KAISER DAILY HIV/AIDS REPORT
A service of kaisernetwork.org
http://www.kaisernetwork.org/dailyreports/hiv
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Monday, May 5, 2003

POLITICS AND POLICY
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1. Washington Post Profiles Abstinence Sex Education Advocate, HHS Deputy
Secretary Allen Who Is Federal Judicial Nominee


ACROSS THE NATION
========================================
2. San Francisco Chronicle Examines 'Dual Epidemic' of Crystal Meth Use,
HIV Infection

3. San Antonio, Texas, Group Aims To Start Not-For-Profit Needle-Exchange
Program


GLOBAL CHALLENGES
========================================
4. Baltimore Sun Compares China's Responses to SARS, HIV/AIDS


OPINION
========================================
5. Kaiser Daily HIV/AIDS Report Summarizes Opinion on House Passage of
Global AIDS Bill

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POLITICS AND POLICY

1. Washington Post Profiles Abstinence Sex Education Advocate, HHS Deputy
Secretary Allen Who Is Federal Judicial Nominee

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17524

The Washington Post today profiles HHS Deputy Secretary Claude Allen, who
has been criticized by comprehensive sex education advocates for his
support of abstinence-only sex education and who last week was nominated to
the 4th U.S. Circuit Court of Appeals. As HHS deputy secretary, Allen has
supported doubling federal funding for abstinence-only education and has
said that encouraging teenagers to abstain from sexual intercourse until
marriage is the best way to prevent pregnancy, HIV/AIDS and other sexually
transmitted diseases. He has since become a "prime target" for sex
education advocates who say that his promotion of abstinence-only education
has harmed sex education programs that teach safe sex, according to the
Post (Shear, Washington Post, 5/5). The complete article is available
online.


ACROSS THE NATION

2. San Francisco Chronicle Examines 'Dual Epidemic' of Crystal Meth Use,
HIV Infection

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17525

Crystal methamphetamine use among gay and bisexual men has "reached
epidemic proportions," and health officials have linked the increased use
of the drug -- a powerful form of speed -- with an increase in the number
of HIV/AIDS cases among men who have sex with men, the San Francisco
Chronicle reports in the first part of a three-part series on the drug,
which is also known as crystal meth, chrissy, tina, tweak and crank. At a
recent meeting in Sacramento, Calif., about crystal meth use, HIV/AIDS
prevention officials said that gay men in the state who use the drug are
twice as likely to be HIV-positive than gay men who do not use the drug.
In addition, a California study found that of 63,098 gay and bisexual men
tested for HIV at public clinics in 2001 and 2002, 7.1% who used crystal
meth were HIV-positive, compared with 3.7% of gay and bisexual men who did
not use the drug. Researchers also found condom use rates among gay men
who use the drug are lower than among men who do not use crystal meth.

Reaction


Dr. Jeffrey Klausner, San Francisco Department of Public Health's director
of sexually transmitted disease prevention and control, said, "We have all
sorts of levels of evidence [on HIV/AIDS and crystal meth use], and it's
all pointing in the same direction: The crystal meth epidemic is playing an
important role in increasing sexual risk behaviors and that is leading to
new HIV and STD infections." Dr. Grant Colfax, director of HIV prevention
studies for the San Francisco health department, is calling for a "full
array" of programs, including treatment, counseling and prevention, to be
"tailor-made" for crystal meth users who "fall below the drug-dependency
radar." He also said, "We're trying to de-link substance abuse from risk
behavior, to get guys to be safer while using substances. People use
[crystal meth], and they're not able to assess their risk behavior." San
Francisco officials are planning a televised hearing for Wednesday on
crystal meth use in the gay community, the Chronicle reports. City
Supervisor Bevan Dufty said, "I recognize people are going to make their
own choices. But we have a responsibility to make it an informed choice,"
adding, "As community leaders and friends, we have to speak loudly about
the clear and present danger of crystal meth." The second article in the
series -- published today -- offers a "portrait of a crystal meth addict,"
and tomorrow the series will conclude with the story of a Walnut Creek,
Calif., teenager's crystal meth use (Heredia, San Francisco Chronicle, 5/4).

