2004 August 13
You've probably heard about the CDC's alleged proposal to require that any organization that receives public funds must change all educational materials it releases to publicize the "lack of effectiveness of condom use".
Unfortunately, the "Condom Wars" column that warned of this particular shady trick on the part of the Bush Administration hinges on a serious misreading of the actual text of the proposed regulation change. The actual text requires "medically accurate information regarding the effectiveness or lack of effectiveness of condoms in preventing the sexually transmitted disease the materials are designed to address.".
As a result, the government has received a great deal of feedback decrying an anti-condom plot that wasn't in the guidelines. Meanwhile, it seems like very few people noticed the bits where they *do* recommend life-threatening distortions - specifically, the recommended sample lecture for high-school students starts off with a couple of paragraphs that imply that a mutually monogamous relationship is more effective than a condom and that whether or not a drug is legal makes more of a difference than whether or not one shares needles. While these inanities are contradicted later in the sample lecture, I can't see a curriculum that contradicts itself in the first three paragraphs being very effective.
You can submit comments via their webform at http://www.cdc.gov/nchstp/od/content_guidelines/comments.htm and email at hivcomments@cdc.gov.
They can also be reached by phone at 404-639-8040 and by snailmail at 1108 Corporate Square, Atlanta, GA 30329; however, I don't know if the phys/phone contacts take comments on specific issues or are just for general information. The comments deadline is the end of August 16th, 2004, so hurry if you're contacting 'em.
(Incidentally, and obnoxiously, they don't have the actual text of the guidelines up on their website - I had to dig through the Federal Register to get at them.)
Here, in case anyone cares, are my Official Comments as sent to their webform.
Upon review of the proposed revisions to to interim HIV content guidelines for AIDS-related materials, I have the following observations:
- Funded organizations should be reminded that some populations may underrepresent or misrepresent their involvement in risky practices. Drug using and sexually active youth may fear legal, social, and parental repercussions, for example. The phrase "For those individuals who do not or cannot cease risky behavior" could be interpreted as meaning that risk-reduction information does not need to be made accessible to anyone who is not believed to be engaged in risky practices.
- Emphasising abstinence from illegal IV drug use is dangerously misleading. Shared or otherwise contaminated needles can spread HIV regardless of whether they are being used for illegal drugs, legal drugs, piercings, or tattoos. Focussing on the illegality of the drug may cause users of legal or semilegal drugs (insulin, some nutritional supplements, diverted morphine) to assume that the material is not relevant to them.
- The CDC educational guidelines linked to encourage monogamy and abstinence from illicit drugs. To the extent that education drifts from health protection to moralization, it is likely to lose effectiveness. In particular, it may lead to HIV education being perceived as anti-drug propaganda.
- There are inaccuracies in the sample high-school lecture: if the wart/lesion is not covered, both HPV and herpes can spread, and, if I recall correctly, the 1985 cutoff for testing of donated blood for HIV only applies to blood products obtained in the US.
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