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What Are We Getting for Our HIV Dollars?

Part 2 [Warning: Graphic material follows]

By Linda Harvey
 May 16, 2006

At 25, the AIDS epidemic shows little progress, except for erecting an expensive bureaucracy, a thriving 'gay' lobby and a war on abstinence

 . How effective are current strategies in the U.S?
 . Our teens: caught in a war against abstinence
 . A close look at the "battleground" state of Ohio
 . What's with all the "unknown" HIV cases?
 . Youth, HIV and corruption

 In Part One of this article, we gave an overview of HIV/AIDS expenditures  in the U.S., and the lack of verifiable progress achieved in lowering the  incidence of HIV. We also outlined the recent aggressive campaign against abstinence-until-marriage education programs launched by the contraceptive distribution network (Planned Parenthood, SIECUS and others) in conjunction with HIV and AIDS groups.


The Ohio Example

 To get a clearer picture about both abstinence education and HIV prevention efforts, let's take a closer look at one state. I have chosen my home turf, the "battleground" state of Ohio.

 Ohio's 2000 census revealed that there are over 1.3 million school age children between the ages of 10 and 18 in Ohio.1 This age group is the primary target of abstinence- until- marriage education efforts. In 2005, 153,578 people, mostly students in this age range, were unduplicated clients of the largest abstinence network in Ohio, that of the Ohio Department of Health and its sub-grantee programs. With combined federal and state funding that year of over $2.1 million, that amounts to just under $14 per client. Many of these students were reached multiple times during the year.2 Another $8 million in federal funds is awarded directly to a number of abstinence groups in Ohio, who reach an even wider audience with the message of abstinence.

So slightly over $10 million per year of public funds is spent currently in Ohio to persuade the target-age audience of over 1 million students that abstinence until marriage, with no mixed messages, is the key to a healthy and productive sexual and social future. That is a mere $10 per person for this wide audience. Many if not most taxpayers would consider this a meager amount of funding for such an important job, yet it's a start in working toward two major goals at once: reducing teen pregnancies along with the incidence of sexually transmitted diseases. Teen pregnancies have been trending downward in the past decade in Ohio, and many have noted that this tracks with the implementation of abstinence education.

Yet among  HIV and AIDS activists and even some public health professionals in Ohio, these programs and expenditures are cause for great alarm. It's odd that those who object seem to be speaking from the same talking points.

Teresa C. Long, M.D., who hails from San Francisco and Berkeley, now heads the Columbus (OH) Health Department. She had critical words for abstinence education in a recent newspaper interview. "The emphasis [on sex education] nationally has been on abstinence-only education, which does not seem to be working for some of the youth we serve..We continue to battle misinformation, lack of information and opposing social norms." Concerning sex education, she said, "Young people seem to have much less access to health education and sex education than generations a few years ago." 3

This astonishing position reflects both Dr. Long's need to get out more as well as a misalignment with the facts. Teen pregnancy rates in the Columbus area have been heading downward since the late 1990's, so there is some reason for celebration, not doom and gloom.4 One would think she might have mentioned this positive trend.

If one attributes the youth pregnancy rate decline in Columbus to better condom use, that would discredit the claim that youth "don't have access to health education" (probably meaning explicit anatomical instruction on condom use). So – are kids getting the "needed" condom lessons-and that's the reason for the better trends? If so, Dr. Long hasn't been filled in and is wasting time criticizing the abstinence message. But if, as is more likely the case, abstinence- until- marriage lessons are the main cause for the decline, why the bitter if misdirected abstinence criticism? 

There's a possibility we have public health officials who are more biased than objective.

Criticism from other quarters is similarly bold, biased and confused. A group of "gay, lesbian, bisexual and transgendered" Ohio Department of Health employees met "outside of the workplace on their own time," and sent a complaint letter in 2004 to Dr. Nick Baird, director of the Ohio Department of Health, about the state's abstinence program among a litany of other gripes.5 On the heels of this, Earl Pike, executive director of the AIDS Task Force of Greater Cleveland and Dr. Tracey Lind of Trinity Cathedral (an Episcopal church) in Cleveland, held a press briefing in February 2005 complaining about the state funding of abstinence programs.

Rev. Dr. Lind reportedly bemoaned the funding of abstinence education, which he said left AIDS prevention programs without money, a wildly inaccurate assertion.6 After a flurry of other press releases during 2005 to make an issue out of a non-issue, their anger was aired in several major newspaper articles, courtesy of apparent allies in the media.

