For twenty-five years, people have asked me: "When is The Front Runner movie coming out?" "Wasn't Paul Newman going to star in it?" My 1974 novel about a gay athlete's effort to make the 1976 Olympic team has a checkered history in Hollywood. In turn, I've had the chance to study another checkered relationship: the one between gay books and gay movies. It's a subject of special interest to independent publishers, who now publish the vast majority of gay-themed books.
Despite the gay world's love of film, despite mystique around books adapted for the screen, not much gay-themed U.S. fiction or nonfiction has made it into the rolling credits. Some did, but the book list is short, compared to that long celluloid line of original gay-themed scripts that get produced.
While major U.S. releases with gay-male, lesbian, bisexual, or transgender (glbt) themes are few -- homophobia still rules some of American society and fierce closetedness of some gay people in the film industry is partly to blame -- the problem is more complex than that.
Not until the late 1970s, when a few dissidents bucked the all-controlling studio system to produce subjects that studios wouldn't touch, did the independent-film movement spark the first real surge of glbt-themed films. The next indie wave was stars starting their own productions, so they could do parts that studios wouldn't let them touch. New financial resources flowered to bank these non-studio films. Today, glbt themes are grabbing a growing share of that artistic film market. We're also more visible on TV, especially as cable blurs the old line between Hollywood and television. At every level of the industry, glbt people are now firmly entrenched -- from agents to top executives and financiers -- and their attitudes and tastes are factors in what glbt projects get green-lighted.
In 1997, as my business partner Tyler St. Mark and I revived our effort to get The Front Runner into development, we began to notice the monopoly of "new" and "cutting edge" in gay films. If a new book doesn't sweep immediately into development it might be quickly forgotten. Many in gay Hollywood would rather write a sparkly new screenplay than take a book in print, even a classic or a best-seller, as a starting point.
One reason why so few glbt titles get filmed is that many are studies, theory, activism, health, pornography, or self-help books and inappropriate for the screen. Even a documentary has to tell a good story. Not for nothing does A&E advertise its expanded movie menu as "getting back to good stories." In mainstream film, countless nonfiction books have been made into gripping films, yet the list of gay-themed features based on nonfiction books is short indeed. To name a few: And the Band Played On, Breaking the Surface, Serving in Silence.
When it comes to fiction, often gltb books focus on style, issues, or inner angst, rather than taking the classic storytelling approach of portraying realistic people who live and struggle in a realistic world -- past or present -- created by the author. It is this classic realism that always made mainstream fiction an enduring resource for filmmakers. In our gay world though, there is a growing prejudice against gay fiction. The first time I heard a young gay director contemptuously dismiss fiction as "something that never happened," my jaw dropped. Many booksellers tell me that sales of gay fiction are down. Most glbt activist and service organizations actually exclude fiction from their reading lists.
So intense is this prejudice against anything "non-happening," especially with plots set in the recent past, that one gay director's question to Front Runner producer St. Mark was: "Why now?" This man wanted to know why any moviegoer would pay $8 to see a gay runner at the '76 Olympics. He suggested that we change it to the 2000 Olympics -- forgetting that a '90s setting would change all the social and personal dynamics of the original story. Films that update stories often don't work well for that very reason.
The old struggle over creative control also keeps books off the screen. In the publishing industry, "control" is largely negotiated between author and publisher. In a film, control is more complicated -- powerful people can exert pressures at any point -- and with gay-themed books it usually hinges on how sexual orientation will be handled. In 1990, Dave Pallone's autobiography, Behind the Mask, was put into development by an independent film company and Bruce Willis was interested in playing the lead. The project fell through (Pallone told me) when Willis' managers refused to let him do it. Ultimately, creative control is held by whoever owns the negative of the final cut. One heartbroken director told us how he lost control of a film that he'd developed and scripted. A contract loophole allowed the producer to nab the negative and do a new final cut, which removed most of the gay content.
To avoid interference from authors, some independent filmmakers go the do-it-yourself route. A person with a burning idea hammers out a script, then finances, produces, and directs it. Stacey Adair, a young gay director-to-be whom I know in LA, worked on his script for two years before he got into the Sundance Writers Workshop and moved towards development. This kind of film tends to be a personal statement, and such artistic monopolies tend to eliminate a book author, who might make noises about plot points or casting (as Ann Rice did with Interview with a Vampire). Using an original script also spares a filmmaker the cost of paying an author for film rights, and from giving that author a percentage of net profits. The piece of the pie that an author would ordinarily get can become a meaty morsel to offer an investor, in the form of points.
Another trend that bypasses books is the rush of hot glbt news stories direct into TV. Producers can cut a deal directly with the person whose life-story fascinates; then they do an original script. If a book does happen, it is usually an after-the-fact tie-in. Thus we have a rash of films about high-profile murders, including two on Brandon Teena. This omission is especially true of films with a gay-teen theme. Teens are the biggest U.S. movie audience, with power to put films like Titanic in orbit. There has been a rash of gay teen coming-out films, yet some popular, award-winning, classic or original youth books have been passed over (see sidebar). The same is true of adult books. Some classic titles became film properties many years ago, with fits and starts of development since then, but no wrap yet and the rights are gathering dust on studio shelves. There can be legal obstacles, or the author might be dead, with a homophobic family estate keeping control. Director Arthur Alan Seidelman told me about his abortive 1970s effort to film, Fire From Heaven, Mary Renault's novel about Alexander the Great. It was to be a TV mini-series but the network wanted to de-gay Alexander. Seidelman, who is gay, refused to cooperate. The rights are still tied up in this defunct project.
