering in a sparkling pink minidress, gesturing in that familiar way, Minnelli kicked off her set with "Cabaret."

She also, devilishly, kicked off her shoes and made a sly joke: "These shoes are killing me. This and another ex-husband!"

The crowd roared with laughter, appreciating the songbird as fighter who has well learned to channel adversity into positive action. [...]

"I worry people aren't maintaining vigilance in preventing this disease," Minnelli said, dashing off the latest stats for women and children in the poorest countries, who are contracting AIDS at an alarming rate.

"This disease isn't over yet," Minnelli said, her deep brown eyes big as saucers as she jutted out her slightly quivering chin in defiance. "This battle is not won. So we keep on fighting."

(Photo credits: Top image by Drew Altizer; special to the Chron. All other images from CDC-funded ads.)

Thursday, November 16, 2006

SF Chron Reporter Gave $200 to Abortion Ballot Initiative Fight

The San Francisco Chronicle in August 2004 had to reassign its letters editor after it was discovered he had donated money to Sen. John Kerry's presidential campaign, and a article for PBS's Online News Hour site noted the following:

The newspaper has a policy prohibiting journalists from giving money to campaigns without first consulting top editors.

If that is indeed the paper's policy, then it may be safe to assume the editor's approved Chronicle business writer Ilana Debare's $200 donation on October 3 to the No on 85 state ballot initiative, which would have required parental notification before young women could have abortions and which was defeated by the voters. Records at the California Secretary of State's campaign finance disclosure site reveal that Debare listed the SF Chronicle as her employer.

Perhaps the Chronicle's top editors allowed Debare to make the donation because as a business reporter, she does not cover reproductive rights.

Debare's $200 gift was not the only donation by a Chronicle employee in a state race this year. The chief financial officer for the paper, Elizabeth Cain, contributed $250 on May 8 to Democratic Sen. Jackie Speier's unsuccessful effort to win the Lt. Governor's office, according to state campaign disclosure files.

Like many newspapers, I imagine the Chronicle has separate ethics policies for the business and editorial sides of the paper, making it probably okay for executives to donate, but not journalists.

What other San Francisco reporter made a contribution to a politician this election season? According to FEC files, Al Hart of KCBS News Radio, gave $500 on March 7 to Democratic US Rep. Ellen Tauscher to help her retain her seat in Congress.

It just doesn't seem like a real election cycle unless San Francisco journalists make monetary donations to their favorite candidates and against ballot initiatives.

Wednesday, November 15, 2006

(Source: National Institutes of Health)

Transcript: CDC HIV Boss, Surgeon General, Catholics, World AIDS Day and Gays

To be honest, I'm not sure what to make of the recent conference call transcript from the National Catholic AIDS Network, the fact that the US Deputy Surgeon General Dr. Kenneth Moritsugu and the CDC's openly gay chief for HIV prevention, Dr. Kevin Fenton, participated in the early part of the call before getting off and allowing the Catholics to debate amongst themselves over World AIDS Day activities, HIV prevention and testing, and the church's response to helping people with AIDS or at risk of contracting HIV.

Neither Moritsugu nor Fenton broached the subject of gay men and AIDS, even though gays comprise the largest transmission category of people with AIDS, on the November 1 call. (Link to the full transcript is at the end of this post.)

Moritsugu had this say though about the church:

Well, you know, I’d like to begin first by saying that we really need to applaud the Catholic Church for the really outstanding job that it does on a daily basis to help so many including those affected by HIV/AIDS.

And I'm also grateful that today everyone on the call is taking time to participate to learn from one another, to challenge yourselves on how you might augment your parish’s response to HIV/AIDS.

Too bad the Catholic Church Moritsugu applauds opposes equal rights for gays, condom distribution and truthful messages about sex and averting HIV transmission.

Would have been nice, not mention honest, of the openly gay Fenton to say something, ANYTHING, about his gay brothers grappling with HIV issues. He could have cited the CDC's own current HIV prevention brochure which highlights gay men thrice.

From the CDC:

- Among African Americans, young gay men and young heterosexual women are hardest hit.

- Prevention efforts are aggressively targeting a wider range of communities than ever before, including gay men of color, African-American and Hispanic women, white gay men, injection-drug users, and adolescents as they come of age.

- Peer outreach for gay men.

