FRC Against Dybul: Putting a Gay Man in Charge of AIDS Prevention Like a “Fox in charge of the henhouse”

Ian

Remember that post about David Kuo's new book Tempting Faith? People have been wondering out loud after its release this week if the Religious Right would freak out and live up to the titles given them by some in the Bush Administration ("whackos," "nuts," etc.) Well, whether they've read the book or not, check this out...

Referring to Mark Dybul, the Bush Administration's appointee to direct the President's Emergency Plan for AIDS Relief (PEPFAR), Peter Sprigg of the Family Research Council (FRC) had this to say:

Remember that post about David Kuo's new book Tempting Faith? People have been wondering out loud after its release this week if the Religious Right would freak out and live up to the titles given them by some in the Bush Administration ("whackos," "nuts," etc.) Well, whether they've read the book or not, check this out…

Referring to Mark Dybul, the Bush Administration's appointee to direct the President's Emergency Plan for AIDS Relief (PEPFAR), Peter Sprigg of the Family Research Council (FRC) had this to say:

“We have to face the fact that putting a homosexual in charge of AIDS policy is a bit like putting the fox in charge of the henhouse.

While there haven't been many additions to our Reckless Rhetoric section of the website since we launched in May, Mr. Sprigg definitely deserved his place of dishonor in that section. (Granted, there could be daily additions if we searched widely enough, but who really thinks these people are worth keeping track of that dilligently?)

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Check out other Reckless Rhetoric to see what the "nuts" have been saying about reproductive health issues.

Silenced in a Sex Obsessed Culture

Lara Riscol

In our sex-saturated consumer culture, abstinence-only's refusal to talk openly about sex sends a mixed message. How can we talk about sex in a way that makes sense to us, and to our relationships? What is healthy sexuality? And how can we teach it in such a toxic environment of extremes?

Spring fever has sprung! Just as a sobering CDC study report breaks that one in four American teen girls has a sexually transmitted disease, crime-busting Gov. Eliot Spitzer resigns for itching an eighty-grand, reportedly condom-free prostitution habit. Instantly the scandal storm blows bigger and more bizarre as New York's new governor holds an emergency press conference to confess — also with wife by side — to several affairs, one over several years. Meanwhile, journalists struggle for truth in the public dispute between New Jersey's former "I'm a gay American" governor and his divorcing wife about their alleged three-ways with their young male driver.

News hasn't been this salacious since the Starr Report. And camera crews still have to dispatch to spring break hot spots to capture the bouncing B-roll of oiled and bronzed female flesh so news pundits can opine on America's moral decline.

Family values conservatives are spinning the current chaos to pin the blame on sexual health education and to push for more abstinence-only programming, already a $1.5 billion social engineering boondoggle that mandates the expected sexual standard for children (up to 29 years old!) be within marriage. Never mind that most of us at some point explore our sexuality outside of marriage – even chastity champions like Sen. David Vitter (R-LA), a longtime patron of prostitutes. Never mind that real life proves that a wedding ring doesn't protect you from disease and despair, even if you're not a political wife. Never mind that the United States leads the free world in rates of HIV, other STDs, teen births and unwanted pregnancies — purity pushers don't want to send our kids any mixed messages. "Our challenge is that the government wants to talk about preventing the spread of STDs and HIV without talking about sex," says sexuality educator Deb Levine.

In our sex-saturated consumer culture, abstinence-only-unless-married is a mixed message. How can we talk about sex in a way that makes sense to us, and to our relationships? What is healthy sexuality? And how can we teach it in such a toxic environment of extremes?

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"We sell and promote sex with everything from soap to cars, but it's still for the most part a closeted discussion. It is most absent in a meaningful way in curricula geared toward our most vulnerable sexually active populations," says Lennie Green, who at John Hopkins University facilitates communication among groups of young African American men who have sex with men — a community the CDC reports to have experienced a spike in HIV infections.

"We seem to have this Sunday morning church mentality when we discuss sexuality, but when we review societal practices there's a major dichotomy in our rhetoric and what we actually do," says Green. "The weakest link has been ‘family values.' They strike out against subcultures they find amoral, and crusade to establish law and order in bed. Even in the face of disease we hang onto old archaic beliefs that sex will not happen until marriage. Our public health record has been trashing that theory for decades."

