It’s
impossible
to
imagine
that
a
four-day
conference
where
the
terms
“oral
sex,”
“anal
sex”
and
“casual
sex”
were
used
hundreds
of
times
per
day
could
be
as
unstimulating
as
the
Centers
for
Disease
Control
&
Prevention’s
annual
National
HIV
Prevention
Conference
this
week
in
Atlanta.
In
fairness,
no
scientific
conference
is
sexy
or
entertaining.
But
the
CDC’s
drowsy
gathering,
whose
theme
was
“Promoting
Synergy
Between
Science
&
Program,”
did
more
to
expose
the
disconnect
that
exists
between
the
HIV-prevention
industry
and
the
people
it
is
trying
to
protect.
The
impromptu
response
to
HIV/AIDS
by
everyday
gay
people
early
in
the
epidemic
was
more
effective
than
the
corporatized
strategies
of
today,
which
are
constrained
by
politics
and
scientific
protocols,
AIDS
activist
and
researcher
Rafael
Diaz
said
at
the
conference.
“As
prevention
became
a
professional
endeavor,
the
exhaustion
[among
the
public],
the
‘Us
vs.
Them’
started
to
happen,”
said
Diaz,
director
of
the
Gay
Men
of
Color
Initiative
at
the
University
of
San
Francisco’s
Cesar
Chavez
Institute.
“We
need
to
put
prevention
back
in
the
community.”
In
an
indication
of
CDC
strategies
missing
the
mark,
the
agency
touted
at
the
conference
eight
new
“Diffusion
of
Effective
Behavioral
Interventions”
—
which
are
also
known
as
“DEBIs,”
and
are
the
only
type
of
program
eligible
for
CDC
funding
—
with
not
a
single
one
of
the
interventions
targeting
the
most
at-risk
group
in
America,
gay
and
bisexual
men.
The
CDC
also
announced
that
only
20
percent
of
all
gay
and
bisexual
men
come
in
contact
with
one
of
its
DEBIs,
with
critics
charging
that
systemic
barriers
prevent
more
programs
geared
toward
gay
and
bisexual
men
from
becoming
available.
“And
this
is
26
years
into
the
epidemic,”
conceded
Kevin
Fenton,
director
of
the
CDC’s
AIDS
prevention
programs,
who
is
openly
gay.
“So
we
do
have
some
way
to
go
in
penetrating
our
prevention
interventions.”
Additionally,
the
federal
government
has
responded
to
rising
HIV
rates
by
flat-funding
the
CDC
throughout
most
of
the
Bush
administration,
decreasing
the
agency’s
actual
buying
power
by
19
percent
— to
1993
levels
—
when
adjusted
for
the
depreciated
dollar,
said
David
Holtgrave,
a
former
CDC
researcher
who
now
works
at
the
John
Hopkins
Bloomberg
School
of
Public
Health.
But
government
problems
have
been
a
hallmark
of
the
domestic
AIDS
epidemic,
and
many
activists
say
it
doesn’t
relieve
individuals
and
communities
of
their
responsibilities
in
preventing
the
spread
of
HIV.
“The
civil
rights
movement
didn’t
get
funded
by
the
federal
government,”
said
Robert
Fullilove,
a
researcher
at
Columbia
University.
“We
have
the
capacity
…
to
let
people
know
the
all
clear
has
not
sounded.”
Various
“homegrown”
HIV
prevention
programs
sprouted
up
during
the
first
15
years
of
the
epidemic,
until
there
were
so
many
that
there
was
confusion
among
community-based
organizations
about
which
interventions
worked,
said
CDC
researcher
David
Purcell.
“In
the
beginning,
there
was
no
such
thing
as
a
DEBI,”
said
Purcell,
who
noted
that
the
CDC
first
released
a
compendium
of
evidence-based
interventions
in
1999.
There
are
currently
14
DEBIs,
three
of
which
are
specifically
designed
for
gay
and
bisexual
men.
“With
[the
CDC
announcing]
eight
new
DEBIs
coming,
to
not
see
any
that
are
specifically
for
[gay
and
bisexual
men],
particularly
[gay
and
bisexual
men]
of
color,
is
really
surprising,
because
we
really
need
more
resources
for
that
population,”
said
Victor
Martinez,
a
regional
director
for
Bienestar,
a
Latino
AIDS
agency
in
Los
Angeles.
Any
AIDS
non-profit
that
receives
funding
directly
from
CDC
must
use
the
dollars
on
DEBIs,
with
CDC’s
mantra
being
“fidelity
to
protocol.”
The
CDC
also
funds
state
and
local
health
departments,
which
then
distribute
the
money
to
local
non-profits.
Health
departments
have
more
flexibility
in
funding
“homegrown”
interventions,
but
many
maintain
the
CDC’s
insistence
on
DEBIs,
Purcell
said.
Developing
a
creative,
relevant
and
locally
produced
intervention
into
a
DEBI
is
a
complicated,
years-long
process
that
many
community-based
organizations
lack
the
capacity
to
undertake.
The
DEBI
threshold
requires
interventions
to
be
scientifically
proven
via
randomized
control
trials.
Under
increasing
pressure
from
activists
and
non-profit
agencies
who
complain
that
the
DEBIs
are
too
limiting
and
not
always
applicable
to
different
populations,
the
CDC
unveiled
a
new
funding
system
based
on
“Tiers
of
Effectiveness.”
Instead
of
exclusively
funding
DEBIs,
the
CDC
will
begin
evaluating
other
interventions
to
see
if
they
might
contain
useful
strategies,
even
if
they
lack
solid
scientific
evidence,
Purcell
said.
Funding
priority
will
be
given
to
Tier
I
and
...