After Moritsugu and Fenton left the conference call, a concern tangentially related to gay men was raised and address by Catholic AIDS officials:

Sergio Farfan: Yes. My name is Sergio Farfan I’m from New Orleans, Louisiana Latino Health Coalition. I have three - what it was saying is the (unintelligible) is there’s a big stigma because a lot of the population (in this context) are thinking that HIV is a white gay man disease and we had to work hard to change that mentality on the people. Also I have a question that is talking about prevention. What is the Catholic Church’s stand regarding the use of condoms?

Dan Lunney, church official: The Catholic’s position on the use of condoms is because the Catholic teaching is that sex outside of marriage or actually sex in marriage is the teaching, that any advocacy or any programs that encourage sex outside of marriage would be against teaching.

And so the church - and then the other part is that looking at the teaching on birth control, that the church teaches again that in marriage and in all sexual activity there needs to be an openness to life that the church does not support the use of condoms.

It should be pointed out that yes, gay white men have been heavily impacted by HIV/AIDS, but it is not a gay disease or a black or Hispanic or Asian or female disease, and that this information should be shared by the man from the New Orleans Latino group who raised the question. And I don't know what to suggest about the church's murderous policies on condoms and sex outside of marriage, which does not recognize gays can't get married, so of course we're having sex outside of that woeful institution.

Excerpted comments made by the federal health officials:

Dr. Moritgusu:

On behalf of the US Department of Health and Human Services, I’d like to welcome all of you to today’s important call. [...]

We’re committed to improving health literacy which means that we try to provide information in such a way that the people we serve will hear, will understand, and will embrace our messages and that they will be able to act on that information and make choices that will best protect and improve their health. [...]

Well, you know, I’d like to begin first by saying that we really need to applaud the Catholic Church for the really outstanding job that it does on a daily basis to help so many including those affected by HIV/AIDS.

And I'm also grateful that today everyone on the call is taking time to participate to learn from one another, to challenge yourselves on how you might augment your parish’s response to HIV/AIDS.

It really is an opportunity because from the faith-community standpoint, the faith community oftentimes sees individuals, perhaps once a week, compared to the number of times that people see their health provider, which might be perhaps once a month or even less frequently. [...]

First, I want you to think about what you as individuals can do, you as parishes can do to challenge other faith and service organizations to join in the battle against HIV/AIDS. Because the government can’t win this battle alone, the Catholic Church can’t win this battle alone, and yet every single one of us collectively can have a major impact on how HIV affects our communities. [...]

The second is that I want you to listen with intent on today’s call. Intent to learn and to put what you learn into action for those whom you serve and for the people with whom you worship.

The third request is that I hope you will share with all of us on the call your best practices. If you have an HIV prevention or testing, or treatment program in your parish that you feel is working, tell us about it.

You’re going to hear from your colleagues who will share their best practices with you later on in the call. I give your fellow travelers in the faith an opportunity to learn from you. [...]

And fourth, I’d like each of you to think about how HIV affects your own life and the lives of those you serve. Because we are most committed to the fight when we can feel empathy for the struggles that our families, that our friends, that our neighbors face.

And finally, I’d like to request that every Catholic parish in this country educates its parishioners about HIV and to encourage your members to get an HIV test. [...]

Help us to do this. Educate those in your parish about HIV. Encourage them to be tested even if they think they may not be at risk. And share with your colleagues
what you have learned on today’s call. We’re here to work together with you and I want to thank you in advance for what you all are doing to help improve the health of our nation.

And these were some of Dr. Fenton's remarks:

I may also say as I begin that I'm so delighted to have this opportunity to collaborate with and to work with colleagues in the Catholic Church and I am entirely looking forward to very good things arising from this collaboration and indeed collaborations in the future.

I am the Director of CDC’s National Center for HIV, STD, and TB prevention. And in that role, I oversee CDC’s prevention program that aim to reduce burden of HIV, other sexually transmitted diseases, and tuberculosis in the United States. There also plans to add prevention of viral hepatitis to our center’s mission. [...]

Nearly half of those 1 million people in the United States living with HIV are African-Americans, about a third are White and about 17% are Hispanic and about a quarter of those living with HIV are in fact women. [...]

