Skip to comments.CDC's HIV Prevention Plan Faces Criticism
Posted on 07/28/2003 7:09:00 AM PDT by Brian S
CDC's New HIV Prevention Plan Faces Mounting Criticism From AIDS Groups
The Associated Press
SAN FRANCISCO July 28
Workshops on safe sex in San Francisco's Mission District. HIV-prevention skits developed by teenagers in Chicago. A ministry that counsels black women in Baltimore, where syphilis rates are shockingly high.
All are among the programs that could lose funding under the new HIV prevention strategy from the Centers for Disease Control and Prevention, which calls for increased attention to people who already carry the virus that causes AIDS.
CDC officials say they intend to pay for the new initiative by diverting $42 million that now goes to nonprofit groups like those in San Francisco, Chicago and Baltimore, whose work with uninfected people has been the norm for keeping the virus from spreading.
The plan, unveiled in April, faces mounting criticism from advocates and some federal lawmakers, who say it will shortchange proven prevention methods and represents a dangerous shift in the government's effort to combat HIV. They'll be pressing for more answers at the CDC's National AIDS Prevention Conference, which starts Sunday in Atlanta.
"You can't argue with an initiative that centers its AIDS-prevention efforts on people who carry and can actually spread the disease," said Debra Fraser-Houze, president of the National Black Leadership Council on AIDS. "But one that only focuses on people who are already HIV positive, and takes no responsibility for prevention among people who are not yet positive is insane and, I feel, genocidal."
The CDC's change threatens 211 community-based organizations nationwide, most of which serve minority communities and other populations that are at the highest risk of developing AIDS.
In announcing the new strategy, CDC director Julie Gerberding said it was clear that existing prevention efforts have "stalled." She cited rising rates of sexually transmitted disease rates in many U.S. cities, and that an estimated one-quarter of the more than 800,000 people living with HIV are unaware of their status.
About 40,000 more people in the United States are diagnosed with HIV every year; the CDC hopes to reduce that by half by 2005.
At the same time the CDC is changing its emphasis, President Bush has pledged $15 billion to fight AIDS in Africa and the Caribbean, providing medicine and caring for orphans of the disease. The House has approved more than $2 billion for HIV/AIDS as a first installment of the five-year plan.
Dr. Robert Janssen, director of the Division of HIV/AIDS prevention at CDC, said in an interview this past week that the agency doesn't plan to stop funding traditional prevention activities in the U.S., but they will represent "a smaller share" of federally supported efforts.
"What we don't want to do is just hand out condoms and brochures," he said.
Janssen said community-based non-profits may reapply for grants and have a good chance of receiving them if they redesign their programs to focus on HIV-positive populations.
If they don't, their CDC funding will likely run out in May.
They can still apply for money from $140 million in prevention funding the CDC provides to state and local health departments, although those agencies also are being directed to make targeting people already infected with AIDS their top priority.
Many advocates suspect the new initiative is motivated as much by politics as by science. Gerberding's April announcement came without any input from long-established AIDS advocates and on the heels of the CDC's audit of Stop AIDS, a San Francisco prevention program that has run workshops congressional conservatives deemed obscene.
"The conservatives, for a very long time, have worried that this kind of money for education and prevention efforts was just community development money for homosexuals and drug users," said Steven Tierney, director of HIV Prevention for the San Francisco Health Department.
Janssen rejected the idea that the shift was political.
"All of the recommendations in the initiative we have been talking about for a number of years," he said. "This all started in the Clinton administration."
Still, David Holtgrave, a predecessor of Janssen's at the CDC and now a professor of public health at Emory University in Atlanta, said "it's fair" for advocates to be concerned about cuts in HIV-prevention programs that have been shown to be effective.
The Congressional Black Caucus, House Minority Leader Nancy Pelosi and other lawmakers are urging the Bush administration to reconsider the changes.
"This is like we just threw public health out the window," said Del. Donna Christensen, who represents the Virgin Islands and is the first female doctor to serve in Congress.
Exactly. The CDC is doing the right thing. The only thing this does is causes complacency.
If the CDC is FINALLY going to recognize that ONLY people with HIV can spread HIV, then this is good news. They have wasted decades avoiding this very basic premise.
Oh, yes, "genocidal", I'm sure.
Newsflash: If a person engages in risky sexual activity, or IV drug use, they stand a much greater chance of contracting HIV than those who do not. It does not take one dollar to get this message across.
Debra Frazer-Houze is just ticked that her group may not be getting free money to spend on ritzy offices and extravagant vacations anymore. All the money spent in the last 15 years has not slowed the spred among the risk groups mentioned above - and it never will.
Of course. Better to piss away huge amounts of money on the feel-good banana/condom circuit when all you really need to tell them is "Want aids? Be a homo or a mainlainer or both".