"The biggest challenge is to be open on the subject of sex," says Kylee Darcy, a freshman at UC Berkeley and winner of the Fresh Focus Sex Ed Video Contest. "In spite of all the sexy messages out there, communication about sex is still shrouded with taboo. It's pretty ridiculous to think that an abstinence program is going to be able to outweigh the hundreds of sexual suggestions I get everyday from TV, the Internet, magazines, billboards, music, fashion, etc. Sex is something everyone, whether they want to do it or not, needs to be clear about. And the only thing that can create clarity is communication."

Darcy's animated video, showcased in January at Sex::Tech: Focus on Youth, the first STD/HIV prevention conference focusing on youth and technology, illustrated pop culture's sexed-up messages crushing the scale against abstinence-only messages. "The abstinence-only program is not productive, but sex ed that just addresses the physical act of sex and contraception is also outdated," Darcy continues. "Yes, students need to know about contraception and disease, but sex ed should be as much about the interpersonal as the physical. Good sex ed can help create rapport between young people and their parents as well as young people and their partners."

If speaking honestly about sex in person can be daunting, then the "perceived anonymity" of technology and new media can free youth to ask questions they might find uncomfortable, says Deb Levine, founder and executive director of the Internet Sexuality Information Services (ISIS). "Our culture promotes shame and embarrassment about explicit discussions of sex, sexuality and sexual health," she says. "We interviewed young men and women to find out how they wanted to receive sensitive information, and mobile phones were unanimously considered to be an acceptable and private way to talk about sexual issues." So ISIS engages in strategic collaborations to promote sexual health via cell phone, PDAs and the Internet.

"Overall, when people are asking about communication-building skills, they're wanting to know how to talk about sex without shame, how to talk to partners candidly without stepping too hard on insecurities or sensitivities, how to feel assertive in talking about it all," says Heather Corrina, founder and editor of Scarleteen.com, an independent online sexuality education resource and community for young adults that takes a feminist, inclusive and often humorous approach to answering sensitive questions. "For the girls particularly, lack of assertiveness is always a big area of need, and not just with birth control, but overall with negotiating sex and relationships. A lot of what would help is for adults to not just prepare kids to say ‘yes' or ‘no,' but prepare them for the fact that all of this communication and negotiation tends to be a lot less black and white than that, and a lot more nuanced," says Corrina, a passionate workhorse who runs Scarleteen — which serves up to 30,000 users a day — solely on donations.

Approximately a third of the content in the model sexuality education guidelines by the Sexuality Information and Education Council of the United States focuses on relationship and communication skills, says Monica Rodriguez, SIECUS's Vice President for Education and Training. "The ultimate goal of sexuality education programs is to help young people grow up to be sexually healthy adults. We need to move beyond just giving information — young people need to be given opportunities to practice skills in decision-making and communicating decisions to a partner," she says.

Fueling the myth that sexual health education causes promiscuity is blood sport in traditionalists' sex-driven culture war. "In our abstinence-only world today, people sometimes confuse providing sexual education with promoting sexual activity for young people," says Deb Levine. Debra Hauser, executive vice president for Advocates for Youth, agrees. "Even enlightened educators fear that parents and administrators will react negatively to a curriculum that promotes healthy sexuality — that the perception will be that they are condoning or promoting sex," says Hauser, whose group lobbies for the stalled REAL Act to provide unprecedented funding for sex ed that goes beyond today's disease-prevention model. "The perception of many is that [sex ed] needs a heavy-handed message that teaches sex is likely to lead to negative outcomes. Thirty years of public health research shows that teaching young people about healthy sexuality does not promote sex." And since talking sex beyond bananas and virginity pledges is essential to facilitating healthy identities and relationships, sexuality educators and advocacy organizations like SIECUS make easy targets. To show that sex ed undermines parents and corrupts childhood innocence, culture warriors cherry-pick from sexual health programs to find scary words like "masturbation" and "pleasure."

"I am always interested in the way teachers are so afraid of discussing anything that might be pleasurable," says sex educator McCaffree. "Youth will want to know why people even have sex if there is no pleasure. They are very concrete early on, and it doesn't make sense to approach with all the negatives. Helping them see why and how people enjoy their sexuality is important…When a program only deals with teen pregnancy, STIs, rape and those topics, pleasure is replaced with fear-based negatives." McCaffree cites the United Church of Christ/Unitarian Universalist sex ed curriculum, Our Whole Lives, as a program that understands the importance of teaching about pleasure and the diverse reasons why individuals and couples are sexual. Rather than pretending our sex-soaked society doesn't affect young people, "Our Whole Lives is the antidote to an overly sexualized society," says Ann Hanson, Minister for Sexuality Education and Justice, UCC. OWL's "program assumptions" include the tenets that "sexuality includes more than sexual behavior" and "people engage in healthy sexual behavior for a variety of reason, including to express love, to experience intimacy and connection with another, to share pleasure, to bring new life into the world, and to experience fun and relaxation." "OWL doesn't focus only on the negatives of sex, but encourages exploration of all aspects of sexuality," says McCaffree. "When you include everything, pleasure can be more readily seen."