Yes, it is. And I really want to (unintelligible). It’s certainly is still a devastating problem in the Unites States. And the disease has been actually devastating for communities of color. African-Americans bear a greatly disproportionate burden of the HIV and AIDS epidemic in the United States. More than half of the new HIV diagnoses and 33 states in the US between 2001 and 2004 were among African-Americans, although Blacks represent just about 13-1/2% of the populations in these states. [...]

We believe that routine HIV testing will help to ensure that more people learn whether they’re infected with HIV, allowing them to benefit from earlier access treatment and to reduce the risk of infecting their partners. [...]

People diagnosed early in their infection lives longer and healthier life. And by making HIV testing a routine part of their care, we believe that stigma surrounding HIV testing will decrease. So if providers tests all their patients and no one is singled out and a negative test will not imply that you’re in high risk, just that you were tested. [...]

(Tyrone): Good afternoon. Particularly for Dr. Fenton, you mentioned prevention and that being a part of your role and also the term best practices was mentioned, how would you advise church leaders? How would you advise parents and educators about some of the best practices in terms of effective prevention?

Kevin Fenton: Thank you very much for that question. There are a number of ways in which you would be able to get information on best practices or what I prefer to call promising practices, because that perhaps much more reflective of the states of evidence that we have available today.

One very good source is looking at Web sites such as the CDC’s HIV Web site which is on And information on key prevention activities, best practices, and promising practices on prevention are available through that Web site.

But at the local level, local health departments, your local HIV department, will also have information and resources on effective intervention and effective tools that can be used to educate to provide awareness to encourage HIV testing among parishioners. And partnerships with local health departments are going to be very key at the local level to really enhance your HIV prevention efforts. [...]

(Janet): I would like to know at what age do you recommend that the youth be - that people be tested for HIV/AIDS? In my church which is predominantly African-American Catholic, we’re trying to get a program for our youth and I want to know if it would be appropriate when we address how we use the recommend testing for them?

Kevin Fenton: (Janet), thank you. That’s an excellent question and it’s one that we often get from parishioners and colleagues working with youths across the country. CDC has recently issued new recommendations on HIV-testing in healthcare settings. And we now recommend that all patients between the ages 13 to 64 years be tested for HIV. And the reason why we’re encouraging that age group is two reasons -- two fold.

Firstly, there’s an increasing data from behavioral surveys which suggest that a significant proportion of young people are sexually active at earlier ages.

Secondly, it is important that HIV testing and the process of HIV testing is socialized and seen as part of general and good healthcare among Americans and therefore getting into the habits of going in for your health checks, having an HIV test, talking about issues with your physician, can be part of a socialization process for young people.

And therefore encouraging HIV testing and awareness at that early age, we believe is a good thing.

You read this entire transcript at the National Catholic AIDS Network's web site. Click here.

Tuesday, November 14, 2006

Audit: "Widespread Deficiencies" in CDC HIV Prevention Grants

In September 2005, as America grappled with the devastation of New Orleans brought on by Hurricane Katrina and the incompetence of the Bush administration, the Department of Health and Human Services released an audit titled "Management of HIV/AIDS Prevention Grants by the Centers for Disease Control and Prevention."

This important fiscal audit escaped the AIDS community's attention, and even though the audit came out more than a year ago, attention still must be paid to the findings.

Everyone concerned about AIDS and preventing new HIV infections should be concerned that the audit found very lax oversight on the CDC's part in managing millions and millions of taxpayer dollars. You can read the full HHS audit by clicking here.

More than a year later, I think it's time to ask CDC director Dr. Julie Gerberding what has been done since the audit was released to provide much-needed additional oversight to its HIV/AIDS prevention grants.

Here are selected findings of keen interest to me:

From the executive summary --

During fiscal years (FYs) 1999 through 2003, the period of our audit, the Centers for Disease Control and Prevention (CDC) used more than $2.6 billion of HIV/AIDS prevention funds to award grants for State and local health departments and community-based nonprofit organizations to carry out surveillance, testing, counseling, research, conferences, outcome evaluations, and other related activities. These grants serve as important tools in carrying out CDC's mission of preventing and controlling HIV and AIDS. [...]

The objective of our audit was to determine whether CDC complied with applicable laws, regulations, and departmental policies in managing its HIV/AIDS prevention grants.