Other gay-themed books don't get filmed because they don't fit today's "formula" in the gay film biz. "Formula" has to do with what you spend on a film versus what you earn. Hollywood has gone from shunning gay content to segregating it into a growing limited-release category. (This is industry-speak for films that are too controversial or risky for general release.) This "specialty" road for a gay film is well worn: The small budget ($2 -- $3 million) film opens at a glbt film festival, where a boutique distributor picks it up. After a short run in limited-release theaters that cater to gay people, it goes into home video. Now and then a gay film makes it to limited international release. Increasingly there are cable re-runs (HBO has been a pioneer here), where a glbt film may reach a wider non-gay audience. Investors, producers and distributors are said to be making money on these budget films. One gay mogul made it clear to us that "formula" spells maximum net profit from minimum effort.
Some glbt stories can't be translated into film for just a few bucks, taking them immediately out of the above formula. Fire from Heaven, with its armies, chariots, period costumes, and need for big sets might have a shot in the U.K., where the BBC and other funders put money into expensive productions like Wilde, but not in the U.S., so long as budget rules. In a word, "specialty" is not only politically safe -- it is economically safe.
Vito Russo called my own novel, The Front Runner, "the most celebrated failure to produce a film from gay fiction." The book made Time and New York Times best-seller lists in 1974, when Hollywood was just beginning to grapple with the idea of portraying openly gay people. In 1975, Paul Newman took a year's option. He planned to direct -- and the script was the first hurdle. How would the two men's relationship be handled? The love scenes? Nudity? Two men kissing, or just touching? Today these are still big questions for actors, producers, directors, and studio executives but in 1975 the questions loomed even larger. Jeremy Larner was hired to write the script but when I finally read it, my heart sank. The Oscar-winning writer had backed away from depicting love between men. Evidently Newman was not happy with the script either, because he didn't pick up the option.
In 1977, I sold The Front Runner rights to director Frank Perry "in perpetuity" (without a time limit). I'd always assumed that, despite the fact that the film never got made, once you sell film rights in perpetuity, you can't get them back. But by the 1990s movie case law was changing and more authors were successfully attaching themselves to film projects, as Armistead Maupin did with Tales of the City. So, I had my legal counsel go to work and after four years of litigation, the rights came back to me in 1997. St. Mark and I decided to produce The Front Runner, independently, and Wildcat Entertainment, sister company of Wildcat Press, was formed. Barry Sandler (Making Love, Crimes of Passion) joined our team as my co-writer -- followed by Emmy-winning director Seidelman (Walking Across Egypt, Hill Street Blues).
These days I spend most of my spare time watching movies. Often I am amazed at how swiftly we as gay people stereotype ourselves in our own films, despite our bitter complaints that mainstream media typecasts us. How many cookie-cutter films about show biz, drag queens, hustlers, sugar daddies, coming out, tricking and AIDS will glbt moviedom be willing to absorb, before people clamor for more original, offbeat stories? It's great that specialty films get made, and make money. But tolerance is growing nationally, in spite of attempts at censorship and right-wing catfights over Queer as Folk.
The time is here for more general-release gay films that have the star power and scope of Philadelphia, but open and honest glbt content. In short, we need intelligent development of more movies from books. Film can mean not only a powerful infusion of new economic health into independent publishing, but also new creative motivation.
A library's worth of popular, award-winning, classic and original books published by independent publishers have been passed over by filmmakers.
Gay Teen Themes
Dream Boy by Jim Grimsley (Algonquin Books)
Reflections of a Rock Lobster by Aaron Fricke (Alyson Publications)
Emerald City Blues by Jean Stuart (Rising Tide Publishers)
Trying Hard to Hear You by Sandra Scoppettone (Alyson Publications)
Gay Adult Themes
With '40s revival and sounds of swing in the air, I'm wondering when somebody will rediscover The Catch Trap, Zimmer Bradley's vivid love story of two young male performers in a traveling circus. When gay filmmakers finally discover the Vietnam War, perhaps one will have the guts to film that searing novel about an eighteen-year-old Marine medic, The Boy Who Picked the Bullets Up by Charles Nelson (Lyle Stuart). And where are the gay and lesbian detective and mystery films, with novelists like Katherine Forrest and Michael Craft so popular? For example, Name Games by Michael Craft (Minotaur Books) and Curious Wine by Katherine Forrest (Naiad Press).
As our new President takes office, I will still be feeling that chill up my spine I felt when I saw the Web site for the "HIV Stops With Me" ad series (www.hivstopswithme.org). Aired in San Francisco, the TV ads derive from what the CDC calls "alarming" statistics showing a rise in unprotected sex among gay and bisexual men. The ads were funded by the CDC and the San Francisco Department of Public Health.
These ads don't just "target" local men in the PR sense -- they put these men square in the sniper crosshairs. The message couldn't be clearer, with a funereal black page and the logline jumping out in flaming red -- "HIV+ gay and bisexual men have the power to stop the epidemic."
Really? HIV-positive gay and bi men have that power even as AIDS is declared a global security threat by the UN, and a national security threat by Washington? As the media declare that "millions are dying all over the world," and these estimated millions are said to be mainly heterosexual women and children? So what's behind these ads?
Earlier this year, U.S. AIDS policy underwent a paradigm shift. The CIA and NSA (National Security Agency) were given oversight over AIDS. The nation's public-health system is now virtually on a wartime footing -- meaning that uniforms, not white labcoats, are in charge. CDC's website has a bioterrorist-alert page, equating AIDS with anthrax attacks by Iraq. Noting this shift, South African President Thabo Mbeki voiced concerns over CIA interference in his country's AIDS controversy. AIDS apologists snidely dismissed Mbeki as paranoid. Doubtless Mbeki reviewed the CIA's long history of covertly involving U.S. troops in other countries' affairs -- notably Vietnam, Guatemala, Colombia -- and felt a chill of his own.
In short, epidemic disease is now the excuse for U.S. and U.N. interference in certain countries' political affairs. Behind its family-friendly fa*ßade, the CDC is a major player in international public-health wars. When Ebola virus broke out in Uganda recently, the CDC was one of the first on the scene.
