At 25, the AIDS epidemic has seen only mediocre progress.But it does have an expensive bureaucracy, a thriving ‘gay’lobby and a war on abstinence
• How effective are current strategies in the U.S?
• Our teens: caught in a war against abstinence
• A close look at the battleground state of Ohio
• What’s with all the “unknown” HIV cases?
• Youth, HIV and corruption
Any teen today looking for a sure-fire career path, where the jobs will be plentiful and the accountability small, should consider becoming an HIV prevention educator. The U.S. HIV/AIDS bureaucratic monster, like the disease, continues to grow and thrive, extending its greedy tentacles into countless nooks and crannies of social services, health care, education, research, and politics.
The AIDS epidemic just turned twenty-five years old, yet refuses to grow up and has moved home to stay. So tolerant is our approach, in fact, that the Centers for Disease Control (CDC) is poised to recommend that HIV tests become a part of “routine” care for Americans even as young as 13, and the FDA, at the request of the American Red Cross and other groups, may soon drop the ban on blood from men who have sex with men. Should we first, perhaps, ask a few tough questions about how this epidemic is unfolding?
Where’s the genuine progress being made? Do we know—and are we willing to admit-- where the real risks are? Or are the hard truths submerged under the power of radical special interests? And, can we truly afford to let taxpayer dollars fund the death of long-standing and effective societal norms?
Perhaps a new measure of our country’s economic health might be to estimate its “GED” – gross epidemic dollars. How much are taxpayers shelling out, and for what results?
Let’s look at some numbers. In 1989, there were over 43,000 new cases of AIDS diagnosed, and 28,000 deaths. In 1993, at the peak of the disease, there were nearly 80,000 cases of AIDS diagnosed during the year, and nearly 46,000 deaths.
In 1995, the numbers began to decline, with 70,000 new cases diagnosed and over 51,000 AIDS deaths.1 Total U.S. government spending that year on the epidemic was $6.8 billion.2 There was a “bubble” in the numbers during the years 1990-97, due in part to the CDC’s expansion of the case definition of AIDS, resulting in a sharp spike in the data on new AIDS cases, which then evened out again. So tracking the real epidemic with consistent parameters has been difficult. To further muddy the waters, when looking at numbers from 1998 to the present, the CDC cautions that these are only “estimates.” 3
New AIDS cases in the U.S. now hover at almost 43,000 a year, about where they were in 1989; new cases of HIV are near 39,000.4 For 2007, the President has requested $18.9 billion in spending on domestic HIV/AIDS programs. Most of this goes toward care and treatment of persons with AIDS; nearly $1 billion is slated for HIV prevention.5 This does not take into account the millions on top of this allocated for HIV/AIDS by state governments and private funding, nor does this include any of the global AIDS programs funded by the U.S.
Over half a million people in our country have died of AIDS, and although recent new cases are lower than at the peak of the disease, annual new cases started rising again in 2001.6 While there are now promising drug treatments to prolong the lives of AIDS patients, we do not at all have a handle on this disease, despite enormous, ever-rising expenditures. Some observers, like the editors of the Wall Street Journal in a recent article,7 see great progress when looking back at the mid-1980’s (150,000 new infections a year compared to now). But such optimism assumes consistencies that have simply not existed.
One recent move by the CDC holds great promise for providing more accurate information about the epidemic. Unbeknownst to most Americans, some of the cities and states with the highest-density populations of homosexuals have not been reporting reliable HIV and AIDS data to the federal government. In fact, as of the end of 2004, the statistics on HIV and AIDS published by the CDC only accounted for an estimated 61% of the epidemic.8 For some reason, states like California, Illinois, Massachusetts, Pennsylvania, the District of Columbia, Oregon and Washington (among others) have been conducting primarily anonymous HIV testing, which is too unreliable to be included in serious trend reports.9
The CDC is now requiring that in order for states to receive federal funding, they must implement a reporting system that can be confidential but must include some client identifying mechanism. Threatened with loss of funding, many of the previously uncooperative states have seen the light and are implementing these procedures.
The AIDS death rate has slowed mostly due to new drug treatments introduced in the mid-1990’s. A fairly sizeable chunk of the federal AIDS budget goes toward ADAP, the AIDS Drug Assistance Program, which makes costly drug treatments available to those with limited incomes. Still, high numbers of new people join the epidemic each year, lining up for expensive drugs and years of treatment. The drug therapies cost between $10,000 and $20,000 per patient per year.10
AIDS’ activists exert constant pressure to keep budgets high and accountability minimal. At the same time, they demand sexual freedom especially for male homosexuals, thus ensuring new infections will occur. Their strident voices and aggressive tactics include vilifying ideological opponents, which helps deflect evaluation from their own effectiveness.