During FYs 1999 through 2003, CDC management of HIV/AIDS prevention grants did not always comply with applicable laws, regulations, and departmental policies. We reviewed PGO (Procurement and Grants Office) and Center records related to 15 grants and identified widespread deficiencies throughout the preaward, award, and postaward phases of CDC's grants management operations. For example:

- Preaward Phase: Grant files contained no evidence that CDC staff had performed required cost analyses of applications from any of the 15 grantees to ensure that proposed costs were allowable and reasonable for the work to be performed.

- Award Phase: Awards for 14 of the 15 grants lacked clear, specific objectives providing a basis for assessing grantees' accomplishments, and, in fact, 2 of those 14 grants contained no objectives at all.

- Postaward Phase: CDC awarded continuation grants to 13 organizations even though they had reported few or no accomplishments or had failed to submit required accomplishment reports. [...]

Given the extent and the significance of the deficiencies that we identified with respect to the 15 grants, we concluded that CDC could not be assured that its grants management operations provided appropriate direction and oversight for the activities of grantees under the HIV/AIDS prevention program. [...]

Introduction to the audit --

Our audit covered the period October 1, 1998, through September 30, 2003. Because most HIV/AIDS prevention grants are awarded on a 5-year incremental basis, this audit period allowed us to assess CDC's grants management program throughout the entire grant cycle. [...]

We used a judgmental process to select 15 grants to begin our review of PGO and Center files. We selected the 15 grants by type of grantee, in an attempt to ensure an appropriate mix of State and local health departments and community-based nonprofit organizations, and by the geographic location of the grantee, in an attempt to eliminate any potential variances. [...]

- CDC Did Not Perform Required Cost Analyses of Grant Applications: Grant files contained no evidence that CDC personnel had performed required cost analyses of applications for either new or continuation awards to any of the 15 grantees. Instead, most of CDC's documented "cost analyses" were simple restatements of the proposed budgets with a signature. [...]

CDC's files for the 15 grants in our review showed no evidence of the analysis required above. In fact, records titled as cost analyses on four grants contained, without any explanation, approval for unallowable indirect costs proposed as direct costs.

- CDC Did Not Always Analyze Available Data on Potential Grantees: Grant files contained little or no evidence that CDC staff had reviewed audit reports on organizations applying for HIV/AIDS prevention grants, as required under GPD 3.06, or queried departmental databases to identify auditors' findings and opinions from audits performed in accordance with Office of Management and Budget (OMB) circular A-133.

Files for 11 of the 15 grants did not contain an audit report for any of the five years in our audit period, or any evidence that the reports had been obtained, and none of the files contained audit reports for every year. Further, 14 of the 15 grant files had no evidence that CDC personnel had queried databases that catalogued previous grant awards to identify grantees that had been debarred or placed on special restrictions because of significant operational problems. The 15th file indicated that CDC staff checked the database for 1 of 5 years but contained no evidence that they analyzed the data.

If CDC personnel had reviewed A-133 audit reports found at the Federal Audit Clearinghouse, they would have noted that 8 of the 15 grantees were in weak financial positions or had significant management and/or operating deficiencies. [...]

- CDC Did Not Always Ensure That Grants Were Based on Specific Objectives: Award documents for 14 of the 15 grants in our sample lacked clear, specific objectives that CDC could use as a basis to assess grantees' accomplishments, [as required by law]. In fact, CDC original award documents for 2 of the 14 grants contained no objectives at all because the award documents had not incorporated either CDC's program announcement or the grantees' application for funds.

The objective of one grant, for example, was to evaluate the effectiveness of other grants and to "provide evaluation resources" to assist other grantees in measuring their own effectiveness. However, the grantee could not develop an evaluation protocol acceptable to CDC during the 3-year grant period and was unable to perform an intended study, even though it expended all funds. A grantee official stated that the organizations never understood what CDC wanted it to do. [...]

- CDC Did Not Consistently Require Progress Reports: Two of the 15 grant award documents did not include requirements and deadlines for submission of progress reports that CDC could use to evaluate the grantees' actual progress in meeting the projects' goals and objectives, [as required by law]. [...]

- CDC Awarded Continuation Grants Even Though Grantee Had Not Reported Significant Accomplishments: CDC awarded continuation grants to all of the 13 organizations with multiyear projects even though the grantees had reported little in the way of actual accomplishments or had failed to report their accomplishments on a timely basis. Although [the law], and departmental policies all require agencies to evaluate grantees' accomplishments, CDC's grant files contained no evidence that CDC personnel took any action when grantees submitted reports showing few or no accomplishments or when they submitted reports late or not at all.

