Dear Mr. President:
As leaders of national, regional and local organizations committed to ending the human suffering caused by AIDS, we are appreciative of the focus you and your administration have placed on the global AIDS pandemic. We also recognize and applaud the work Secretary Thompson and the Health and Human Services (HHS) staff put into approving the new HIV rapid tests. Your recognition of the importance of fighting HIV/AIDS is to be commended.
We are deeply troubled, however, by recent developments and federal policy changes in HIV prevention. The most recent actions by the Centers for Disease Control and Prevention (CDC) with regard to federal funding of locally-approved HIV prevention programs at the STOP AIDS Project in San Francisco are only the latest in a series of events which appear to prioritize political ideology over sound science and public health practices. The cumulative effect of these policy changes threatens to increase, not reduce HIV transmission rates, and jeopardizes the lives of thousands of men and women across the country who are at risk of HIV infection.
We simply cannot afford for HIV/AIDS to continue to be mired in political debate. Unfortunately, these recent actions seem to be not just isolated events but indicative of a growing and very troubling trend. Increasingly, federal agencies are making politically motivated decisions intent on dismantling or discrediting programs and funding initiatives targeted at those communities most at risk of infection: people of color and gay and bisexual men. This trend is not acceptable and works against not just the health and safety of at-risk groups, but the health and safety of all citizens. We need your leadership on this issue. We have outlined our major concerns below:
HIV prevention has never been funded at the levels needed to meet the CDC's goals of halving HIV infections by 2005. When more people than ever before are living with HIV/AIDS, flat funding is simply not acceptable. Forty thousand Americans are newly infected with HIV every year, half of them under the age of 24. Further, the epidemic is hitting low-income communities of color hardest. Adequately addressing the epidemic now means recognizing long-existing health disparities and dealing with social mores in tandem with traditional HIV prevention. We must fully arrest this epidemic -- and that requires a national commitment to both sound public health and compassion on a larger scale than we have seen in the twenty-two year history of AIDS.
We are further concerned that the recommendations for prenatal HIV testing policies will result in pregnant women being HIV-tested without their knowledge and explicit consent. Data demonstrate that states with so-called opt-out prenatal HIV testing policies have high percentages of pregnant women who do not know they have been HIV-tested. Medical ethics require that patients understand their examinations and treatment, especially concerning a disease as medically and socially serious as HIV/AIDS. Providing pregnant women with information about HIV and an opportunity to choose an HIV test is not an onerous burden upon medical providers.
The recent actions of the CDC with regard to the STOP AIDS Project are a prime example of an organization creating culturally relevant programming. While the work that STOP AIDS does may be, at times, controversial to some people, they are working to build innovative, culturally competent, scientifically-based and effective prevention interventions that address the realities of HIV risk and prevention for a particular community at high risk of infection. Multiple and invasive government program reviews and financial audits have shown that they have complied with the requirements for review and approval of their materials. The CDC itself in February reported that they were using current, effective models as the basis for their work. STOP AIDS continues to be singled out for attention based solely on the politically-motivated demands of conservative Congressional idealogues. This has extended far beyond reasonable oversight or accountability and become nothing more than harassment.
This kind of relentless and intrusive engagement between the CDC and a grantee sets a troubling precedent. The chilling impact this has had on community-based prevention efforts across the country is unacceptable. The law governing the federal funds at issue here forbids their use "to provide education or information designed to promote or encourage, directly, homosexual or heterosexual activity." It is clear that these programs are designed not to promote sexual activity, but instead are designed to promote the adoption of behaviors that lower the risk of HIV transmission. The efforts that STOP AIDS is engaged in are completely consistent with both the spirit and the letter of the law. While these programs may make some people uncomfortable, STOP AIDS is doing what is necessary and appropriate to save lives in a community at imminent risk.
AIDS is a public health crisis, not a political campaign. We ask you and your agency officials to work with community-based HIV/AIDS prevention organizations, and refrain from stonewalling those whose HIV prevention philosophies do not match the most conservative political ideologies. We ask you to call on Congress to do the same.
We continue to be troubled that sound public health information is being measured against a political standard and not by science. We refer to the fact that information about condoms and condom efficacy virtually disappeared from the CDC Web site for more than a year. Scientific studies have proven numerous times that condoms work and public health experts continue to advise that condoms should be a part of a comprehensive approach to HIV and STD prevention.
While the best protection against STDs, including HIV, is to abstain from sex or remain monogamous with an uninfected partner, it is also critical to ensure that sexually active individuals have information about condoms. In addition, comprehensive school health education -- including encouraging teens to delay sexual activity and providing them with appropriate, scientifically accurate information on the effectiveness of condoms -- is critical.
In particular, when HIV/AIDS researchers are implicitly or explicitly discouraged from doing research that includes any mention of gay or bisexual men, or sexual behavior between men that may put them at risk for HIV transmission, there is a clear censorship of potentially life-saving information that could help a community still devastated by the AIDS epidemic and new infections. We call on the Administration to protect science from such dangerous politics.
Mr. President, your Administration has the responsibility to support sound public health and science-based HIV prevention models and programs that allow all Americans to benefit from research and public health policy without regard to the divisive politics of a few politicians. We call on you to halt the regressive policies of censorship and intimidation -- both regulatory and informal -- that put American lives at risk.
We ask for a timely response from your office regarding these concerns.
William E. Arnold
Title II Community AIDS National Network
Treatment Action Group
New York, NY
A. Cornelius Baker
cc: Cabinet members (listed by name)
All members of Congress
Democratic candidates for President
Back to the TAGline October 2003 contents page.