Washington Blade - August 11, 2006
Ryan Lee

"We have committed more resources for HIV research than any other government in the world," said Tom Coates, director of the UCLA Program in Global Health. He cited as examples the President's Emergency Plan for AIDS Relief, first outlined in President Bush's 2003 State of the Union address, along with the billions of dollars in AIDS funding allocated to the U.S. Department of Health & Human Services.

"But then we get hung up on issues like promotion of abstinence-only education, or [needle exchange programs]," Coates said. "We get tripped on our own ideology, and our lack of knowing the evidence."

The Bush administration has already come under attack for again limiting the number of U.S. government scientists who can attend the XVI International AIDS Conference, which takes place Aug. 13-18 in Toronto. The biennial meeting brings together about 20,000 AIDS workers and is where some of the most important breakthroughs in the fight against AIDS have been announced, such as when anti-retroviral drugs were unveiled at the 1996 conference in Vancouver.

Travel restrictions implemented by the office of the U.S. Global AIDS Coordinator following the 2002 International AIDS Conference in Barcelona - at which former HHS Secretary Tommy Thompson was booed by critics who believed the U.S. contribution to the Global AIDS Fund was insufficient - reduced the maximum number of HHS officials who can attend the conference by two-thirds, from more than 230 in 2002 to 50, according to HHS spokesperson Bill Hall.

"But if there's a justified need, we can go beyond that," said Hall, who noted that 76 HHS delegates are scheduled to attend the Toronto conference. Twenty of the delegates represent the Centers for Disease Control & Prevention, with the remaining representatives coming from the Health Resources & Services Administration and the National Institutes of Health.

"Any type of travel needs to be approved to avoid duplication of efforts," Hall said. "[There are] certain thresholds at which further justifications need to be made."

The restrictions were caused by a reduction in the HHS travel budget for the International AIDS Conference from $3.6 million in 2002, to approximately $500,000 for the 2004 and 2006 events, according to CDC and HHS.

The limits keep U.S. brainpower from interacting with leading global counterparts, according to critics.

"For me, it's a shame, and it was stupid and shortsighted that the U.S. has restricted the number of NIH and CDC people from coming to the conference," said conference co-chair Mark Wainberg, who added that U.S. leaders were treated unfairly at previous conferences.

"[PEPFAR] is a lot better than nothing, and it's a hugely generous program," said Wainberg, who described the proverbial glass of U.S. anti-AIDS efforts as "well more than half full."

Research includes gay and bi men

There is buzz around possible drug therapy and delivery breakthroughs that will be discussed Aug. 17, and Wainberg said the conference will also draw attention to rising rates of HIV among gay and bisexual men in the U.S. and Canada.

Two CDC presentations scheduled for the conference highlight trends among gay and bisexual men, including one analysis of more than 10,000 gay men that showed HIV-positive men were twice as likely to use crystal meth than men who were HIV-negative. The 15-city study also showed that crystal meth users were more likely to engage in the highest risk sexual behavior.

Noting that black gay men are the population most heavily affected by HIV in the U.S., the CDC also plans to show how HIV prevention programs used for other populations can be successfully adapted to work with black gay men.

An alleged failure to create unique, tailored messages to black gay men has been a common criticism of the CDC and other U.S. agencies from some activists.

"The resources are only part of the equation - you have got to include the community when you're doing [HIV-prevention] efforts, or else it's not going to be successful," said Mark McLaurin, executive director of the New York State Black Gay Network.

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