- CDC Did Not Require Correction of Grantee Deficiencies: The grant files showed that technical reviewers had noted significant deficiencies in 10 of the 13 organizations applying for continuation grants, but CDC did not require corrective action. The files contained no evidence that CDC personnel asked 5 of the 10 grantees to provide additional information in response to the noted deficiencies. Further, although grant files contained no evidence of any response from four of the five organizations that had been requested to provide additional information, CDC took no additional action.

Iran Hangs Gay Man in Public; S.F. Plans Reaction

As I post this, I am in the process of contacting friends and politicians about an emergency response, possibly a candlelight vigil and speak out, here in San Francisco. If I have anything to say about this latest gay hanging in Iran, I will all I can to make sure silence is not the response from US citizens opposed to the death penalty, regardless of sexual oriention. I'll let you know how and when San Francisco will react to this hanging of a gay man in Iran.

From the Iran Focus news site:

14 Nov 06

Iran hangs gay man in public

Tehran, Iran, Nov. 14 - A gay Iranian man was hanged in public on Tuesday in the western city of Kermanshah on the charge of sodomy.

Shahab Darvishi was charged with organising a "corruption ring", deliberate assault, and "lavat", which means homosexual relationship between two men or sodomy, the official news agency IRNA reported.

Darvishi was hanged in the evening in Kermanshah's "Freedom Square" in front of hundreds of people, the report said.

Under Iran's Islamic Penal Code, homosexuality between consenting adults is a capital crime and official Iranian sources express hostility to homosexual practices. A state radio commentary on March 7, 2005 criticised gay marriages in Western countries.

Ayatollah Ebrahim Amini, an influential cleric, said in his Friday-prayer sermon in Qom that gay and lesbian marriages reflect a weakness of Western culture, state television reported on July 13, 2002. Ayatollah Ali Meshkini in his Friday-prayer sermon in Qom criticised the German Green Party for being pro-homosexual, state television reported on April 29, 2000.

Sunday, November 12, 2006

3Q SF DPH AIDS Stat: Lowest Cases in 8 Years - 100 in '06

(3rd Quarter AIDS Cases, SF, 1999 - 2006)

You know the drill by now, don't you? New HIV or AIDS or STD stats come out from the San Francisco health department, showing continued declines of infections and full-blown cases, and DPH and local AIDS groups develop laryngitis. I blog on the latest figures, bringing some activist attention to them, and the city that has seen so much loss from AIDS over a quarter century, yawns mightily.

The SF DPH's new quarterly AIDS surveillance report was issued last week, and few are talking about it, and no media are reporting on it. The latest third quarter full-blown AIDS caseload fell again this year, to 100, and in the context of eight year's worth of third quarter AIDS reports on the web, the 2006 data is the lowest reported third quarter number in eight years.

That's almost a full decade of AIDS dropping. And this laudable development comes when there is a decline in new HIV infections, not to mention the rise in male rectal gonorrhea that is happening, not because of more rubber-less gay sex, it is due to an enormous jump in number of more tests for the butt-infection.

Doesn't anybody care that the damn good news about the epidemic proudly marches on?

When, and if, the AIDS epidemic in San Francisco ever ends, I believe historians will look back at all the available epi data and see the beginning of the end in the surveillance reports.

Let's go to the figures:

SF DPHD Quarterly AIDS Surveillance Reports
3rd Quarter Data, by Year
Table 5, Page 5

1999 / 324

2000 / 316

2001 / 302

2002 / 224

2003 / 188

2004 / 190

2005 / 181

2006 / 100

This excerpt comes from the Executive Summary of our latest epi data summary, that should be read by member of Congress, before he or she votes on any HIV/AIDS funding bill:

Latest HIV/AIDS Epi Report from SF DPH
August 2006

The current HIV/AIDS epidemic is characterized by no apparent increases in HIV infection rates over the past five years, and with considerable decreases in some populations. A number of factors may account for these trends.