If we translate the CDC/SFDPH ads into political English, the message is: HIV-positive gay and bi men are responsible for the AIDS epidemic -- because those who "cause" it are the ones who can "stop" it. These men could be held accountable by military intelligence for any real (or perceived) failure to act as the government demands.
As an old CIA watcher, dating from the sixties and seventies when I helped cover cold-war politics as a Reader's Digest editor, I suspect these ads are what spooks call "disinformation" (government-speak for propaganda). The federal government is retooling the 1980s "gay plague" for use in today's domestic political arena. For maximum credibility it launches the reinvention in gaydom's flagship city, San Francisco. Yet, internationally, the U.S. carefully refrains from talk of gays ending AIDS, and pours billions into fighting an AIDS that is "everybody's disease." Hence the hypocrisy, as Washington speaks with a forked tongue about AIDS.
It won't be the first time that homosexuals are deemed "security risks." In the 1950s, the McCarthy hearings trained their crosshairs on gay men in sensitive government jobs.
And this is not the first time I've mentioned the shell games that public-health officials play with some statistics while trying to justify their demands for funding and public support. The CDC has taken notice of my comments, and sent a letter to A&U defending their crosshairing of gay and bi men (see this issue's Mailbox). Ronald O. Valdiserri, deputy director of CDC's national Center for HIV, STD and TB Prevention, insists that "men who have sex with men (MSM) still represent the single largest share of new infections, estimated to account for more than 40 percent of all new HIV infections." In his September 15 letter, Dr. Valdiserri adds that heterosexual men and women account for thirty-three percent of new infections. I can't help wondering about the sexual orientation of the remaining plus or minus twenty-seven percent. Is it lesbian and bi women? No -- according to the CDC, the mystery remainder is injection drug users, which is not a sexual orientation. Here we see the fallacy of "risk group" statistics -- they don't always add up. And they're just estimates, because -- as the CDC admits in its own fine print -- the counters don't always know the risk in reported cases.
A recent AP story quotes different CDC statistics: "Blacks and Hispanics accounted for nearly 70 percent of new HIV infections from July 1999 to June of this year, a striking change in what was once known as a disease of gay white men... The groups hardest to reach in prevention campaigns -- high school dropouts, former inmates and the homeless -- are disproportionately black and Hispanic." So with bigger groups that are said to need targeting, why is the CDC pumping millions into a disinformation campaign aimed at gay and bi men in a single city?
In my opinion, the federal government wants to make covert use of homophobia, even as the CDC pays lip service to the idea that homophobia is not a good thing. The government wants to keep Americans believing that gay and bi men are still causing most of the HIV problems. This way, Americans are more likely to accept stringent new public-health surveillance and controls, in the interests of fighting the gay/bi "threat." When the security crackdown comes, most citizens will be less likely to sympathize with gay and bi men. In fact, it'll be dangerous to sympathize -- you might be listed as a "security risk" yourself. Civilians who get in the way of a war machine are always viewed as expendable.
Am I being paranoid? The record bears me out. Past "security" scares about unpopular groups -- notably Japanese-Americans and German-Americans -- resulted in human-rights abuses that most Americans were happy to overlook. Americans are already accepting greater infringements on their personal liberties -- wiretapping, police searches without warrants, etc. -- in the interests of "fighting crime and terrorism." National public-health "security" will be achieved through coercive new state laws already appearing on the books. More about that in "a future" Left Field column.
Valdiserri complains that "some members of the gay community remain skeptical of government information." Well, some of us can add and subtract. The accuracy of government AIDS statistics is under growing fire in the gay world, as the Bay Area Reporter and rethinking-AIDS groups analyze statistics on which the SFDPH based their case. The Bay Area Reporter cites what it calls "continuous inaccuracies regarding HIV infection rates," and actually forced the SFDPH to backtrack on some figures.
Indeed, any U.S. citizens who have an HIV-positive test on record, whatever their sexual orientation, need to ponder the deadly direction of this ad campaign. And what of free speech for those who question this new AIDS policy? Will we be viewed as "security risks" too? Yes, that's definitely a chill I'll be feeling, as the new President takes office.
For Further Reading
CIA report on global infectious disease: www.cia.gov/cia/publications/nie/report/nie99-17d.html
Analysis of CIA report by Fintan Dunne: www.aidsmyth.addr.com/news/000430nicreport.htm
CDC's Five Year Plan: www.cdc.gov/nchstp/od/news/draft.plan.pdf
A life-and-death question is in the air, about medicine and money.
Recently the New England Journal of Medicine voiced growing unease with conflict of interest, in a landmark editorial titled "Is Academic Medicine for Sale?" Conflict of interest means financial ties that confer inappropriate or even illegal income to a scientist. In the same issue, NEJM's national correspondent, Dr. Thomas Bodenheimer, described two major studies in which most of the researchers have money ties to manufacturers of the very drugs they're studying.
Any Internet search shows that issues of "ivory tower crime" have been hotly debated since the late 1980s -- mostly behind the scenes, in scientific publications and the so-called alternative media. Some scientists view the debate as an attack on science, while others welcome it. In 1996, Scientific American complained that some scientists' secrecy around important discoveries is motivated by their intent to file lucrative patents. The magazine quoted Steven A. Rosenberg, chief of surgery at the National Cancer Institute, as saying that, "it is a very clear moral issue.... humans beings suffer and die who need not have done so."
In a word, some people are getting too cozy at that nexus where health science, government, business, nonprofits and media all intersect. In the current permissive atmosphere, some scientists can reap huge profits and power from unchallenged conflict of interest. Along the way, not only can "scientific truth" be skewed, but people's lives and health can be destroyed.
