Special Report: Here is how obscenity issue was raised
Here is how obscenity issue was raised
Storm coalesces around San Francisco group
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Obscenity may be in the eye of the community beholder, but that apparently won’t stop the federal government from taking a peek. HIV/AIDS prevention programs, funded by the Centers for Disease Control and Prevention in Atlanta, now are at risk of losing funding if local review panels fear that their program materials could be considered obscene by federal officials. The Office of Inspector General (OIG) and the Department of Health and Human Services (HHS) are conducting comprehensive reviews of all CDC-funded HIV/AIDS program activities, reviewing their financial accountability as well as performance measures. The reviews also will assess whether these programs are adhering to CDC prevention material requirements.
The way the process has been working is that organizations apply for a CDC grant to fund a specific HIV/AIDS prevention project. Project materials are reviewed by a local program review panel, which, using that community’s standards, assesses whether the materials meet CDC requirements. If some materials are considered obscene or appear to promote directly sexual activity or injection drug use, then the review panel may reject those particular items.
Now, there will be an additional layer of accountability: The OIG and HHS intend to review the same programs and materials and decide whether these adhered to the same guidelines for which they were reviewed by the local program review panel. Critics say OIG audits and accountability reviews always are important, but what HHS Secretary Tommy Thompson has proposed is designed to have a chilling effect on the more effective HIV/AIDS prevention programs that target gay and homosexual men and youths.
Here’s how the controversy began:
• August 2001: U.S. Rep. Mark E. Souder (R-IN), the chairman of the House subcommittee on criminal justice, drug policy and human resources, wrote a letter to Thompson concerning the activities of STOP AIDS Project Inc., a not-for-profit organization that targets HIV prevention efforts in the community of men who have sex with men in San Francisco.
• Sept. 12, 2001: Thompson spoke with Souder about the issue and told Souder he had requested the OIG to review the matter.
• September - October 2001: Inspector General Janet Rehnquist investigated Stop AIDS at Thompson’s request to determine whether two CDC-funded programs complied with the terms of the CDC’s agreement and guidance.
• Oct. 12, 2001: Rehnquist, in a letter to Thompson, dated Oct. 12, 2001, stated that the project’s workshops provided HIV/AIDS prevention information but did not comply with the cooperative agreement and other CDC guidelines.
Rehnquist’s letter reads, in part: "We determined that materials from the Project’s workshops providing information on HIV/AIDS prevention did not fully comply with the cooperative agreement and other CDC guidance. Some of the information presented in the workshops, in our opinion, could be viewed as encourag(ing), directly . . . sexual activity,’ in violation of CDC’s guidance. In addition, the Project did not follow the CDC requirement that curriculum materials be evaluated by a local review panel." The letter went on to say that the project’s advertisements, "in our opinion, could be construed as encourag[ing], directly . . . sexual activity’ and as obscene,’ and thus not in compliance with CDC guidance."
The letter continues, "These types of inappropriate activity should be controlled by the Project’s local review panel. Because we are concerned that the panel is not carrying out its duties in accordance with CDC guidance, we recommend CDC write the Project and its local review panel and remind both that the CDC guidelines, including the guidelines’ basic principles, must be applied by the panel in its review of all AIDS-related materials. We also recommend that CDC send letters to all recipients of grants and cooperative agreements that may use AIDS-related materials, reminding them of the specific contents of the guidelines, including the basic principles."
Great Sex Workshop’ criticized
STOP AIDS Project adheres to its community’s standards, and it’s a dangerous precedent for Rehnquist to second-guess the local program review panel, says Darlene Weide, MPH, MSW, executive director of STOP AIDS Project. "Communities are the ones that need to determine what local community HIV prevention needs are, and not politicians or bureaucrats in DC," Weide says. "We have the STOP AIDS Project — all materials and workshop curriculum have been approved by local review boards set up by the Department of Public Health, and we’re in full compliance with HHS guidelines."
Rehnquist specifically objected to STOP AIDS Project’s "Great Sex Workshop" and its primary goal, which Rehnquist’s letter says is "to examine ways of reducing the spread of HIV and other STDs [sexually transmitted diseases]’ and explore ways of making and keeping sex safe, erotic, fun, and satisfying (That’s great sex!).’"