And this passage is taken from the minutes of a recent health commission meeting:

SF Health Commission
September 25, 2006

An analysis of rectal gonorrhea trends in San Francisco revealed that between 2001 and 2005, reported cases of rectal gonorrhea increased more than two-fold, from 213 cases to 461 cases. STD Prevention and Control believes that a large part of this increase can be explained by its expanded rectal screening program and improvements in testing methodologies.

During this time period, the number of rectal GC screening tests supported by the STD Program increased 250%.

Saturday, November 11, 2006

"Day of Wrath" Screens at Pacific Film Archive, Nov 12

Seems very appropriate, given Tuesday's election and the results, that "Day of Wrath" is screening this weekend.

I've never had the opportunity to see this classic film as it was meant to be seen, projected up on a silver screen, so going to the Pacific Film Archive over in Berkeley tomorrow is going to be a long-awaited treat for me.

The Criterion Collection DVD of it is remarkable in its beautiful transfer from film to disc, but I'm quite old-fashioned with indulging in cinematic pleasures. That means watching masterpieces in a dark theatre with a great sound system, all cell phones and electronic devices turned off, and other cineastes worshipping at the celluloid alter.

Here is the listing from the PFA calendar:

SUN NOV 12 2006
"Day of Wrath"
Carl Th. Dreyer (Denmark, 1943)

“It has been said that Carl Dreyer's art begins to unfold just at the point where most other directors give up. Witchcraft and martyrdom are his themes—but his witches do not ride broomsticks; they ride the erotic fears of their persecutors. . . . In 1623 the young second wife of an austere pastor desires his death because of her love for his son; when the pastor falls dead, she is tried as a witch. As the girl is trapped, and as all possibility of hope is stripped away, one's identification with her fear becomes unbearable; then Dreyer dissolves our terror as we see that the individual is now laid bare, purified beyond even fear. It is a world that suggests a dreadful fusion of Hawthorne and Kafka: the young wife becomes what she and the others believe a witch to be. This psychological masterpiece . . . is one of the most completely moving films ever made.”

—Pauline Kael

Written by Dreyer, Mogens Skot-Hansen, Poul Knudsen, from the play Anne Pedersdotter by Hans Wiers-Jenssen. Photographed by Karl Andersson. With Thorkild Roose, Lisbeth Movin, Sigrid Neiiendam, Preben Lerdorff Rye. (97 mins, In Danish with English subtitles, B&W, 35mm, From Janus/Criterion Collection)

Thursday, November 09, 2006

(CDC-funded ad that was so controversial, it was pulled from the streets of Philadelphia within days after it was unveiled on bus shelters, this past August.)

BAR: Gays Split Over HIV Ads, Ex-POZ Editor Wants Ads Halted

For the past two or three months, I've been engaged in an online discussion with several people with AIDS or HIV and prevention advocates regarding the non-stop barrage of social marketing campaigns, which all too frequently are driven by fear, alarm and hysteria, targeting HIV poz folks and sexually active gay men.

We've debated the harmful effects of hostile ads over the course of the epidemic, the federal government funding the controversial ads, diminishing stigma against people living with HIV, getting AIDS Inc and the queens working at the ad agencies behind the ads to stop ignoring our concerns and begin a respectful dialogue with us about the ads, the benefits and demerits of serosorting, and lots and lots of other important related HIV issues.

Now, Zak Szymanski over at the Bay Area Reporter, has written a fairly comprehensive and lengthy article in today's paper that provides fair and balanced coverage to these matters, with many voices speaking up about improving HIV prevention plans. (I wish this were the first of three or four part series of articles on the problems caused by needlessly controversial social marketing campaigns, because the issues are so complex and can't be fully addressed in a single BAR article.)

These are my favorite excerpts from the BAR story today:

To a welcome reception on Monday, November 6, the San Francisco Department of Public Health released its long-anticipated "Disclosure" campaign. Featuring psychedelic photographic images by photographer Duane Cramer and emphasizing HIV status disclosure as a means of prevention, the DPH bus stop and billboard effort is a groundbreaking, community-led prevention method that marks the first time a public health agency has recognized the validity of "serosorting" – a longtime gay community practice where men have a variety of sex, some of it unprotected, with men of the same HIV status. [...]

The San Francisco campaign comes several weeks after the Los Angeles Gay and Lesbian Center launched its controversial "HIV is a gay disease" campaign, and about 10 months after gay men grew vocally critical of the billboard in San Francisco's Castro District earlier this year that proclaimed, "New Years Resolution: I Won't Infect Anyone." All of the campaigns were designed by the San Francisco-based firm Better World Advertising, which has attracted a growing number of critics in recent years.

