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Condom Wars
New guidelines gut HIV prevention -- and endanger young people’s lives 
by Doug Ireland
June 27, 2004
First Published in the LA Weekly

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Lethal new regulations from President Bush’s Centers for Disease Control and Prevention (CDC) in Atlanta, quietly issued with no fanfare last week, complete the right-wing Republicans’ goal of gutting HIV-prevention education in the United States. In place of effective, disease-preventing safe-sex education, little will soon remain except failed programs that denounce condom use, while teaching abstinence as the only way to prevent the spread of AIDS. And those abstinence-only programs, researchers say, actually increase the risk of contracting AIDS and other sexually transmitted diseases (STDs).

Published on June 16 in the Federal Register, the censorious new CDC guidelines will be mandatory for any organization that does HIV-prevention work and also receives federal funds -- whether or not any federal money is directly spent on their programs designed to fight the spread of the epidemic. (The CDC is the principal federal funder of prevention education about HIV and AIDS, and its head a Bush appointee). It’s all couched in arcane bureaucratese, but this is the Bush administration’s Big Stick — do exactly as we say, or lose your federal funding. And nearly all of the some 3,800 AIDS service organizations (ASOs) that do the bulk of HIV-prevention education receive at least part of their budget from federal dollars. Without that money, they’d have to slash programs or even close their doors.

These new regs require the censoring of any “content” -- including “pamphlets, brochures, fliers, curricula,” “audiovisual materials” and “pictorials (for example, posters and similar educational materials using photographs, slides, drawings or paintings),” as well as “advertising” and Web-based info. They require all such “content” to eliminate anything even vaguely “sexually suggestive” or “obscene”-- like teaching how to use a condom correctly by putting it on a dildo, or even a cucumber. And they demand that all such materials include information on the “lack of effectiveness of condom use” in preventing the spread of HIV and other STDs -- in other words, the Bush administration wants AIDS fighters to tell people: Condoms don’t work. This demented exigency flies in the face of every competent medical body’s judgment that, in the absence of an HIV-preventing vaccine, the condom is the single most effective tool available to protect someone from getting or spreading the AIDS virus.

Moreover, the CDC will now take the decisions on which AIDS-fighting educational materials actually work away from those on the frontlines of the combat against the epidemic, and hand them over to political appointees.

This is done by requiring that Policy Review Panels, which each group engaged in HIV prevention must have, can no longer be appointed by that group but must instead be named by state and local health departments. And those panels must then take a vote on every single flier or brochure or other “content” before it is issued.

This means that, under the new regs, political appointees will have a veto and be able to ban anything in those educational materials they deem “obscene” or lacking in anti-condom propaganda. With Republicans controlling a majority of statehouses, and having handed over control of the health departments to folks deemed acceptable to the Christian right and cultural conservatives in many Southern and Midwestern states -- and the rest of public-health departments notoriously subservient to political pressure from the state and local legislatures that control their appropriations -- anti-condom junk science that plays politics with people’s lives will rule the day.

Under the new regs, it will be impossible even to track the spread of unsafe sexual practices -- because the CDC’s politically inspired censorship includes “questionnaires and survey materials” and thus would forbid asking people if they engage in specific sexual acts without protection against HIV. For that too would be “obscene.” (Questions about gay kids have already disappeared from the CDC’s national Youth Risk Survey after Christian-right pressure).

So what will be left? Why, the abstinence-only ed programs dear to Bush’s heart and to the Christian right. A third of all federal HIV-education money -- some $270 million more in Bush’s latest budget -- now goes to abstinence-only programs, almost universally to Christian groups as part of Bush’s “faith-based initiatives” (no Jewish or Muslim groups receive any funds). This is a brilliant maneuver -- Bush has turned money earmarked for fighting AIDS into political pork for his Christer base. Much of this money goes to anti-abortion groups masquerading as “women’s health” or “crisis-pregnancy” centers. Others receiving such funds engage in religious propaganda -- a federal judge found that Louisiana’s federally funded Governor’s Program on Abstinence illegally handed out Bibles, staged anti-abortion prayer rallies outside women’s clinics, and had students perform Bible-based skits.

Yet Bush’s Health and Human Services Department refused demands to audit the Louisiana program, while at the same time conducting repeated harassing audits of effective AIDS-fighting groups that have vigorously protested Bush policies on AIDS, like New York’s Gay Men’s Health Crisis and San Francisco’s Stop AIDS Project. (The latter lost its federal funding earlier this year for sex-ed thought crimes similar to those banned in the new CDC regs -- a pre-emptive warning to all other ASOs to toe the Bush-Christer line -- and subsequently got a $100 contribution from former Bush AIDS czar Scott Evertz, ousted by Bush’s theocrats, to help continue what he called Stop AIDS’s “good work”).

Teaching about condoms doesn’t increase sexual activity and certainly doesn’t increase unprotected sex, but abstinence-only ed does both. For example, a Minnesota Department of Health study of the state’s five-year, abstinence-only program found last year that sexual activity by students taking the program actually doubled, from 5.8 percent to 12.4 percent.

Even more alarming, a study by Columbia University Department of Sociology chairman Peter Bearman of the sex lives of 12,000 adolescents from 12 to 18 years old over a five-year period found unsafe sex much greater among youth who’d signed pledges to abstain from sex until (heterosexual) marriage (a key component of most abstinence only–based education programs, which leave gay kids, who can’t get married in 49 states, to face a lifetime of chastity).

The Columbia study, released last March and financed in part by the National Institute of Child Health and Human Development, showed that while 59 percent of teenage males who did not pledge abstinence used a condom during sex, only 40 percent of abstinence-pledging boys used a condom. As Bearman told The New York Times, telling teens “to ‘just say no,’ without understanding risk or how to protect oneself from risk, turns out to create greater risk” of HIV and other STDs. In his study, 88 percent of those who’d pledged chastity reported having sex before marriage. The large Bearman study confirms one published in the American Journal of Sociology in 2001, which showed that pent-up sexual desire and failure to realize risk exposure among students in abstinence-only programs made them a third less likely to use condoms than others, even if, on average, they began having sex a year and half later.

All those numbers help explain why the new CDC regs are causing outrage and anguish among leaders in the AIDS community. “Kids are being taught that condoms don’t work, while real life-saving HIV education is being eviscerated across the board,” fumes Sean Strub, founder of POZ, the magazine for the HIV-positive community. And, Strub points out, the Bush administration has hamstrung AIDS organizations, “which are faced with the terrible choice of prioritizing care for existing HIV-positive clients over speaking out against the new CDC rules and risking losing their federal funding.”

There’s only a tiny window of opportunity to try to get the new CDC censorship rules changed before they go into effect (the deadline for public comments is August 16 -- they may be e-mailed to or faxed to 404-639-3125.) But when the regs begin to be felt, just watch already-rising AIDS infection rates really soar.

Doug Ireland is a New York-based media critic and commentator whose articles appear regularly in The Nation, Tom, and In These Times among many others. This article first appeared in the LA Weekly.

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