The New England Journal of Medicine, feeling that the public should know who is paying who, now requires financial disclosure by authors of original research articles. Some disclosures are so lengthy that the magazine can't print them all, so posts them on its website! The NEJM confessed that it had a hard time finding editorialists whose financial profile is clean enough for credibility. It said:
"Ties between clinical researchers and industry include not only grant support, but also a host of other financial arrangements. Researchers serve as consultants to companies whose products they are studying, join advisory boards and speakers' bureaus, enter into patent and royalty arrangements, agree to be the listed authors of articles ghostwritten by interested companies, promote drugs and devices at company-sponsored symposiums, and allow themselves to be plied with expensive gifts and trips to luxurious settings. Many also have equity interest in the companies."
Added NEJM: "Many researchers profess that they are outraged by the very notion that their financial ties to industry could affect their work. They insist that, as scientists, they can remain objective, no matter what the blandishments. Can we really believe that clinical researchers are more immune to self-interest than other people?"
Prodded by this controversy, the U.S. government may be on the verge of tightening federal standards on how scientists operate. Indeed, the Public Health Service started its Office of Research Integrity in 1989, in the wake of scandals around HIV research done by Robert Gallo's "dream team". The problem is, ORI doesn't look closely at conflict of interest. It focuses on what's called "scientific misconduct" -- namely fabrication, falsification or plagiarism in research data. Last year the Public Health Service proposed stricter standards -- but these do not address financial misconduct.
For politicians, conflict of interest is a deadly issue -- especially in election years. As I write this, Al Gore fights off those stinging wasps of allegations about the Buddhist temple fundraiser, while George Bush and running-mate Dick Cheney fight off stinging allegations about their financial ties to the Texas energy industry. Newt Gingrich stopped being a contender when the public realized he'd been lobbied by Big Tobacco. Financial misconduct can heat up special-prosecutor investigations (as in the Monica Lewinsky affair), even result in indictments (as it did recently with alleged pay-offs around the Salt Lake City Olympic Games).
Big Tobacco investigations have spotlighted scientific conflict of interest with searing political clarity. In a recent Reuters report, a European executive of Philip Morris admitted that his company had paid scientists to attend WHO meetings and try to influence WHO's anti-tobacco campaign.
But the average citizen who is shocked at Big Tobacco's maneuvers should be shocked that the same threat of "paid scientists" looms over Big Medicine as well.
Would you believe children's vaccines? The national mandatory-vaccination program for children is growing, and enormously lucrative. In 1991 the National Vaccine Information Center asked for the resignations of two scientists, citing their conflict of interest for receiving over $800,000 in fees and grants from vaccine manufacturers. The NIH refused to take action.
In a related case, reporter Barry Forbes wrote in The Tribune, Mesa, Arizona:
"Seems that a couple of key federal advisory committess involved in vaccine approval got their fingers caught in the cookie jar. These committees advise the U.S. FDA and CDC on which vaccines to approve and foist on an unsuspecting public, and which ones to add to the incredibly lucrative Childhood Immunization Schedule. The Committee on Government Reform discovered that 3 out of the 5 FDA advisory committee members who voted to approve the deadly rotavirus vaccine in December 1997 had financial ties to pharmaceutical companies. Remarkably, those same companies were developing different versions of the vaccine. Ditto for 4 out of the 8 CDC committee members in June 1998. The vaccine was pulled from the market after it was found to cause severe bowel obstructions."
These cases are not isolated aberrations, and show how the medical and life-sciences industry has become one of the world's biggest -- rivaling food, energy and armaments, with dizzying profits from global marketing of vaccines, tests, drugs and food supplements to billions of people worldwide. Without a doubt many of the products they make are beneficial, when marketed in a legitimate way according to genuine need. When I had Lyme disease, I was glad for a new antibiotic that provided effective treatment!
But this volatile mix of medicine and politics brings mixed blessings. According to the Public Citizen's Congress Watch, pharmaceutical companies are not only the biggest lobby spenders in Washington, but also major contributors to Presidential campaigns. Big transnational companies have a vested interest in which party controls the White House and Congress. They aim to maximize global profits by getting tariffs lifted on drug exports, extending current patents and preventing developing countries from manufacturing their own inexpensive generic drugs. They spend liberally on R & D, ever searching for that new drug to amp profits.
With all this money around, the temptation to skew a study in an alluring direction might be hard for a scientist to resist.
Indeed, things are so relaxed that some scientists don't bother to hide business connections that would be a PR problem for the average politician: industry grants, industry-paid trips to conferences, industry consulting fees, patent ownerships, etc. They insist that this is simply how science has to be done these days. Internationally, "partnership" is the buzzword as the UN, World Health Organization, IMF and World Bank all work openly with scientists, transnational corporations, governments and NGOs in "partnerships" that sell health care and medical products to the world. Recently a group of UN observers expressed concern at how the UN, once widely viewed as a bastion of international integrity, is becoming a clearinghouse of commercial interests.
Indeed, few global health players hide their coziness with the World Bank. Among corporations, for example, Glaxo Wellcome is poised to market AZT to millions of HIV+ mothers and children around the world -- thanks to U.S. and WHO policy making AZT a recommended drug. As I learned from Glaxo Wellcome's website, two people on its board of directors, Ronald H. Schmitz and Michele Barzach, also hold current positions within the World Bank system. (As I wrote this, Glaxo Wellcome merged with SmithKline Beecham Plc, forming the world's 2nd largest pharmaceutical company). Among NGOs, there is the powerful International Association of Physicians for AIDS Care, with 10,000 members who are doctors and health-care professionals in 52 countries. According to their own website, IAPAC is partly funded by drug companies, and has its partnership with the World Bank. IAPAC's own conferences are drug-sponsored.
Even the recent XIII International AIDS Conference in Durban, South Africa, which got so much publicity positioning as a humanitarian event, was funded by corporations and branches of the U.S. government. Most of Durban's presentations and workshops focused on drugs. Why should anyone be surprised at the strong pro-industry noises that came out of this conference?
