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June 16, 2003 Secretary
Tommy Thompson
On behalf of AIDS Action’s Board of Directors and our diverse, nationwide membership of community-based HIV/AIDS service providers and public health departments, and for all people infected with and affected by HIV/AIDS, I am writing to express serious concern over recent actions taken by the Centers for Disease Control and Prevention (CDC), which have challenged the design of certain HIV prevention programs. I am also concerned that these actions may have larger implications for the CDC’s funding policies for HIV prevention programs. The CDC’s recent letter to the STOP AIDS Project of San Francisco suggests that it may be taking steps to reduce the local control and alter the programmatic content of HIV prevention messages—messages that have been historically effective at reducing the spread of HIV. Responding to a public health crisis, such as the HIV/AIDS epidemic, requires a comprehensive response that reaches all populations; therefore, it is critical that the decisions regarding which prevention messages are most appropriate be made locally, by those who are most familiar with the specifics of their own epidemic. Decisions on what works best in New York or San Francisco can be made best by public health professionals working in these communities—and not by using a one-size-fits-all federal approach. As long as community-based organizations funded with CDC dollars continue to follow CDC guidelines regarding explicit materials, they must be allowed a certain level of discretion in determining what is most effective for their target audiences. In turn, local control of HIV prevention messages should encourage diversity in scientifically-based programming. Yet repeated inquiries into the activities of STOP AIDS and other community-based organizations seem to suggest an unacceptable shift away from scientifically-based programs that deal realistically with sexual activity. As you are well aware, HIV continues to be spread primarily through sexual activity, and any effort to prevent further infections and encourage safer behavior must account for this fact. If the U.S. government hopes to achieve its goal of reducing HIV rates by 50 percent, we have to do what other G-8 countries have done: get real about HIV transmission in sexually active adults. How do we expect to prevent HIV transmission among sexually active adults if we don’t take advantage of programs like those offered by the STOP AIDS Project? Responsible public health practice demands that we take a long, hard, realistic look at what works—and what doesn’t—in HIV prevention and design. Then, we must implement our efforts accordingly. AIDS Action remains committed to working with our partners in both government and the community to ensure that we continue to do everything possible to reduce the rate of HIV transmission in this country. We would welcome the opportunity to sit down with you to discuss ways in which we can work together in order to implement scientifically-based strategies that respond to the HIV/AIDS epidemic in a responsible and realistic manner. Working together we can ensure that the CDC, and indeed all other branches of the Department of Health and Human Services, continue to do everything possible to bring this epidemic to an end. Sincerely,
Marsha A. Martin, DSW
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