Monday, January 21, 2008

How the SF Chronicle Creates
'Gays = Disease' Panics that Stigmatize

I saw a posting on a gay blog last week, questioning how the San Francisco Chronicle could play such a key role in launching homophobic headlines around the globe last week with its reporting on gay staph infection. The answer is simple. Practice.

As a longtime observer of the paper's coverage of HIV/STD issues and gay men, I wasn't the least bit surprised last week when UCSF issued its inflammatory release on gay staph infection, an order really to Sabin Russell to jump, and the Chronicle made its standard reply to UCSF: How high?

The Chronicle's gay staph coverage, which more than set the tone for worldwide stories, was typical for this sort of "gays = disease" reporting.

In case you didn't know this, let me point out some truth. Every Chronicle story about gays and infections and UCSF has the same elements of dedicated researchers find alarming results about gays and sex, and can be summed up in two words: "UCSF said." The details evolve, of course, with each story, but the take-home message never varies: Gays = disease.

The two Chronicle articles that got the nasty homophobic headlines rolling globally, quoted only UCSF researchers. Indeed, one of the stories quotes or cites the same researcher 14 times.

If the paper can allocate so much ink to the UCSF experts, it should also be able to include a teensy-weensy quote from someone skeptical of the research driving the latest "gays = disease" panic. That is, if the paper is upholding fair and balanced tenets of journalism, and not serving as a stenographer.

Absolutely no voices from outside UCSF made it into the gay staph pieces. This is the way the paper always writes these stories, or, for slight variation, the Chronicle locates someone at DPH to back up whatever scary claim in being made.

Opinions from those pesky questioning activists who don't work for either UCSF or the DPH? Don't bother the Chronicle with anything other than slavish devotion to the institutions! Activist skepticism never gets into these sort of stories.

And forget about finding an average gay in the streets reaction piece, like, the New York Times article on Sunday. Nice of the Gray Lady to do what the local rag won't -- listen to gays who don't depend on UCSF/DPH for their livelihood and report their anger.

I've gathered some of just a few articles, out of the hundreds to choose from, that show a remarkable sameness:

"UCSF said," or "DPH said," or for real variety "UCSF said and DPH confirmed," or vice versa. And I mean in practically every one of these stories and their ilk.

Of the many things I want to come out of last week's gay staph controversy, at the top of my list is a public accounting by the gay community of the decades of stigmatizing stories in the Chronicle.

Let's start that discussion by looking at excerpts from the past articles, which you should read in their entirety:

This January 23, 1999, article allowed a UCSF researcher to present her modeling theory in the paper without any challenge, and lacked any gay or AIDS patients' voices.

A bitter irony underlies the spectacular success of the new protease inhibitor drugs that have helped so many people with AIDS return to good health -- at least temporarily.

The multidrug ``cocktails'' work so well because they are attacking the strains of the AIDS virus that are the least resistant to drugs, according to Dr. Sally Blower, an epidemiologist at the University of California at San Francisco. [...]

Blower and her UCSF colleagues have developed mathematical models to describe the way epidemics spread and the effects of drugs and vaccines on those epidemics.

Then there's this January 29, 1999, article on barebacking with the lurid headline "Russian Roulette Sex Parties," which is not driven by either UCSF or DPH, but I include it in this survey because it created much anger and controversy in the gay community and clearly shows how the paper likes sensationalism to go along with such pieces.

Now a fringe element, linked by the Internet, is taking it even further. Web sites are offering lists of ``extreme sex'' party sites where the prospect of becoming infected or of infecting others is part of the erotic allure.

At a ``Russian roulette party'' set for next month in Houston, a posting seeks three healthy men to have sex with five other men. Four of those must be HIV negative, but the fifth is already infected with the AIDS virus.

On August 13, 1999, this story about a confusing mathematical modeling DPH/UCSF study assessing great risk of contracting HIV through anal versus oral gay sex, ran on page one. The UCSF and Chronicle are obsessed with such modeling creations, and modeling does have a place in battling HIV, but so many of the stories about modeling require a calculator and strong math skills to figure out what was studied and what it means for average gays.