Critics of HIV social marketing campaigns often find their objections described as problems with the messages, while sponsors of the messages often point to the discussion generated by the controversy as a mark of success.

But there is more to the debate than a simple disagreement over the slogans and images in HIV prevention advertisements. At the core of such campaigns is a set of assumptions or conclusions drawn about gay men, namely, that they are not talking enough about HIV.

It's a reasonable conclusion, said Les Pappas, founder and president of Better World Advertising and a former HIV prevention staffer at the San Francisco AIDS Foundation. Pappas – who conducts focus groups with men who have sex with men and who said he has been astounded by some of the misinformation that continues in the gay community – said there is no other way to explain why seroconversions continue. [...]

But there is another possibility, say some longtime AIDS activists and educators: that gay men are in fact talking about HIV and taking care of each other, but that a post-crisis climate has meant more people – positive and negative – are using harm reduction approaches and taking calculated risks they can live with. Critics of marketing said the evolution of the disease from a death sentence to a more manageable condition – combined with the declining HIV rates among gay men – mean that sex with without condoms is often practiced with thought, discussion, and safety rather than recklessness.

"The tone of many of these campaigns presume the lowest common denominator of gay men. But the gay men I know are smart, savvy, sophisticated, and caring of one another. They are talking about HIV and interested in serosorting and knowing more of the science behind it," said Los Angeles-based HIV activist and writer Tony Valenzuela. [...]

Such a prevention trend is something that has already been acknowledged by AIDS health advocates: earlier this year, San Francisco's DPH predicted a 10 percent drop in new HIV infections in San Francisco in 2006 compared to 2001, with another 20 percent decline in the rate of HIV transmission among gay and bisexual men. Chief reasons cited by AIDS groups for such progress was the decline in meth use and the increase in serosorting. [...]

Messages that imply an irresponsible community can further stigmatize gay men and thus encourage new infections, said Walter Armstrong, former editor-in-chief of the internationally distributed Poz magazine. Recently troubled by the Los Angeles "HIV is a gay disease" campaign, Armstrong is among a growing chorus calling for an end to all HIV social marketing.

Such measures "may seem controversial or even counterproductive on the surface. but I think this would, at best, force us and the prevention 'establishment' to find more scientific, more innovative, more responsive forms of HIV prevention and, at worst, just silence all the slogans that have never been anything but truisms, half-truths, or outright lies, starting with 'Safe Sex Is Hot' back in 1986."

Armstrong said such campaigns are always steps behind what gay men are already doing; "it wasn't until the mid-1990s that the big gay groups officially ranked oral sex as low risk, despite the fact that gay men had never used condoms for blowjobs." [...]

Valenzuela, whose grassroots group "Real Prevention" has taken to task recent HIV marketing efforts, said his group was mixed on the L.A. campaign, but that most people agreed it's counterproductive to measure a campaign's success by the community in-fighting that occurs as a result of its controversy.

"[LA Center officials] said their goal was to get people talking. In the forums and meetings I attended, people were talking, but not about how to have safer sex or do real HIV prevention," said Valenzuela, who also takes issue with the campaign's "Own It. End It" slogan, which he says promotes a "fantasy" that it is possible to end HIV through prevention alone.

Valenzuela is not convinced that a moratorium is the solution to the inherent limitations of HIV prevention marketing – "maybe we are expecting too much of this vehicle" – but he would like to see posters that are arming gay men with information that is useful for what they are already practicing, rather than telling them what to do. A recent anti-smoking ad, he said, told people who wanted to quit that they would "need a plan," acknowledging the complexities of that decision without resorting to scare tactics. [...]

"I beg to profoundly differ with Better World; poz guys are not the cure," said one man in response to the ads on an e-mail list that discusses prevention campaigns. "The cure is a scientific breakthrough that we have been denied as a society by inadequate early response and funding for research that goes all the way back to the Reagan administration. The cure is not anything young poz men can do; it's the charge of scientists and researchers the world over from an infectious disease, medical, and biochemical approach. Even if there is a role for positive men to attempt to prevent new infections, they share this responsibility with negative men who need to also protect themselves."

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