But industry is not the sole axis of financial leverage. U.S. government money continues to flow freely into medical research (though in other areas, the end of the Cold War and Congressional budget-cutting has slackened government R & D). NIH and the National Institute of Allegies and Infectious Diseases are still funding many scientific studies. The federal government has a track record of withholding funding, or threatening to withhold it, if you don't toe the party line. It frequently jawbones cultural institutions and public schools with this threat. Recently Uncle Sam even threatened to withhold disaster-relief funds from the states! One can't help but wonder to what degree the threat of government funding loss is a factor in what some scientists may "discover."
Each year, ORI investigates several dozen cases of "ivory tower crime." The investigations are closed, low-key. Last year, according to ORI's website, 12 scientists were found "guilty" of scientific misconduct. Sentences are light, considering that this "misconduct" might risk human lives. Typically the person must formally retract the faulty research, can't be eligible for federal funding for 5 years, etc. Often perpetrators are small fry -- like the Colorado nurse who altered research data to allow ineligible patients to qualify for AIDS research.
The military, who also fund medical research, is equally eager to keep science crime out of the news. Among other things, they have an interest in vaccine research because of their mandatory-vaccination policy for personnel.
Investigation of Lt. Col. Robert Redfield (also a member of Gallo's team) and his alleged manipulations of HIV viral-load figures was done "internally" by the Army. Dr. Redfield was cleared of the charges. But, according to Public Citizen's Health Research Group, "the version of the Army internal investigation that can be obtained through the Freedom of Information Act has approximately 50% of its contents whited out, lending new meaning to the term whitewash. Public Citizen has sued the Army under the Freedom of Information Act seeking the full report, and that suit is currently before the D.C. District Court."
But it's in the AIDS world where the conflict-of-interest questions have been most doggedly avoided. It doesn't take a rocket scientist to figure out why. Global AIDS policy takes an absolutist position, based on assertions that HIV science is absolutely accurate. It is said that HIV is absolutely the cause of AIDS, that HIV tests and approved drugs are absolutely beyond factual challenge. Indeed, in a recent speech, one absolutist -- Dr. Mark Wainberg, president of the International AIDS Society -- openly called for AIDs dissenters to be jailed. Even most major media have bought the absolutist HIV position. We are expected to believe that AIDS research, alone of all areas of science, is magically free of undue influence or those "sales of academic medicine" that has the NEJM so worried. Today HIV absolutism would be threatened if a single "AIDS science for sale" investigation were to be breaking news for a few months. Public confidence in AIDS policy would go up in smoke. Perhaps this explains why, after l'affaire Gallo, science scandal has been kept behind the scenes as much as possible.
In my opinion, we should hold biomedical scientists as ethically and legally accountable as we do our politicians and our judges. After all, it's our lives we're talking about here. How amazing that a scientist can call for criminal penalties for anyone who publically questions HIV research, yet scientists who do commit research "misconduct" get a slap on the wrist.
Yes, we need answers to this urgent question: how much of today's AIDS research is truly "scientifically accurate" -- and how much of it is a house of cards held in place by somebody's ability to pay? With all the talk of AIDS being a national security threat, and UN troops enforcing global AIDS policy, the United States has no right to proceed as long as this life-and-death question is hanging in the air. Science for sale, and the potential for fraud and health danger it may cause, will have a bomb-blast effect on billions of people's lives -- and on health care -- for a long time to come.
For further reading:
New England Journal of Medicine at www.nejm.com
Reuters story about NEJM stand at www.harmsen.net/heal/abcnewsunder.html
Nicholas Regush, ABCNews, on conflict of interest at www.abcnews.go.com/sections/living/SecondOpinion/secondopinion.html
Patricia Nell Warren, author of The Front Runner, writes commentary for many gay and mainstream publications. Her editorials are archived at wildcatpress.com. Email: email@example.com.
As the world moves toward a global AIDS policy that will affect every heterosexual on the planet, our country is still hammering on homosexuals. Every day I watch the great river of AIDS news coverage, and on the average I still see more talk about gay risk than straight risk go floating by. It seems like moralistic anti-gay outrage is needed to fuel heterosexual AIDS awareness.
On its Web site, the CDC has a whole subpage devoted to women who have sex with women (WSW). When you follow the link, you find little of any significance. The CDC admits that it's really hard to find U.S. cases of female AIDS that have woman-to-woman sex as the sole risk factor. But they try! The agency says:
"Through December 1998, 109,311 women were reported with AIDS. Of these, 2,220 were reported to have had sex with women; however, the vast majority had other risks (such as injection drug use, sex with high-risk men, or receipt of blood or blood products). Of the 346 (out of 2,220) women who were reported to have had sex only with women, ninety-eight also had another risk -- injection drug use in most cases. Women with AIDS whose only reported risk initially is sex with women are given high priority for a follow-up examination. As of December 1998, none of these investigations had confirmed female-to-female HIV transmission. A separate study of more than one million female blood donors found no HIV-infected women whose only risk was sex with women."
Translation: After twenty years of the epidemic, there is no evidence that WSW sex is a dire health threat to the United States. So much for all those claims that "the gay lifestyle is unhealthy."
Other public-health sectors also stay obsessed with that same "medical moralism" about gay and bisexual sex. Yet our current national statistics (if we can believe them) clearly suggest that young heterosexual men are higher-risk, especially if they are black and Latino.
According to recent CDC figures, new AIDS cases declined for more populations, but the number of cases actually increased nationally among women (by two percent) and heterosexuals (by nine percent). Women account for over fifteen percent of cumulative AIDS cases nationally, and 21 percent of cases reported between July 1996 and June 1997. AIDS-related deaths among men fell by 25 percent, deaths among women only dropped by 10 percent. But AIDS-related deaths dropped much less quickly among African-Americans, Latinos, heterosexuals and injection drug users as compared to whites and men who have sex with men.
