On June 20, shortly before President Bush’s whirlwind tour of Africa, America’s AIDS advocates sent him a remarkable letter (see www.nmac.org/public_policy). Signed by 151 groups, it amounts to a community consensus on Bush’s HIV policies here at home. “Increasingly,” it says, “federal agencies are making politically motivated decisions intent on dismantling or discrediting programs… targeted at those…most at risk: people of color and gay and bisexual men.” The letter describes an administration that—far from ignoring the epidemic—has devoted an unprecedented amount of activity to it. The aim, however, has been not to deal with the disease, but to politicize it, maximizing its potential as a hot-button issue in Bush’s re-election strategy. Even as this “compassionate conservative” promises a $15 billion bounty to fight global AIDS, he is very effectively using the crisis in his own backyard to rally the the Republican party’s evangelical Christian wing. You, dear reader, are a bone thrown to the divine-punishment pack.
Does this sound like paranoid lefty rhetoric? Well, look at the facts: In 2001, Secretary of Health Tommy Thompson ordered an investigation of San Francisco’s Stop AIDS Project, charging that its safe-sex programs are “obscene.” Family-values groups were predictably outraged that their tax dollars were paying for “Booty Call” workshops where homosexuality is promoted (that’s still illegal). The CDC dutifully followed up with an “accountability” audit. Last February, Julie Gerberding, MD, the HIV specialist Bush appointed to head the CDC, exonerated the group. Then, in June, allegedly after an ultimatum from the religious right’s reps in Congress, Gerberding did a groveling about-face. She ordered a repeat audit, even proposing that the government seize control of all federally funded prevention from local communities. A month later, 11 additional audits were in the works.
Certain administration tactics are so shamelessly disrespectful of science as to seem fanatical, befitting a born-again president who believes “the jury is still out” on evolution. For instance, all information about condoms was deleted from the CDC website for a year, creating—poof!—an abstinence-only virtual reality. Meantime, staffers at the NIH and CDC are urging grant applicants to avoid certain words: men who have sex with men, commercial sex workers, needle exchange, condoms and transgender. This blacklist writes off not only those of us at highest risk but two decades of hard-won prevention lessons. What does the administration propose instead? Its new CDC initiative rolls out HIVtesting and what it cheerfully calls “prevention for positives,” which so far has little to do with safe sex and a lot with such “proven” public-health measures as partner notification. In case you were wondering why you should care about any of this, that’s one reason.
Last week, someone forwarded POZ an e-mail written by Roland Foster, a congressional staffer and the religious right’s AIDS go-to guy. The e-mail was part of a larger argument he was having with an advocate about the failure of traditional prevention and the need for “new” approaches, such as abstinence. To support his claim—and, implicitly, his cause—Foster quoted, of all people, POZ Publisher Brad Peebles. “I failed prevention. Or prevention failed me,” Brad wrote in the July/August 2003 Publisher’s Letter, trying to provoke an honest discussion about the real-life challenges of “prevention for positives.” “And we are failing to stop the spread of HIV in our communities. But I have to admit that for most of these last 10 years, I haven’t cared.” To see Brad’s original meaning perverted, made to serve an agenda that is morally and scientifically bankrupt—well, I was dumbfounded. How had POZ been so stupid as to play right into their hands? After all, POZ has a deeply ingrained ethic of telling hard truths, courting controversy, owning rather than covering up. That’s what living through the AIDScrisis demands. To understand the failure of safe sex, for example, we had to start by ’fessing up to our own failure—and our real feelings about condoms, cum and other things on Bush’s blacklist. Yet seeing our own words used against us, I had to ask myself if that ethic was worth the risk. A small thing, I guess—but I still feel the chill.
As for the advocates’ letter, at presstime Bush had no response. If you have one for Bush, e-mail Roland Foster at Roland.Foster@mail.house.gov.