"It is really important for people to have information in making decisions about their sexual risks,'' said Susan Buchbinder, an epidemiologist with the city health department and senior author of the report.

Each time an uninfected man engages in unprotected receptive anal intercourse with an HIV-positive partner, for example, chances are 1 in 120 that he will become infected with the AIDS virus.

Oral sex, often seen as a safe alternative to anal sex in the gay community, poses a small but significant risk of infection. Each contact poses about 1-in-2,500 chance that an exchange of semen from an HIV-infected partner will transmit the disease.

How confusing was the Buchbinder modeling study and Chronicle coverage? So confusing the researchers were forced to hold a town hall community meeting in the Castro, as reported in the pages of the Bay Area Reporter, and ignored by the Chronicle.

The meeting was hastily scheduled following widespread media coverage of a recent DPH study (see the August 19 Bay Area Reporter), widely interpreted to show that oral sex without condoms, while not the riskiest of sexual activities, is not without risk for transmission of HIV, the virus that causes AIDS. The purpose of the meeting was to provide community members an opportunity to ask questions directly of the researchers, including epidemiologists Dr. Susan Buchbinder, of DPH; and Dr. Eric Vittinghoff, of the University of California at San Francisco (UCSF).

However, the presentations seemed to pose more questions than provide answers for some members of the audience, many of whom seemed to be looking for simple answers that were not available. The researchers frequently were forced to draw on anecdotal evidence and small, old studies to speculate about the risks of various sexual practices.

One in a very long line of federally-funded studies by UCSF to find that gay men are having sex, even with HIV still around, was the basis for this August 27, 1999, story stigmatized gay men for their very human sexual desires. And of course, the head of DPH is included with a quote backing UCSF.

What the UCSF study didn't research, and the Chronicle didn't report on, never does actually, is how HIV prevention experts didn't know how to recreate prevention in the age of protease inhibitors. So much easier to blame gays for rejecting the hysteria-based prevention messages of the 1980s.

Gay men in San Francisco are rapidly dropping their guard against a renewed outbreak of HIV infection, with half of those in a recent survey reporting they have had sex without condoms.

Of greatest concern to researchers is that nearly a quarter of those participating in a University of California at San Francisco survey said they had had unprotected anal intercourse with a partner whose HIV status was either unknown to them or different from their own. [...]

"I feel sad for my community,'' said Dr. Mitchell Katz, director of the San Francisco Department of Public Health and a gay man. "I do think that this could have been the time when we made significant progress in the elimination of this disease.''

This frightening January 28, 2000, story, quoting only the researcher, was one more about gays still having sex! And like the earlier January 1999 article about a similar study from the same UCSF researcher, Sally Blower, this one omits voices of gays, people with AIDS and anyone challenging the modeling methods.

A substantial increase in high-risk sexual behavior in San Francisco's gay community could all but eliminate the potential benefits of new AIDS drugs, scientists are reporting today. [...]

"It's a complicated picture, but the bottom line is we really could make things a lot better with these antiviral medicines,'' said Sally Blower, an epidemiologist at the University of California at San Francisco.

Blower and her colleagues produced an elaborate mathematical model to find out just how the life- saving drugs might affect the course of the AIDS epidemic in the San Francisco gay community.

Perhaps the most infamous article from the paper to generate oceans of ink, and a few million bucks in federal funding, was the front-page story on the HIV rate supposedly surging, on June 30, 2000:

"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.''

This news article is illustrative of Chronicle reporting on gays and diseases other than HIV, AIDS, syphilis, gonorrhea, and hepatitis. In this case, it involved shigellosis and followed the template of "DPH said." The story ran on September 12, 2000.

A majority of the cases reported this year have been among gay men, who can be exposed to shigella bacteria through oral-anal contact. [...]

Dr. Tomas Aragon, director of Community Health and Epidemiology, said that there is a chronic low-level form of shigellosis in San Francisco's gay community and that periodically the number of cases will rise, particularly during the summer months.