Most startling of all: The CDC estimates that nearly 50 percent of all new infections are now related to injection drug use. Fifty percent!
This being the case, why are some public-health and media operatives still so quick to go for the item or statistic about unprotected sex that includes the word "gay"?
San Francisco is a good example of a city where the Department of Public Health insists on a gay positioning for its AIDS scene, despite statistics that prove otherwise. According to the "Overview of Health Statutes," released last month by the SFDPH, there was an 83.9 percent decline in gay and bisexual AIDS cases between 1990 and 1999. So why is the SFDPH spending CDC money on a prime-time TV prevention campaign aimed at local gay men? How about using some of that money to reach the 50 percent who use IV drugs? Or those women or young heterosexual men at risk out there? A campaign like this may convince the moralistic crowd that "something is being done about the gay menace to American health," but it won't deliver the numbers that the right kind of campaign targeting drug users could deliver. Yet CDC funds are evidently available to repeat this gay campaign in other cities.
Public-health officials are sucking in their breath at reports that a new, more nasty strain of HIV is around -- one that is nonresponsive to protease inhibitors. According to the reports, one in five HIV-positive people now have the new strain. "It's a dangerous situation," said Brian Byrnes, director of education with the AIDS Action Committee of Boston. But so far the only worries I've seen in the news were about gay men catching this strain. Not about women or young heterosexual men. Or those 50 percent drug users.
Blood donations are a big flinch-point of anti-gay bias. In its masterpiece of contradictory policy, the FDA forbids donations "if you are male and have had sex with another male since 1977 -- even if only once," as Douglass Starr pointed out in the Los Angeles Times. "You can't give blood for the rest of your life if you've ever had homosexual relations with a gay man -- even with a condom -- at any time in the past 23 years," Starr went on. "But you can if it's been a year plus a day when you last had unprotected sex with prostitutes, drug users, or even with AIDS patients."
HIV-positive gay and bisexual men in uniform get the hot spotlight when they're discharged, because of mandatory testing in the armed forces.
It isn't hard to figure out that bias is driving this targeted moralism. What concerns me is the dishonesty it creates in our national life. Thanks to these examples of skewed public-health rhetoric, it is not surprising that many Americans still live in a bubble about what the "global AIDS epidemic" is. Around the world, the vast majority of those estimated 49 million infected people, who might be dying of whatever virus or opportunistic infection is killing them, are heterosexuals. Yet we still have the irate reader who dashes off a haughty letter to the Orange County Register, informing us all that "it is well-established that homosexuality is the major cause of AIDS."
In developing countries, some leaders are not buying the U.S. party line that AIDS must be positioned as a gay disease. Indeed, they must tread lightly on orientation issues, because their heterosexual male populations are fiercely hostile to any inference that risky sex equals MSM (men who have sex with men) sex. South African president Thabo Mbeki certainly noticed the curious way in which our AIDS propaganda doesn't dovetail with the rest of the world. In his now-famous letter to President Clinton, Mbeki politely said: "As you are aware, whereas in the west HIV/AIDS is said to be largely homosexually transmitted, it is reported that in Africa, including our country, it is transmitted heterosexually."
In short, we are trying to export a fraudulent morality -- a two-faced AIDS rhetoric.
The United States is underwriting more international AIDS funding than any other country on earth -- an effort directed at billions of heterosexuals in hundreds of countries. Yet many Americans are still stubbornly, defensively, grimly trying to keep that moralistic homosexual spin on AIDS at home. In so doing, they promote a reluctance by many heterosexuals to take personal responsibility for their own "morals" and their own health.
Patricia Nell Warren writes for A&U, the national AIDS magazine, where this article originally appeared.
It isn't exactly a state secret that the U.S. is having a major epidemic of sexually transmitted disease. Reportedly syphilis, once almost eradicated, is back. Recent CDC figures for chlamydia, gonorrhea and herpes 2 infection among teens are alarming. Less than 10 percent of teens screened for STDs give their orientation as gay. Yet government and news media continue to obsess about gay sex. In view of CDC's decision to consider STDs and tuberculosis as co-factors of HIV infection, this old obsession is making for new screaming headlines. We are entering Stage 2 of 1980s AIDS hysteria.
In April, for instance, 51 cases of syphilis among L.A. County gay men made the Los Angeles Times. L.A.'s Channel 2, which loves to wring every ounce of drama out of drive-bys and hot pursuits on the freeways, did high drama about the public-health vans pulling up in West Hollywood and Silverlake to make testing available to gay men. From there, the gay drama reverberated around the world, as far away as India, where it was noted by the SATHI AIDS newsletter.
According to the Times, "Health officials in Los Angeles County report that a syphilis outbreak among gay men in the area has doubled to 51 cases in two weeks. Peter Kerndt, director of the county's sexually transmitted diseases program, noted that 28 of the 51 men have HIV, which is particularly worrisome because syphilis sores increase the risk of HIV transmission ... Last year, none of the 120 syphilis cases recorded in Los Angeles County were among gay men, suggesting that this year there has been a decline in safe sex practices among some gay men in the area."
The same month, the AP screamed another headliner: "A tuberculosis outbreak in the transgender communities of Baltimore and New York City may be spreading to other cities, the government said Thursday. The Centers for Disease Control and Prevention confirmed 26 active cases and 37 dormant cases of tuberculosis, most of them connected to members of the transgender community in the two cities. The government said 62 percent of the tuberculosis patients tested positive for HIV."
These stories come on the heels of earlier screamers from San Francisco, over 17 cases of syphilis that the San Francisco Dept. of Public Health insisted were linked to gay male chat rooms on the Internet. Months later, statements by SFDPH, claiming that gay male sex practices are still driving the AIDS epidemic, are still reverberating nationwide.