3. San Antonio, Texas, Group Aims To Start Not-For-Profit Needle-Exchange
Program

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17526

A group of AIDS advocates in San Antonio, Texas, plan to form a
needle-exchange program designed to reduce HIV transmission among injection
drug users, the San Antonio Express News reports. The program, which
organizers are calling the Bexar Area Harm Reduction Program, would
distribute free, sterile syringes to injection drug users in exchange for
used syringes and would offer a variety of AIDS and drug use education and
counseling services. Needle-exchange programs have provoked controversy in
the past over concerns that they encourage drug use, so the group is
seeking to quell possible objections to the program by seeking the support
of local officials and churches and community-based groups in the area.
Bexar County currently has an estimated 9,000 drug users who account for
17% of the area's AIDS cases, according to the San Antonio Metropolitan
Health District's HIV Prevention Program. The group is currently applying
for not-for-profit status, analyzing costs and seeking charitable donations
for the program, Bill Day, spokesperson for the group, said, adding that
they hope the program will be operational by September (Barnes, San Antonio
Express News, 5/1).


GLOBAL CHALLENGES

4. Baltimore Sun Compares China's Responses to SARS, HIV/AIDS

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17527

Although the Chinese government has "virtually declared war on SARS, it
continues to do little about AIDS, after concealing the extent of its
spread for years," the Baltimore Sun reports. The country's government has
dedicated about $12 million to HIV/AIDS programs, which is approximately 5%
of the amount China has dedicated to treating SARS patients. Hu Jia, an
HIV/AIDS advocate with Aizhi Action Project, a Beijing-based
nongovernmental AIDS organization, said, "AIDS broke out in the very poor
areas, and people there have no power." SARS has predominantly affected
Beijing, Hong Kong and Guangdong province, "where the economies are the
most developed and are closely connected to the world," Hu added. SARS
"will embarrass the government if it spreads further," but AIDS patients
"are not as lucky," according to Hu (Epstein, Baltimore Sun, 5/4). The
full story is available online.


OPINION

5. Kaiser Daily HIV/AIDS Report Summarizes Opinion on House Passage of
Global AIDS Bill

Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17528

The House on Thursday approved 375-41 an international AIDS bill (HR 1298)
that would authorize $15 billion over five years to fight AIDS in Africa
and the Caribbean. The bill, sponsored by Rep. Henry Hyde (R-Ill.), would
authorize $3 billion a year for five years to international HIV/AIDS
programs, with up to $1 billion in fiscal year 2004 going to the Global
Fund to Fight AIDS, Tuberculosis and Malaria. Hyde's bill endorses the
"ABC" HIV prevention model -- abstinence, be faithful, use condoms -- which
has had success in lowering AIDS prevalence rates in Uganda. The bill also
allows international organizations that counsel about abortion to receive
U.S. funding on the condition that family planning and abortion programs be
financed and run separately. In addition, the bill would establish a new
federal task force to act as a shadow for the Global Fund as part of an
effort to allay fears among many Republicans that the fund is inefficient
(Kaiser Daily HIV/AIDS Report, 5/2). A summary of opinion pieces
responding to the bill's passage appear below:

Lawmakers


* Rep. Judy Biggert (R-Ill.): Biggert, who sponsored an approved
amendment that calls for the president to establish an outreach and
awareness campaign about the Global Fund, said, "Governments alone cannot
conquer this enemy [HIV/AIDS] -- there is so much more that individual
citizens and charitable foundations can and will do if we give them the
avenue, the information and the opportunity" (Biggert release, 5/1).

* Rep. Joseph Crowley (D-N.Y.): Crowley, who sponsored an amendment to the
bill that calls for educating men and boys about gender equality, said, "I
sincerely hope that through [this] education, women and girls will be
socially empowered. This is critical to reducing the spread of HIV
worldwide." He added, "AIDS has no borders or boundaries. It affects a
family in Uganda just as it affects a family in the Bronx" (Crowley
release, 5/1).

* Rep. Tom DeLay (R-Texas): House Majority Leader DeLay said that the
United States should support AIDS prevention methods that have been "proven
effective" -- including abstinence -- adding that some people "still accuse
abstinence proponents of being on a moral crusade. But this entire bill is
a moral crusade, not to impose our values on anyone, but to save a
continent from the Great Plague of our age" (DeLay release, 5/1).

* Rep. Dennis Hastert (R-Ill.): Speaker of the House Hastert said that the
bill is a "common-sense investment in the future." He said, "By helping
people of Africa deal with the AIDS crisis, we help them build a better
world for their children," adding, "As we help them, we build better good
will, which will lead to better relations between our nation and the
nations of Africa in the future" (Hastert release, 5/1).

* Rep. Betty McCollum (D-Minn.): McCollum, who sponsored an amendment
that would allocate a minimum of 10% of the bill's proposed funding for FY
2006 through FY 2008 to programs aimed at AIDS orphans and children
affected by HIV/AIDS, said, "America possesses the wealth, the knowledge
and the leadership to partner with the people of Africa to save lives"
(McCollum release, 5/1).

