CDC’s HIV Policy Criticized

By DYANA BAGBY – NY Blade
 

Aug. 20, 2004

ATLANTA — Some AIDS activists and civil libertarians are urging the Centers for Disease Control & Prevention to “reverse course” with proposed changes to its guidelines for HIV education materials.

The proposals include calls for material on Web sites of AIDS agencies receiving funds from the CDC to be reviewed by local health officials and to include information about the “effectiveness or lack of effectiveness of condoms.”

The effort comes as the CDC works to assure its federal funds don’t support programs that it deems “obscene” under the Public Health Service Act or promote sexual activity. The revisions to the “HIV Content Guidelines” also seek to address advances in technology, like Web sites, increase accountability among grant recipients and improve clarity, according to the CDC.

“We’re committed to prevention and going about it the best way possible,” said Tom Skinner, a CDC spokesperson. The proposed changes put more emphasis on the review process of HIV prevention materials, Skinner added. Groups that receive HIV funding from the CDC would be required to certify that state or local health officials reviewed their programs.

“This provision gives local public health officials a veto power,” said James Esseks, litigation director of the ACLU’s AIDS Project, which criticized the proposals in a letter released Tuesday.

“It’s an opportunity for someone who doesn’t have the stomach for some of the materials to say it can’t be used,” he added.

Having a review panel define what is “obscene” could potentially limit prevention efforts, said Jeff Graham, executive director of the AIDS Survival Project.
“ The integrity of the system would be jeopardized by undue influence of politicians rather than strong science,” he said.

In June, the CDC dropped funding of some programs at the Stop AIDS Project in San Francisco, which has been in the crosshairs of conservative lawmakers in Washington, D.C., for the last three years.

The agency was the target of various federal audits and investigations by the CDC because of so-called “obscene” prevention programs targeting gay and bisexual men.

“Oftentimes, the most effective educational materials are explicit — we’re talking about sex,” Esseks said.

Nearly 2,000 comments about the proposed revisions were posted on the CDC’s Web site this week, though the public comment period ended Aug. 16. The CDC plans to publish a final document with any changes by December, Skinner said.

Current guidelines don’t target materials posted on HIV prevention Web sites, and some of the information on a site may not be posted using CDC funds, Graham said. To have an entire site and its links pre-approved by state and local public health officials could keep helpful information out of the hands of at-risk individuals, he said.

Another proposed change would eliminate the ability to establish review panels of specific minority and ethnic groups targeted by the prevention materials. Under current guidelines, such survey groups exist.

“With these proposed changes, ‘politically disposable’ communities [such as minorities, the underprivileged and youth] could be silenced,” Graham added.

The proposed guidelines were also criticized in a letter signed by five Democratic members of the U.S. House: Reps. Nancy Pelosi, Henry Waxman, Barney Frank, Tammy Baldwin and Janice D. Schakowsky.

“Separately, these proposed changes to the HIV/AIDS content review process seem unnecessary at best and misguided at worst,” the letter states. “As a whole, the proposal, if implemented, would delay and politicize the review process for HIV prevention materials, reducing the effectiveness of community-based organizations’ and health departments’ work against HIV and AIDS.”

Graham said the timing of the proposed changes is suspect. “I do think the timing, with this being an election year … leaves the door open that these [proposed changes] could be politically motivated,” he said.

Skinner said the “HIV Content Guidelines” were last revised in 1992 and the review portion has been in place for nearly 20 years. The current proposals have been in the works for about a year, he said.