Weide says the workshop’s purpose is to teach sexually active men the skills they need to increase their ability to negotiate safe sex and disclose their HIV status. "In San Francisco, one out of three gay and bisexual men are HIV-positive, and 80% of all new infections are among gay and bisexual men, so we do targeted preventions," Weide explains. "We have found that men who are high-risk-takers do not come to workshops titled The Four-Hour AIDS Lecture.’"
Rehnquist’s letter also finds fault with the workshop called "Booty Call," which is based on a book titled Anal Pleasure and Health - A Guide for Men and Women, written by Jack Morin, PhD, a San Francisco-based researcher and therapist. "The course outline indicates that the workshop discusses the taboos of anal eroticism, the 10 things men and women still do not know about anal sex, and ways to avoid injury and the transmission of STDs," Rehnquist writes. "Although the workshop arguably discusses the harmful effects of promiscuous activity, it nevertheless appears to focus equally on, and possibly to promote, sexual activity."
The goal of the "Booty Call" workshop is to bring sexually active men together to discuss their challenges in using condoms for anal sex and to develop the skills needed to practice safe sex, Weide says. "In San Francisco, we are competing with a lot of other social events, and we know that we have to be competitive to bring these men into prevention programs."
• Nov. 14, 2001: Thompson wrote Souder about the issue and provided Souder with a copy of the OIG report. Thompson said he was having the OIG and HHS Deputy Secretary Claude Allen further examine all department-funded HIV/AIDS activities.
• Nov. 30, 2001: At a Youth and HIV Prevention: New Directions conference held Nov. 30 in Washington, DC, Scott Evertz, director of the White House Office of AIDS Policy, stated, "It is very important that messages be targeted to the audience that they are being directed to. And in some cases, that may mean something that my 76-year-old mother in a suburb of St. Louis may not want to see, but that someone living in the Castro in San Francisco has to hear."
• Dec. 13, 2001: U.S. Rep. Nancy Pelosi (D-CA) wrote Thompson with her concerns over the administration’s report about STOP AIDS Project’s prevention programs.
Pelosi wrote, in part: "I am writing to express my strong concern about the Office of the Inspector General Report on HIV prevention programs at the San Francisco Stop AIDS Project, issued by Janet Rehnquist on November 16, 2001. I believe the report seriously mischaracterizes the work of this unique community-based organization and ask that potential punitive measures against Stop AIDS project be set aside in favor of strengthening technical assistance from the Centers for Disease Control and Prevention to this and other HIV prevention entities to assist them in adhering to federal regulatory, administrative, and programmatic requirements."
Pelosi’s letter further says: "The report issued by the Office of the Inspector General makes several questionable claims about the work of Stop AIDS Project and the use of HIV prevention funds in San Francisco. Specifically, the report claims that CDC guidelines on AIDS-related materials, issued on June 15, 1992, were violated because materials used for workshops, in the opinion of the IG, directly encouraged sexual activity and were obscene.’ However, the workshop materials in question were focused on HIV prevention activities and included information about the potentially harmful effects of promiscuous sexual activity. More importantly, the Supreme Court ruled in Miller v. California that these prohibitions are to be determined by local community standards. The report states that the Office of the Inspector General did not attend any of the workshops in question. However, representatives from the CDC have attended three workshops and did not report them to be promoting sexual activity or obscene.’"
National offensiveness’ standard nixed
Pelosi’s letter adds: "The CDC attempted to implement a national offensiveness’ standard in the late 1980’s. However, this national standard was determined to be unconstitutional and was truck down by the U.S. District Court for the Southern District of New York on May 11, 1992, in Gay Men’s Health Crisis v. Sullivan. Currently, grantees are required to comply with a materials review process based on local community standards. Stop AIDS Project submitted its workshop promotional materials for review prior to conducting the workshops, and was in compliance with the materials review requirements as it understood them."
• January 2002: National AIDS Policy director Evertz met with STOP AIDS Project officials in January 2002 and told them, as well as the San Francisco Chronicle, that he supports their targeted prevention work.
"Basically, what this whole investigation is in my opinion is a red herring," Weide says. "I believe there are a few Republicans in DC who want to de-fund HIV prevention programs for gay men."
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