I wonder why news media aren't screaming just as loudly about rising HIV infection among young heterosexual people. According to the CDC, "HIV infection and AIDS are now the sixth leading cause of death among young persons aged 15 to 24 years."
And where are the screaming headlines on other STDs among the nation's teens? According to the CDC website: "Each year, approximately three million cases of sexually transmitted diseases occur among teenagers."
Let's look at chlamydia. This STD is caused by the bacterium Chlamydia trachomatis, and can be spread even by simple skin or body contact. Says CDC grimly on their website: "Chlamydia is the most frequently reported infectious disease in the United States. From 1984 through 1997, reported rates of chlamydia increased from 3.2 to 207.0 cases per 100,000 population. Based on reports to CDC provided by states that collect age-specific data, teenage girls have the highest rates of chlamydial infection." One of every 10 girls screened were chlamydia+.
The stark CDC report goes on: "Because approximately 75 percent of women and 50 percent of men have no symptoms, most people infected with chlamydia are not aware of their infections. Untreated, chlamydia can cause severe, costly reproductive and other health problems. Up to 40 percent of women with untreated chlamydia will develop PID [pelvic inflammatory disease]. Of those with PID, 20 percent will become infertile; 18 percent will experience debilitating, chronic pelvic pain; and 9 percent will have a life-threatening tubal pregnancy. Tubal pregnancy is the leading cause of first-trimester, pregnancy-related deaths in American women."
In other words, hundreds of thousands of young women will not be having children because of chlamydia -- making zero population growth more of a reality than "Earth First" worries ever did.
So serious is the chlamydia threat that CDC calls for "screening of all sexually active females under 20 years of age at least annually, and annual screening of women ages 20 and older with one or more risk factors for chlamydia (i.e., new or multiple sex partners and lack of barrier contraception). All women with infection of the cervix and all pregnant women should be tested."
Translation: national mandatory chlamydia screening of all pregnant women, same as New York State now requires for HIV. This is serious stuff, folks.
So why are news anchors and wire services not screaming to high heaven about chlamydia? Why are public-health mobile vans not pulling up to every high school in the country? If the CDC wants sexually active girls screened, what better place to do it than at school?
Genital herpes (herpes simplex virus 2) is another STD that news screamers are curiously quiet about. HSV-2 is still incurable, can also be spread by skin-to-skin contact. In cases where a herpes-positive mother is shedding virus at delivery time, her baby could be fatally infected. Under existing criminal law, HIV+ mothers are being prosecuted for attempted murder simply for breast-feeding their babies. If the legislative geniuses who passed these criminal laws were to push their logic, they would prosecute HSV-2+ mothers for attempted murder as well.
CDC makes this dire pronouncement about HSV-2: "Nationwide, 45 million people ages 12 and older, or one out of five of the total adolescent and adult population, is infected with HSV-2. HSV-2 infection is more common in women (approximately one out of four women) than in men (almost one out of five). Since the late 1970s, the number of Americans with genital herpes infection (i.e., prevalence) has increased 30 percent."
CDC adds ominously: "In the United States, HSV-2 may play a major role in the heterosexual spread of HIV, the virus that causes AIDS. Herpes can make people more susceptible to HIV infection, and can make HIV-infected individuals more infectious." So where are the high-decibel headlines about herpes?
When discussing sexual orientation, the CDC often leans hard on the homosexual threat. In its web pages on teen STDS, it says, "Adolescents who are at high risk for STDs include male homosexuals, sexually active heterosexuals," etc. This strange wording suggests that male homosexuals get STDs just by breathing, whereas straight kids get infected only if they actually have sex. CDC has a whole subpage for "women who have sex with women" and tries hard to make a case for lesbian risk, though by their own admission they can't find any U.S. cases where woman/woman sex was the only risk factor. Their most recent breakdown of case reporting shows no figures for lesbian AIDS.
Clearly some government officials and news media are suffering from a disease of their own. Namely, the homophobia that still drives AIDS hysteria in this country. Homophobia is now infecting the larger STD epidemic. It would appear that some public-health and media people are doing this deliberately, hoping to frighten 90 percent of America's population back to sexual health by the show-biz trick of spotlighting disease among 10 percent of the population.
So I'm doing some screaming of my own. Why? Not just because I'm sick of gay sex being demonized. We badly need equal air-time for those millions of heterosexual STDs out there. The STD epidemic has been building since sexual revolution started in the '60s and '70s. The CDC has known this for a long time. Yet Americans are being led to believe that sexually transmitted disease is the fault of those "bad, bad gay men"...that the epidemic can be stamped out by fingering gay people, by insisting that their STD infections are co-factors of AIDS.
Government officials and media people who fail to put those millions of STDs on the six o-clock news must shoulder the lion's share of blame for this vaster epidemic.
Patricia Nell Warren, author of The Front Runner, writes commentary for many gay and mainstream publications. Her editorials are archived at www.wildcatpress.com.
After last year's AIDS conference in Atlanta, newspapers across the country trumpeted the rising HIV infection among African American men. Detroit News columnist Deb Price noted what she called "horrifying" CDC statistics. In the Los Angeles Times, black reporter Earl Ofari Hutchinson lamented:
"Blacks are 10 times more likely than whites to get AIDS and to perish from the disease. They now make up 40 percent of all AIDS cases in the United States ... The CDC blamed the high number of AIDS cases among blacks on bisexual relations by black men. These men infected women with the HIV virus after having sexual relations with other men. In 1997, blacks made up 10 percent of the population in Los Angeles County, yet they accounted for a staggering one-quarter of AIDS cases in the county."
The real horror is this: CDC saddles those gay and bisexual men who do exist in the black community with a staggering statistical blame that isn't even real.