How to Avoid Abstinence: Let Us Count the Ways
Last year the President’s Advisory Council on HIV and AIDS (PACHA) issued a report called “Achieving an HIV-Free Generation.” Its first two findings were, “We cannot treat our way out of this epidemic,” and “HIV is a totally preventable disease.”11 Yet the report went on to equivocate about prevention. Abstinence? Not entirely. “Safer sex” via condoms and clean needles for drug addicts were also recommended. Inconclusively, the report in the end recognized all approaches, which makes no sense because some go in opposite directions.
This seems to be a change. Back in 2004, this Commission called on the president to implement the “ABC” approach for a U.S. education campaign. The “ABC” method, applied with success in Uganda, significantly reduced HIV rates in that country. It emphasizes first, abstinence; then, being faithful to one partner, ideally in marriage; and as a last resort, using condoms. 12 The Ugandan approach was not included, however, in the 2005 PACHA report. It has not been adopted by the Centers for Disease Control, and is not currently used as the principal approach of state health departments. It is, however, the cornerstone of the President’s campaign against AIDS in Africa, to the outrage of many AIDS activists.13
Their rage doesn’t end there. Some within AIDS organizations have joined with the Planned Parenthood/sex education cartel to proactively attack U.S. abstinence programs, accusing them of disseminating “fear” and “shame,” “misinformation” as well as being a waste of money. “Abstinence doesn’t work,” is the battle cry. They dismiss the Ugandan success, saying that condom use was responsible for the success, even though that success has not been duplicated in other African countries with predominantly condom- based methodology.
The First Lady of Uganda, Janet Museveni, spearheaded that country’s abstinence effort, which reduced HIV transmission rates from 15% to 5-7%. She explicitly discourages condoms and encourages abstinence. She speaks to students and advises them to ignore those who push condoms because such groups are primarily interested in profit.14
The First Lady of Kenya, Lucy Kibaki, is also advocating abstinence. In addressing students in Kenya in May 2006, she not only urged girls to be abstinent, but she blamed condom use for the spread of AIDS in her country by encouraging early sexual behavior. Her position has outraged global “safer sex” advocates who have a lot invested in continuing the condom-centered approach.15
The ACLU has called abstinence- until- marriage programs for students “dangerous” and has decried the $206 million federal dollars spent per year on such programs. The group is incensed that some efforts, like a Pennsylvania-based program called “The Silver Ring Thing,” have a Christian message, which the ACLU maintains is inappropriate for the public schools.16 The program is actually structured around an opening rally for students with an abstinence message, music and motivational speakers. Then at the conclusion of the program, students are offered the choice to remain to hear a separate Christian message.17 The ACLU filed a lawsuit against the program with success; in 2005, the program lost some of its federal funding, pending alterations in its approach. The Alliance Defense Fund, defending the group, says that its Christian teaching is “separate in time and place from what the government is funding.”18
SIECUS, the Sex Information and Education Council of the U.S., is especially incensed over too much focus on abstinence. The group claims that while they do believe in abstinence, they do not advocate teaching only about abstinence, because there are no scientific studies (they claim) showing abstinence works.19 The track record is dismal, however, for the mixed messages of their recommended method, so-called “comprehensive” sex ed, which mentions abstinence but concentrates on contraceptives.
And in one of many such intimidation tactics, SIECUS and AIDS’ activists have gotten Rep. Henry Waxman (D-CA) to ask the GAO to investigate National Abstinence Clearinghouse, claiming bias, conflicts of interest, etc., as if they are shocked, shocked, at the very idea. 20 This from the folks who reference studies from the Alan Guttmacher Institute as if they were objective, when AGI was founded by Planned Parenthood and remains a “special affiliate” of the organization.21 Or who quote research from “experts” like Douglas Kirby, who under the guise of science usually finds that pro-condom curricula he developed and markets through ETR Associates (Reducing the Risk and Safer Choices ) are the most effective.22 And who knows what conflicts we would find if we traced the money flowing out of the condom manufacturing industry, truckloads of which are purchased each year by pro-condom groups, using taxpayer dollars?