* Rep. Jim Moran (D-Va.): Although the bill does include "some
objectionable aspects," Moran said that it was a measure he "had to support
because of the greater good it would do in providing billions of dollars to
countries that are desperately trying to prevent the deaths of entire
generations due to AIDS, but lack the financial resources to implement
education and prevention programs." He added that the bill is a "good
first step in helping Africans battle the scourge of HIV and AIDS" (Moran
release, 5/1).

* Rep. Jim Nussle (R-Iowa): "The AIDS situation is truly an emergency,"
Nussle said, adding, "This legislation and appropriate funding will help
[medical professionals] make a difference" in the fight against the disease
(Nussle release, 5/1).

* Rep. Nancy Pelosi (D-Calif.): House Minority Leader Pelosi "strongly
supported" the bill but opposed an amendment sponsored by Rep. Joseph Pitts
(R-Pa.) that would specifically allocate one-third of the bill's HIV/AIDS
prevention funding to abstinence and monogamy programs. She said that the
bill "gives equal weight to a full range of options and relies on the best
scientific information." She added that the bill is not "anti-abstinence"
and "supports a balanced approach to HIV/AIDS prevention" (Pelosi release,
5/1).

* Rep. Joseph Pitts (R-Pa.): Pitts said that the bill "protects
faith-based groups, promotes abstinence, and demands accountability from
the Global Fund," adding, "The bottom line is it gets money to the
strategies that save lives" (Pitts release, 5/1).

* Rep. Bernie Sanders (I-Vt.): Sanders said that the bill is "an
important step forward, but much more needs to be done," adding, "The world
community must make it clear to the drug companies that in the midst of the
[HIV/AIDS] epidemic, life-saving drugs must be made available to all those
who need them." He said, "The issue here is not the profitability of the
drug companies. The issue is saving human lives" (Sanders release, 5/1).


Press Releases


* Advocates for Youth: Pitts' amendment to the global AIDS bill represents
an "unethical and dangerous" approach to HIV/AIDS prevention, Advocates for
Youth President James Wagoner said. "While I applaud Congress for
providing unprecedented funds for AIDS treatment and care to fight global
HIV/AIDS, this vote represents the triumph of ideology over public health
and the promotion of ignorance in the era of AIDS," Wagoner said, adding
that the Senate should overturn the amendment (Advocates for Youth release,
5/1).

* AIDS Healthcare Foundation: "At the heart of this bill is a mission to
bring two million people into antiretroviral treatment who would otherwise
die," César Portillo, AHF chief of public affairs, said, adding that the
bill will "ultimately save millions of lives." The foundation "echoes
President Bush's call on the Senate to swiftly pass similar legislation by
Memorial Day" (AHF release, 5/1).

* Center for Reproductive Rights: Some of the amendments approved as part
of the House bill "ti[e] the hands of the organizations on the frontlines
and should not be included in the Senate's version" of the bill, CRR
President Nancy Northup said. The amendments do not represent a compromise
but "an act that would undermine the work of the very groups most able to
prevent and treat this terible disease," she added. The bill should
demonstrate the United States' "understanding that this can only be done
effectively if doctors are allowed to provide comprehensive counseling,
preventive and treatment services" (CRR release, 5/2).

* Children's AIDS Fund: "With amendments to ensure the 'ABC' model is the
priority intervention for preventing HIV/AIDS, and faith-based
organizations able to fully participate without compromising the tenets of
their faith, the House has passed a Global AIDS Bill that truly works,"
Children's AIDS Fund founder and board member Shepherd Smith said. Smith
added that by "prioritizing prevention with a proven model of success
emphasizing abstinence we finally see hope in ultimately curtailing the
spread of this disease" (Children's AIDS Fund release, 5/1).

* Concerned Women for America: CWA "applauds" the passage of "lifesaving
amendments" to the global AIDS bill. Members of Congress "had a choice
between the Uganda model and the San Francisco model of AIDS prevention,"
Michael Schwarz, vice president for government relations for the group,
said, adding, "The House chose to send life, not death, to Africa" (CWA
release, 5/1).

* Elizabeth Glaser Pediatric AIDS Foundation: "Today was a critical next
towards implementing the president's vision and bringing unprecedented new
resources to this ever-growing pandemic," EGPAF CEO and President Kate
Carr, said, adding, "However, we maintain that a comprehensive approach
that includes condom distribution is the best way to help prevent the
spread of HIV." She continued, "We hope that barriers are not erected to
limit these proven methods" (EGPAF release, 5/1).