Such modern ambiguity conjures apocalyptic nightmares for the moral absolutists who distort the sexual health conversation we need to lead responsible, joyful lives. Talking about sex and sexuality doesn't do anything to young people's "innocence," McCaffree reminds us. "What makes any aspect of sex or sexuality so awful that innocence is removed?" Indeed, courageous souls are working against the tide of America's sexual schizophrenia to help young people communicate openly about their sexual wants and needs. But can we really talk grownup sex today amid the culture warmongering and commercial chatter of the next media sex scandal?

A Turning Point in the Fight Against HIV/AIDS

William Smith

William Smith is Vice President for Public Policy at the Sexuality Information and Education Council of the United States.

For advocates of evidence-based prevention, the International AIDS Conference in Toronto is likely to be remembered as a turning point in our efforts to eradicate HIV/AIDS. From the high-profile attention given to efforts such as microbicides, pre-exposure prophylaxis, male circumcision and harm reduction, prevention has come back to the fore and taken a seat alongside care and treatment, restoring the necessary balance to the global effort. Perhaps most interesting however, has been the repudiation at this conference of the lop-sided prevention efforts that have been focused on abstinence and marriage promotion.

William Smith is Vice President for Public Policy at the Sexuality Information and Education Council of the United States.

For advocates of evidence-based prevention, the International AIDS Conference in Toronto is likely to be remembered as a turning point in our efforts to eradicate HIV/AIDS. From the high-profile attention given to efforts such as microbicides, pre-exposure prophylaxis, male circumcision and harm reduction, prevention has come back to the fore and taken a seat alongside care and treatment, restoring the necessary balance to the global effort. Perhaps most interesting however, has been the repudiation at this conference of the lop-sided prevention efforts that have been focused on abstinence and marriage promotion.

In part, the repudiation has been made easy because the usual promotional tour for these issues has yet to manifest itself in Toronto. In fact, for those of us in the U.S., the near total absence of our government here in Toronto is startling, considering the bill of goods on prevention that it was forcing on the world at the earlier Barcelona and Bangkok HIV/AIDS conferences. In fact, on Tuesday night at an event hosted by The Lancet, Mark Dybul, head of the Office of the Global AIDS Coordinator, told the audience that he believes the focus of prevention is moving toward a firm foundation in evidence. Really.

That is encouraging news from the world's largest donor, but experience suggests a "wait and see" approach. However, if we had followed a public health approach based on sound evidence, instead of letting ideology lead us astray, PEPFAR's promise would have been even more fully realized. In the United States, we have had a quarter-century of experience (and more than $1 billion spent) that has shown us that abstinence-only-until-marriage programs are not sufficient and in fact, if young people are left to dwell in a vacuum without more comprehensive information, they make poorer decisions about protecting their health. As a result, Ambassador Dybul saying we are moving toward evidence seems to assume that the evidence wasn't there at the outset of PEPFAR. This simply isn't true. It was there, but it was jettisoned in some cases and twisted in others to justify a pre-determined approach that public health had already deemed a failure in our own country.

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Some epidemiologists whom I respect immensely have come to regard abstinence and marriage promotion as "overhead" for getting PEPFAR's money where it is needed. That is the wrong diagnosis and all evidence from the US and countries where PEPFAR's more harmful policies are taking hold indicate that it isn't "overhead" – it is a Trojan horse with ominous and long-term implications for undoing the entire framework of preventing the sexual transmission of HIV, including supportive public policies.

Reauthorization of PEPFAR is on the horizon and if the United States continues to believe that it can better distribute funding than coordinated, multi-lateral efforts like the Global Fund, its glaringly obvious problems must be stripped – beginning with the abstinence-until-marriage earmark and the prostitution pledge. Countries need maximum flexibility in crafting and implementing efforts to meet the varied needs of the epidemics in their countries and waivers from silly, ideological hurdles are a cop-out from fessing up to flawed policies.

Enormous work remains to undo the damage that has been done and move forward. Yet, if Toronto is a turning point on this issue, it is because at home and abroad, advocates have sided with evidence – and bolstered their advocacy with a human rights framework and a desire for gender equity – that has restored evidence – not ideology – as the primary guide for prevention.