This isn’t the first investigation Waxman has initiated targeting abstinence educators. At his behest, the minority staff of the Committee on Government Reform of the U.S. House published a report in 2004 dissecting some of the major abstinence-until-marriage curricula in use. The report found (surprise) that there’s little evidence that abstinence programs work. Yet the researcher they refer to is again the omnipresent Douglas Kirby, whose conflict of interest in authoring and marketing condom-based curricula is not disclosed. The report also quotes SIECUS and Advocates for Youth, both pro-abortion/ pro-homosexuality advocacy groups. The report describes supposedly “unscientific” positions taken in abstinence curricula, such as, “Life begins at conception,” or quoting research that condoms fail 14% of the time in real life use. 23 Condom-devotees, quick to tutor our youngest children in the realities of X-rated sex, shudder in horror at revealing how people actually use (or fail to use) condoms. It would seem better perhaps if people had sex in laboratories.
Yet in an irony of ironies, this report itself contains one of the wildest, most unscientific claims we’ve read in recent years. On page 18,in bemoaning that most abstinence curricula don’t urge girls to have routine Pap smears, the report states, “A critical fact for girls and women to know about cervical cancer is that routine Pap smears can prevent most occurrences of the disease.” An examination can prevent cervical cancer? I think the authors may have meant “detect” or possibly in some cases “treat,” but certainly not prevent. This is an astonishing medical breakthrough. Maybe mammograms can prevent breast cancer also. Or, STD testing can prevent STDs. Perhaps there’s a new definition in medical circles now of the term “prevent,” using much the same logic as those who blame “abstinence” as the cause of some pregnancies or STDs, when people decide to not abstain.
The unceasing war against abstinence is also fought within some sectors of the CDC. The Centers for Disease Control historically tilts heavily toward the condom approach and away from abstinence. A recent CDC conference on sexually transmitted diseases in Florida had not scheduled a single speaker on abstinence education, until Rep. Mark Souder (R-IN) complained. Through his efforts, one(1) panel speaker advocating abstinence was allowed at the Jacksonville meeting. The problem, according to Washington insiders, is the liberal CDC staff who routinely ignore the HHS guidelines for such conferences.24
Yet the Ugandan approach remains as Exhibit A of the success of abstinence, compared to the mixed messages across the U.S. The sharp decline in teen pregnancy rates in the U.S since 1990 (down one third between 1991 and 2004 25 ) can really only be attributed to abstinence education, which has been the only new approach taken following two decades of failed contraceptive education programs.
There are also the lessons of history. Of course abstinence works, which is precisely why lip service is given to it even by those, like SIECUS, Planned Parenthood, and AIDS activists, who ultimately undermine, even sabotage its teaching. There’s apparently much invested by some, both monetarily and ideologically, in not encouraging abstinence. How long are taxpayers going to remain patient?
The Latex Barrier to Sanity
Here’s how the thinking goes. Abstinence doesn’t work because teens will inevitably be sexually active. Since teens are guaranteed to fail, the best we can hope for is that they delay and /or “manage” this activity. In fact, teen sex isn’t really all that bad—and may even be good—if they are “ready for it,” and if they use condoms consistently and correctly every time. And of course, the reality of teens or any humans doing this consistently is remote. Those who are most likely to be drawn to sex for pleasure regardless of the risk are also those least likely to sustain condom use once they discover condoms interfere with the sexual experience. Applying such clinical precision is just not going to happen consistently among those who are most at-risk. Also, the known element of alcohol use as a co-factor in out-of-wedlock sex further reduces the likelihood of this ideal usage.
Condoms are a tool of promiscuity, not an ongoing reliable birth control/STD prevention method. So encouraging condom use enables and encourages promiscuity, while simultaneously failing to protect anyone adequately from all the risks. It’s almost as if, almost as if—it’s a set- up for failure.
And fail they do. The National Center on Teen Pregnancy reports that, among sexually active teen girls, almost one-third have gotten pregnant.26 Who knows how many of these were using condoms? Initiating sexual activity has very serious consequences, because even when contraceptives are used, they fail a lot of the time. Accompanying the unwanted pregnancies are often STDs.
Wait—who would want that to happen? Those who profit from the undesirable outcomes of sexual activity, perhaps, all the while labeling it “safety”? Those who have something to gain from HIV and STD counseling and testing, and contraception sales and abortions? We can follow the money, and also follow the sex. Who stands to benefit after teens initiate sexual activity, having been taught this can be done “responsibly,” but when the condom is put away once or twice, or breaks?