* Global Health Council: "This is a remarkable and historic day in the
fight against AIDS," GHC President and CEO Nils Daulaire said. It is now
the responsibility of the Senate to "act quickly and responsibly, and to
ensure that the final bill is a workable, scientifically based approach to
AIDS prevention, care and treatment," Daulaire said, adding, "[O]ur hope is
that congressional appropriators act just as expeditiously, so we can start
delivery of the vital services that we have been talking about" (GHC
release, 5/1).

* HIV Medicine Association: While pleased by the passage of the bill,
HIVMA is "concerned" with the passage of the Pitts amendment. Mandating
that a third of prevention funds be used for abstinence-until-marriage
programs is "not an appropriate public health strategy," Christine
Lubinski, executive director of HIVMA, said, adding, "It is not appropriate
for the U.S. Congress to decide how Eritrea, Haiti and other countries
develop and implement prevention programs to meet the needs of their
cultures." The group plans to work with advocacy organizations to ensure
that the measure is removed from the Senate version of the bill (HIVMA
release, 5/1).

* International Association of Physicians in AIDS Care: "It is encouraging
that this past year has seen so many positive steps toward adequate funding
of the global struggle against the AIDS epidemic," IAPAC Director of Global
Health Policy Scott Wolfe said, adding, "However, it is a shame that the
House was unable to succeed in passing this legislation without amendments
that will reduce its potential impact, if it is ultimately signed into law,
and if these funds are then actually appropriated" (IAPAC release, 5/2).

* NARAL Pro-Choice America: "Common sense and research show that a
multi-pronged approach to preventing AIDS and HIV, that includes both
abstinence and contraception, is necessary to combat the epidemic," Kate
Michelman, president of NARAL Pro-Choice America, said. The focus of the
Pitts amendment on abstinence "could adversely affect millions of the
world's poorest citizens," she added. Michelman concluded, "By indicating
a preference for abstinence, anti-choice politicians claim to know what is
the best policy for countries around the world, when really they should not
be micromanaging how other countries fight the HIV and AIDS epidemics"
(NARAL Pro-Choice America release, 5/1).

* Pangaea Global AIDS Foundation: The House on Thursday approved
amendments that will be "counterproductive to the global AIDS effort,"
according to a PGAF release. CEO and Chief Medical Officer Eric Goosby
said that the Senate "must now respond swiftly by introducing and moving a
similar measure, without the addition of these unnecessary and harmful
amendments" (PGAF release, 5/1).

* Physicians for Human Rights: "Funds for stand-alone programs deny best
public health practices by failing to recognize the value of condoms," PHR
U.S. Policy Director Holly Burkhalter said in regard to the Pitts
amendment, adding, "By diverting AIDS money to ineffective programs, money
will be wasted, and more importantly, lives will be lost." According to
PHR, it is "critical" that the Senate pass comprehensive AIDS legislation
and that Bush request supplemental appropriations to pay for the programs
contained within the bill (PHR release, 5/1).

* Planned Parenthood Federation of America: "While anti-choice members of
Congress waste months playing deadly and unconscionable political games to
appease their right-wing base, women's health and lives hang in the
balance," PPFA President Gloria Feldt said. Stopping the spread of HIV is
"too important" for Congress to succeed in "weaken[ing] the global AIDS
bill with anti-condom, abstinence-only measures," she concluded (PPFA
release, 5/1).

* Population Action International: "It's disheartening that a good bill
with good intentions became burdened by ideology," Sally Ethelston, vice
president of communications at PAI, said, adding, "What could have been a
giant leap forward in the battle against HIV/AIDS was instead marred by
amendments responding to political and not program needs." Congress should
"focus on the best interests of the people these bills are intended to
help" and pass legislation that "bring[s] down the barriers and build[s]
access to a full-range of life-saving services," Ethelston said (PAI
release, 5/1).

* Sexuality Information and Education Council of the U.S.: The Pitts
amendment and an amendment offered by Rep. Christopher Smith (R-N.J.) that
would strengthen "conscience" language already in the bill to ensure that
religious groups will receive funding even if they object to certain
aspects of prevention programs, including condom distribution, seek to
export "policies born of conservative ideology not public health," Tamara
Kreinin, president and CEO of SIECUS, said, adding, "In doing so, we are
censoring critical reproductive health information from the world's most
vulnerable populations." The amendments fail to recognize that "a broad
comprehensive approach that addresses multiple factors, including the use
of condoms" is the best mode of preventing the spread of HIV, Kreinin said
(SIECUS release, 5/1).


