Bay Area Reporter - September 29, 2005
Zak Szymanski, z.szymanski@ebar.com

Others, like San Francisco's Stop AIDS Project, have succeeded without compromise, employing constantly changing prevention messages to reflect current trends, combined with an unchanging commitment to community-driven health promotion. Throughout its own two decades of often-controversial marketing and prevention campaigns, the members of Stop AIDS don't just educate, said the group's communications director Jason Riggs, "they help change behavior, create personal commitments to safer sex, build community support, and live the compelling fact that HIV transmission can be prevented."

In honor of the organization's 20th anniversary, and in recognition of its tireless volunteers and staff, Stop AIDS will host a free exhibition, awards ceremony, and cocktail reception tonight (Thursday, September 29), from 6 to 9 p.m. on the second floor of Citibank, 444 Castro Street.

Hundreds of people are expected to attend the event, which includes the opening of a new exhibition detailing the organization's history with a collection of photographs, media materials, and multiple personal collections. The exhibit runs through November 4 in the space donated by the bank, and offers a way for people to have the often-difficult conversations about what the community has endured throughout the epidemic, according to Stop AIDS Executive Director Robert McMullin.

"What's missing from a lot of HIV/AIDS work is the history of what's happened with HIV and the people from 20 and 25 years ago talking about their experience. A lot of people don't want to have that conversation. This show allows that conversation to happen in a way that is not too personal or painful," said McMullin, who added that tonight's cocktail reception also marks the organization's decision to move the annual awards ceremony to a non-fundraiser setting and allow such honors to be "without subtext, and just about honoring people."

This year's HIV Prevention Awards recipients were selected to reflect their long-term commitments and leadership in the fight against HIV/AIDS, and honorees include Les Pappas, Steven Abbott, Donna Sachet, James Hormel, and Wells Fargo. Stop AIDS "has this heritage of being a part of the community," said McMullin, and tonight's event "gives us a moment to say thank you, and also, to get together as a community and remember what all of it meant."

It has been a long and not always smooth ride for the organization that has built its reputation on providing cutting-edge, sexually explicit prevention messages that are often uncomfortable for people to hear. Stop AIDS is responsible for a lot of first-ever and earliest efforts, including HIV prevention television ads that specifically mentioned the word "gay," campaigns that centered around crystal meth use, and prevention that specifically targeted populations such as men of color, younger men, older men, and female-to-male transsexual men. Its messages and events have sparked community controversy - from its first "Geezer Ball" for mature gay and bi men to its "HIV is No Picnic" campaign, which featured graphic descriptions of the side effects of AIDS drugs to illustrate that while the infection may now be manageable, it is far from desirable.

Feds step in

But its biggest critic has been the federal government, or more precisely, conservative members of government that eventually prompted federal investigations of publicly funded Stop AIDS programming.

The 1990s emergence of the sometimes-celebrated practice of "barebacking" - a new term for the old concept of engaging in unprotected sex - combined with a rise in HIV infection rates led many organizations to approach prevention from a nonjudgmental harm reduction model that emphasized having hot, safer sex with or without condoms in a variety of scenarios based upon individual risk. Between 2001 and 2004, Stop AIDS fell under intense scrutiny by conservative members of Congress who said the organization's materials were "obscene" and promoted "sex or sexuality." Each repetitive audit or investigation, according to Riggs, affirmed that the organization was using current and effective messages and operated with a "gold standard" in terms of financial accounting procedures.

Nevertheless, federal harassment of the group continued, and was "part of a larger campaign designed to defund and intimidate organizations and researchers doing HIV prevention with gay and bisexual men," the group maintained. Simultaneously, millions of dollars were channeled into faith-based and abstinence-only programs. In May 2004, Stop AIDS was informed that although it qualified for federal funding, there was not enough money for the group to receive a grant. This ended more than 10 years of continuous federal funding for Stop AIDS, but in some ways the cuts meant the organization now has more freedom to do the kind of work it feels is necessary.

"In the face of repeated investigations Stop AIDS never modified its programming because we knew what we were doing was working, and we continued to do those things without federal funding," said Riggs, explaining that the group has been securing alternate forms of funding all along, now surviving on a mix of city funds, foundation grants, and private donations. "The nice thing right now is we're free of the harassment and we don't have to constantly defend ourselves against conservative activists or prove that what we're doing is working."

Payoff

The payoff for such commitment is in the numbers themselves: this summer the San Francisco Department of Public Health acknowledged that the city is seeing its first signs of decline in HIV rates, with new infections since 2000 dipping from 900 to 748 per year, and the prevalence rate dropping from 1 in 3 men who have sex with men to 1 in 4. Health officials credited the decline to campaigns that allowed community members to define their own sexual norms and that were not afraid to address trends like barebacking, crystal meth use, and practices such as serosorting, where HIV-positive men have unprotected sex with other HIV-positive men, a trend identified by the Stop AIDS Prevention for Positives program.

Looking to the future, Stop AIDS finds itself once again involved in community conversations that aren't always popular. The alleged racism charges at the Badlands bar, for instance, bring up issues that - without necessarily assuming guilt or assigning blame - need to be given proper and prominent placement in community discussions, said McMullin. So too, do issues of isolation that are faced by many gay community members who come to San Francisco looking for family and are sometimes disappointed by the lack of support.

"We are working with different groups trying to address some of the underlying causes of issues that ultimately become health issues," said McMullin. "Isolation, depression, and substance abuse are all things that can be traced to an individuals' sense of not belonging. That doesn't mean it's the fault of the gay community, but we can address how we create a sense of community and whether we can do a better job taking care of each other. On one level, that's what Stop AIDS has been about since the beginning."

Additionally, in another groundbreaking approach to HIV prevention, Stop AIDS is now looking at risk and behavior through the anthropological lens of "sexual networking," with less of a focus on individual risk factors and more emphasis on "where and with who STDs are moving through a network," said Riggs.

Stop AIDS will be studying the "web of connection between men" as it occurs in gym, leather, nightclub, and Internet scenes, in public commercial sex venues, and in African American communities, "to identity those places where we see STD transmission moving efficiently," said Riggs. "Some forms of partnering networks are less efficient, and some are more efficient at transmitting STDs, which explains why HIV rates can differ vastly among populations that report the same risk behavior."

Interventions, said Riggs, can include modifying the environment in which higher risk activity is taking place, and informing men about the risk levels of their own networks. Gay men often engage in harm reduction practices, deciding to have higher risk activity in certain networks, said Riggs, but such decisions may be based upon false perceptions of those networks. Results of the research will be released within the coming months.

Stop AIDS is also gearing up for its annual casino fundraiser, to be held this year on October 28, and is active in the city's crystal meth task force and other community partnerships.

"The minute we suggest we want to do something healthy and redeeming for the whole community, there is eagerness from the mayor's office, DPH, Supervisor Bevan Dufty, Assemblyman Mark Leno, and a number of local agencies," said McMullin, adding that while tonight's event is not a celebration of the need for Stop AIDS, it is a celebration of its people. "There are people on my board who have been with this agency since the beginning and their perspective is just as fresh and alive as it was the first day they got here. It's such an incredible privilege to work with everyone, and to be able to do something that actually matters."

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