Can the CDC get real and say "prison rape"?
One out of four young black men now spends time behind bars. In another report, Hutchinson noted that half -- meaning one million -- of the 2 million Americans behind bars are black. The National Commission on Correctional Health Care admits that HIV infection is five times higher among inmates than the national average. According to Stop Prisoner Rape (SPR), our men's prisons echo with sexual violence...meaning straight guys raping other straight guys, with gay inmates being raped if they're handy. While same-gender affections do sometimes survive behind bars, rape is more common as a sexual fact. Rape is the weapon of choice for terrorism and social control among inmates. Racial politics, the urge to humiliate your enemy, often explodes into forced anal sex, with whites trying to nail blacks, rival gang members trying to nail each other, etc.
In other words, many of these one million black inmates are at risk from prison rape.
Rape also means that sexually transmitted disease is rampant behind bars. The growing caseload of SPR and International Coalition for Medical Justice include raped inmates who hold prison authorities legally responsible for refusing to protect them and allowing their health to be destroyed by rape.
We're talking AIDS, hepatitis B, syphilis, gonorrhea, herpes II, chlamydia, the gamut. One correctional officer commented recently that the visible untreated genital warts he'd seen among young inmates were stomach-churning. Few prisons have sexual health programs. The Supreme Court recently turned down an appeal from Alabama inmates with AIDS (many of whom are black), meaning it is now legal to deny certain health services to U.S. prisoners. Most inmates don't dare to report rapes, out of deep shame and fear of reprisals. Indeed, according to some reports, some prison officials punish troublesome prisoners by putting them where they'll be raped.
The bottom line: the rapee seroconverts, and when he's released, he takes his untreated disease home to his unsuspecting wife, girlfriend, boyfriend, as well as future babies who might be infected in utero.
California, the Golden State, should be renamed the Prison State. One fifth of U.S. inmates reside in our fantastic array of high-tech prisons, which snakes the length of our state like the Great Wall of China, casting its long shadow across our sunny hills. In other words, a high percentage of our country's black prisoners are located here -- including youth who are dragnetted through ever-more-controversial (because of the police corruption involved) anti-gang operations. Is it any wonder that L.A. County's HIV figures on black males are going through the roof?
As Hutchinson points out, another major concentration of black inmates is in Southern prisons, where authorities have shown a callous lack of concern for prisoners' welfare.
Many Americans are vaguely aware that prison rape happens. It's a standard scene in movies that makes for fictional realism: hardened convicts leering through bars at the handsome young new "fish". Sexual violence is a plot-point in the HBO series "OZ." But when it comes to nonfiction (meaning news), many media and public-health authorities have a morbid Victorian compulsion to hide the link between prison rape and disease.
For a long time, U.S. prison authorities have tried to sweep prison rape under the rug. They must be acutely embarrassed by this ugly extreme of male behaviour, which they can hardly blame on gay men, because gay inmates are usually victims, not perpetrators. Worse, the general level of prison violence proves that authorities have way less control over inmates than they would like us to believe.
Even among prison guards, who are close enough to hear the screams, denial runs deep. After reading one of my postings on the subject, a Florida corrections officer wrote me to carp: "I can understand your concern about the spread of HIV and AIDS. But when you see the punks walking around in tight pants and ëadvertising', then in my opinion they deserve what they get." Thus, in a bizarre recasting of an old bias against raped women, some law-enforcement men now choose to believe that men in prison actually "ask to be raped".
Yes, our wonderful CDC, who is trusted to provide accurate statistics and realistic health policy in the United States, is not honest about prison rape.
Nor are black men and women the only victims. Latino men's HIV/incarceration figures are spiking too, with a correspondening rise in HIV infection among Latina women. Asian and white prisoners get raped. So do women inmates. Young prisoners, including minors sentenced to adult incarceration, are raped by adults. Why is this simple fact, and consequences for the nation's health, escaping the attention of our supposedly all-seeing CDC? Especially now that our prison population has swelled to 2 million humans behind bars?
As for those doughty conservative pundits who believe that our prisons are "country clubs," I would like them to spend one night behind bars, and listen to the screams of some kid being "turned out."
Unfortunately, judging by what I read in the press, many in the black and Latino communities -- including many church people -- follow the party line that their men get HIV only from bisexual sex and IV drug use. They evidently can't admit publically that many of their HIV cases result from prison rape. L.A. Times writer Hutchinson admitted: "Many black church leaders not only have not helped dispel some of the homophobia among many blacks, they've made it worse. They dredge up the oft-cited line in Leviticus in the Bible that condemns homosexuality as ëan abomination' and self-righteously dismiss those who contract the disease as sinful and shameful." Their attitude only proves what a high degree of shame and denial surrounds the subject.
Early this year, former NBA star Magic Johnson joined with AIDS Healthcare Foundation to launch a new magazine, Thrive, targeted to people of color. Hopefully Thrive will help banish the long shadows of prison rape.
Sexual violence has a disastrous and lasting effect on young inmates -- especially the many male teens who now go to adult prison for nonviolent crimes. All those self-righteous new crime-reform bills, which raise the felony bars for juvenile offenders, will cast the longest shadow of all, when these young people -- or their future victims behind bars -- finally get out of prison. Not only will they be emotionally, spiritually and mentally scarred by their prison years, but they will be re-melding their scarred health status -- whatever it is -- back into the general population.
Beyond this, I note late-breaking news in immune-disease research from medical reporters like ABC's Nick Regush, Celia Farber and others. These reports reveal that we still have much to learn about what we call "AIDS". It's not enough that men of color, and prisoners of all races, are hurt by government and media silence. They may also be hurt by a still-unscientific understanding of AIDS itself, and a public and penal policy that rushed to judgment before all the facts were in.
Meanwhile, how much public outrage will it take, to shine some daylight on our prison system's dark role as a vector of disease?