Editorials


* Akron Beacon Journal: Bush should "push harder for what he has called
America's moral duty" to fight the HIV/AIDS pandemic, because "[t]here is a
moral obligation to provide people all available help before it is too
late," an Akron Beacon Journal editorial says. The Journal continues that
the "urgency of the situation imparts its own morality: to provide swift
assistance to treat the suffering millions (which takes compassion) and to
stop the death march of HIV/AIDS across continents (which demands stark
realism)." The editorial concludes that the global AIDS bill "should not
be held hostage to ideology in the abstinence-only versus condom debate"
(Akron Beacon Journal, 5/5).

* Arizona Daily Star: Bush has shown "strong leadership" by supporting
"generous contributions" to HIV/AIDS prevention and treatment programs
throughout the world and by urging Congress to pass a bill that would
provide an "unprecedented amount of foreign aid," while easing "outrageous
obstacles his administration previously required of aid recipients," an
Arizona Daily Star editorial says. Bush is showing he understands that
"aid from the United States is vital in treating and preventing rampant
diseases ravaging entire continents," the editorial concludes (Arizona
Daily Star, 5/5).

* Baton Rouge Advocate: The House was "righ[t]" to pass the Hyde bill, but
it was "probably unwis[e]" of lawmakers to approve Pitts' abstinence
amendment, a Baton Rouge Advocate editorial says. The Advocate continues,
"There is certainly an important place for abstinence programs, but U.S.
aid agencies should not flinch from paying for condom distribution --
however controversial that is in some quarters -- if that is needed in
nations fighting double-digit rates of infection." The editorial calls for
senators to "look carefully at the Pitts amendment," adding that even if
the amendment makes it through this year -- and "is later found to be
unworkable in practice" -- it can be changed. The Advocate concludes that
while the "richest nation on Earth simply cannot stand aside" in the fight
against HIV/AIDS, the fight over the best way to address the epidemic is
"not going to be won in a year" (Baton Rouge Advocate, 5/5).

* New York Daily News: Bush's support for the House-passed global AIDS
bill shows that he is "willing to tick off his conservative base to do
what's right to end" the AIDS epidemic, according to a New York Daily News
editorial. The president's endorsement of the bill is significant because
supporting the measure means "accepting the use of condoms in fighting
AIDS" and "riling those conservatives who insist that abstinence is the
only way to combat the disease," the editorial says. Although
conservatives won a minor victory by approving an amendment that will
allocate one-third of the bill's prevention funds to abstinence programs,
that amount is "too much," the Daily News says. It would be "better to
increase" the amount allocated for medical treatment, or to provide
antiretroviral treatments, orphan care and funding for vaccine research,
the editorial concludes (New York Daily News, 5/4).

* Philadelphia Inquirer: Some of the amendments added to the global AIDS
bill demonstrate how "every government program that has anything to do with
sex [could] get entangled in the social conservatives' domestic agenda," a
Philadelphia Inquirer editorial states. In addition, when the bill heads
to the Senate, lawmakers could make a "deadly choice" to "put ideology
above effectiveness" by adding additional amendments restricting use of the
funds. The editorial continues that abstinence and fidelity should be
promoted, but "not at the expense of information" on safe sex, adding that
"[r]ealism must apply." The editorial concludes, "If the aim is to tame
this killer disease, domestic debates can't be allowed to undermine
effectiveness" (Philadelphia Inquirer, 5/3).

* Sacramento Bee: Although the Pitts amendment directs one-third of the
bill's prevention funds to abstinence programs, that amount is less than 7%
of the "total package" and should "not be a major obstacle" to the bill's
passage, a Sacramento Bee editorial states. Noting Bush's request that the
Senate pass the measure before Memorial Day, the editorial concludes,
"Given the ongoing devastation [of the HIV/AIDS epidemic], it can't be soon
enough" (Sacramento Bee, 5/4).

* Tennessean: Bush "deserves credit for rising above the political fray
and pushing for substantial funding" to fight global HIV/AIDS, according to
a Tennessean editorial. Some have said that Bush's initiative on the
disease has been a tactic aimed at procuring more votes for the 2004
election, but "even if it were a nod to political moderates, so be it," the
editorial continues, adding, "The assistance [contained in the House-passed
bill] will help countries that lack the resources to handle the job. It is
a worthy proposal regardless of what sort of motivations people suspect."
The Tennessean concludes, "The United States may not be able to offer a
cure, but it can offer assistance where it is desperately needed"
(Tennessean, 5/5).

Congressional Quarterly reporter Mary Agnes Carey recaps House action on
the global AIDS bill and discusses the bill's prospects in the Senate in
this week's "Health on the Hill from kaisernetwork.org and CQ," which is
available online.


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