The Cleveland Plain-Dealer published an article in May 2005 reporting on Pike's call for an end to the state's funding of abstinence programs. The PD followed this with an article on August 13, 2005 entitled, "Speaker Choice is Controversial." The PD gave ample space again to Mr. Pike to label as "extremist" and "offensive" a speaker being considered for the 2005 annual meeting of the Ohio Department of Health's abstinence sub-grantees. She was "out of the mainstream," Pike was quoted as saying in a long (and inaccurate) rant about conservative views on homosexuality.

The director of the abstinence program for the state was not quoted i

n the article, nor was there any mention of attempts to contact her.7 The reporter, Regina McEnery, was given an award in December 2005 by the AIDS Task Force of Cleveland.8

So, who was this troublemaking speaker, this pariah and outcast from polite society? None other than Maggie Gallagher, nationally syndicated columnist, Yale graduate, co-author of The Case for Marriage (Doubleday, 2000). But with the Plain-Dealer and screaming activists at their throats, the beleaguered administration of Gov. Robert Taft caved under the pressure and the conference organizers un-invited Gallagher and scheduled a less-recognized alternate. Gallagher was said to be "out of the mainstream," except possibly for the 62% of Ohio voters who passed a tightly-worded pro-marriage ballot initiative in 2004. The state's "gay" lobby must have meant some other mainstream.

What could be provoking such vitriol? Again, we can follow the money and follow the sex.

Funding in Ohio for HIV prevention and AIDS treatment grows and thrives.

In 2005, the combined federal and state expenditures for HIV/AIDS was between $35-40 million,9 roughly three to four times the amount spent on abstinence education. While this at first and even second glances may seem to be an outrageous amount to spend on a 100% preventable disease spread by a relatively few people, there are several ways to break this down.

Around $16-17 million alone is spent on drugs for AIDS patients under ADAP, the AIDS Drug Assistance Program, to assist low income patients in the purchase of expensive antiretroviral drugs.

There have been nearly 14,000 total AIDS cases in Ohio since the start of the epidemic. In June 2005, the number of ADAP clients in Ohio was 1,371.10

Prevention of HIV accounts for over $7 million in state funds11 and over $10 million12 in federal funds in Ohio in recent years. This is distributed among state and local health departments and local HIV/AIDS groups for HIV education and testing. There's also HIV testing at Planned Parenthood locations and other women's health clinics, many of which receive funds under a huge federal program called "Women's and Infant's Care," which includes Title X funds. A request to the Ohio Department of Health to provide a breakdown of the HIV prevention portion of the over $200 million pot of federal dollars allocated to this program annually resulted in a terse response: there was no way to account for the HIV portion alone.13

Some of the HIV education and testing activities take place in a clinic's or organization's offices. But much does not. There are "outreach" activities conducted by groups like the AIDS Task Force of Greater Cleveland, AIDS Volunteers of Cincinnati, and the Columbus AIDS Task Force. This outreach include visits to "gay" bars and bathhouses, "gay" pride parades and circuit parties to meet with men and distribute condoms and brochures. There are even outreach programs to youth, including talks at schools and testing at community homosexual youth clubs, like Columbus Kaleidoscope, which is open for kids as young as 11 or 12 with no parental notification or consent needed. And in and around all of these activities, condoms are distributed and detailed "safer sex" instruction is provided.

Enough latex to pave I-71 between Cincinnati and Cleveland has been spread over Ohio – yet still the HIV cases rise.

In Ohio as in most states, even young minors can consent to health care treatment, counseling and testing without parents' knowledge or approval. When these health care providers, clinic counselors or HIV educators learn about sexual relationships between minors and adults, they are mandatory reporters, required by Ohio law to inform authorities. Is this being done consistently?  Are such reports being filed? Are kids being protected? Or is there a tacit "don't ask, don't tell" policy? Are young teens, like the adult clients, being tutored in the intricacies of graphic sex, mostly homosexual, at taxpayer expense, all in the name of "HIV prevention"?

 The Explicit Nature of Prevention

 The web site of AIDS Volunteers of Cincinnati (AVOC) provides us with examples of how HIV is being prevented. AVOC's  "Men in Touch" program is described on the group's web site: it's a "six week discussion group for men who have sex with men, explores issues related to intimacy, sexuality and HIV/AIDS prevention." AVOC also offers a follow- up program called "Keeping in Touch."14

 Additional advice from the AVOC web site says, "Gay men are still getting infected with HIV. Why? Because some men still don't use condoms." It goes on to say, "Your best weapon against HIV is your brain.With creativity and openness, safer sex can be sexual, sensual, erotic and fun." There follows a detailed discussion of how to have "safe" oral sex, "fingering and rimming," anal sex, how to use sex toys (cleaning them each time), and explicit anatomical instruction on condom use.15 …………..

 The article CONTINUES at