There’s another whole dimension to this debate, centered around the issue of homosexuality. As abstinence educators address classrooms in America, inevitably some students will be considering or already involved in homosexual behaviors. The pro-homosexual and pro-condom devotees accuse the abstinence programs of being “discriminatory” because they dwell on heterosexuality, they discourage all sexual activity prior to marriage, and when they refer to marriage, they mean the man/woman model and no other.
This infuriates Planned Parenthood, SIECUS, Advocates for Youth, and some AIDS/HIV groups. One wonders if the recent anti-abstinence lawsuits, harassment/intimidation tactics, and media campaigns aren’t part of the overall strategy to legalize same sex marriage. Anyplace where the libertine lobby can label traditional sexual morality as “discrimination” is useful to this effort. It wouldn’t be the first time school-age children have been used as guinea pigs for left-wing experiments. The current flood of pro-homosexual “tolerance” lessons and propagandized “anti-bullying” programs are creating in the upcoming generation a growing acceptance of homosexuality and suspicion of tradition, based mostly on misinformation.
It’s time to ask some hard and pointed questions. How dare public health professionals, who know the reality of the current STD epidemic, deliberately steer away from abstinence messages, particularly in relation to our youth? Who says abstinence isn’t possible? Deliberately not providing full disclosure of risks to all citizens, but especially to youth, is shocking, disheartening, and unscientific. Do we apply this to other public health risks, such as smoking and drugs? Generally, no. Discussions of sex bring strangely different standards to the table. Why?
There is nothing lost if teens delay having sex and an awful lot gained, including educational opportunity, maturity and good health. What can possibly be wrong with that? Can’t we agree that we don’t want them to get STDs, pregnant outside marriage, or emotionally devastated? And, do we ever want to accommodate or encourage male-to-male sex, given the risks?
If what we want are long, healthy lives for ourselves, our children and our families, we need to address the ineffectiveness of the current programs; to re-visit the validity of the underlying assumptions, and to ask where such assumptions take us. It’s one thing to be ineffective and waste billions of tax dollars; it’s yet another matter to simultaneously unleash new, long-term health and social problems.
Coming Next--Part 2:
- A close-up of one state—Ohio
- What’s with all the ‘unknown’ cases?
- Youth and corruption
- The future: some ideas
Notes:
- http://www.avert.org/usastaty.htm
- “Spending on the HIV/AIDS Epidemic,” The Henry J. Kaiser Family Foundation ,July 2002, http://hiv.buffalo.edu/pdf/US_Trends_July_2002.pdf
- http://www.avert.org/usastaty.htm
- http://www.avert.org/statsum.htm
- http://www.kff.org/hivaids/upload/7029-03.pdf
- http://www.avert.org/statsum.htm
- “Learning From our Mistakes,” Wall Street Journal, Friday, June 9, 2006, p.W13.
- http://www.avert.org/usastats.htm
- Ibid.
- Presidential Advisory Council on HIV/AIDS, “Achieving an HIV-Free Generation,” released December 2005, p. 20. Available at http://www.pacha.gov/pdf/PACHArev113005.pdf
- PACHA report, page 16.
- PACHA Calls on White House to Consider Implementing ‘ABC’ HIV Prevention Method in United States,” April 6, 2004. http://www.thebody.com/kaiser/2004/apr6_04/pacha_prevention.html
- http://www.lifesite.net/ldn/2005/oct/05101404.html
- http://www.lifesite.net/ldn/2004/jan/04011205.html
- http://www.lifesite.net/ldn/2006/may/06052307.html
- http://www.aclu.org/reproductiverights/gen/12602prs20050516.html
- http://www.eagletribune.com/news/stories/20040322/LI_002.htm
- http://www.washingtonpost.com/wp-dyn/content/article/2005/08/22/AR2005082201230.html
- http://www.siecus.org/reviews.html
- http://www.usnews.com/usnews/news/articles/051008/8waxman.htm
- http://www.guttmacher.org/about/history.html
- http://www.family.org/cforum/fosi/abstinence/ppi/a0028363.cfm
- http://www.democrats.reform.house.gov/Documents/20041201102153-50247.pdf
- Citizen Link, Focus on the Family article “CDC Conference Snubs Abstinence,” May 9, 2006.
- http://www.teenpregnancy.org/press/pdf/Q&A_Science_Says_23.pdf
- Science Says 23 Fast Facts