Here's that UCSF modeling expert Sally Blower again, getting still another puff piece in the paper that presents her finding without questions being raised, or any quotes from gays and people with AIDS. Note that a DPH expert is quoted fully endorsing Blower's work, and two other people are quoted, from, guess where?, UCSF and DPH.

This appeared on August 31, 2001, and was about Blower's HIV drug resistance theories and modeling.

The prediction is the product of a complex computer modeling program developed by UCLA biomathematician Sally Blower, co-author of the paper, who previously conducted her research at UCSF. Her program is based on systems originally developed to predict the risk of nuclear plant meltdowns. Blower has been applying the technique to infectious diseases for nearly a decade.

"We take her work very seriously," said San Francisco Department of Public Health epidemiologist Willi McFarland. The city estimates there are currently 18,000 residents living with HIV. "If lives are shortened by a few years because of drug resistance, it could add up to thousands of years of life lost in the city," he said.

Here's an October 26, 2001, syphilis story that reports without any challenges or questions on allegations by a DPH expert of syphilis spiking. In keeping with Chronicle policies, the matter of increased funding for more syphilis testing and expanded surveillance, two factors that can cause spikes, were not raised as reason for the surge.

Syphilis is spreading at "startling" rates in San Francisco, especially among the city's gay and bisexual men, a Department of Public Health official said yesterday.

The number of reported cases citywide grew from 39 in 1998 to 47 in 1999 and 71 last year. Through September of this year, the San Francisco Department of Public Health has recorded 116 cases, with a majority occurring among gay and bisexual men.

As if the UCSF scaremongers don't get enough space in the Chronicle's news pages, it also makes the op-ed page available to UCSF experts. This piece by Tom Coates, with his usual "woe is the homosexual who's not attending UCSF HIV prevention workshops and not buying the fear of the 1980s anymore," reinforced bigots perceptions about gay male relationships. No real evidence was presented backing the claim that the community has somehow slipped out of our grasp, other than the author's anecdotes. This ran on June 21, 2002, right before gay pride

The gay community in San Francisco has slipped away from gay men. Talking with young gay men, one is struck by the pervasive sense of alienation and the frustration of living in a culture where one cannot get a "real" date but where one can easily and quickly find sex. The flip side is that those gay men who are in fulfilling, long-term relationships live lives totally unrelated to the "gay lifestyle" of easy, breezy sex expressed in the media and pursued, not necessarily satisfactorily, by so many single gay men.
Let's end this small survey with a look at how the Chronicle on December 21, 2004, wrote about another exotic infection, lymphogranuloma venereum, or LGV, to hit the city's gay community. You know the drill. "DPH said," and no other voices were allowed to intrude on stoking fear in the gay community. Even though the number of men with the infection was quite small, the Chronicle story, as is often the case, generated widespread news and controversy.

San Francisco public health officials issued a warning Monday that a rare and potentially debilitating sexually transmitted disease reported recently in the Netherlands has turned up among a small number of patients in the city. [...]

None of the four patients who were found to have the bug in San Francisco had visited the Netherlands, an indication there may be other cases yet to be discovered in the city, said Dr. Sam Mitchell, a Department of Public Health epidemiologist.

The four cases in San Francisco were among gay men, some of whom also tested positive for HIV, the virus that causes AIDS.

1 comment:

Anonymous said...


Thanks, once again, for your articulate and vocal outrage, and always formidable research to back it up. Although people like me expect this from you by now, it's impossible to thank you enough.

Gays and lesbians, globally, are no strangers to such irresponsible coverage, which although maybe hurtful in places like San Francisco, can be devastating for people in places like Wyoming. Matthew Shepard comes to mind.

But when it comes to these kinds of health issues, the danger lies in the willful ignorance of those who believe and lead others to believe that the problem is contained to a particular community.

Imagine the difference in terms of audience awareness, had UCSF genuinely been interested in stemming transmission, sensationalism notwithstanding, had the headline read: "A new drug-resistant staph infection. Just how safe are your workouts at the local gym?"