Dubious Prevention Interventions:
Gay Life
Workshops Workshops|
Fail to Prevent HIV/AIDS |
TheLastWatch
Analysis ...
Or Just More Part II Media Coverage |
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Launched in 1998, but not fully operational until 1999, the Gay Life program targeting gay and bisexual men has now been conducting various Gay Life workshops and interventions for five to six years. During that time, the number of new AIDS diagnoses for gay and bisexual men have remained relatively constant at 398 cases (1999), 361 (2000), 343 (2001) and 306 (2002), according to Table 5 in the September 30, 2003 Quarterly AIDS Surveillance Report issued by the San Francisco Department of Public Health (SF DPH). Due to delays in reporting of new AIDS cases, these numbers are still subject to revision and will likely rise and remain relatively constant (indeed, just a year ago Table 5 in the September 2002 quarterly report listed 15, 23, 27, and 159 fewer cases, respectively, for these four years, that were subsequently adjusted upwards in September 2003 illustrating both the incompleteness and painful slowness of San Francisco’s AIDS surveillance system). Measuring the effectiveness of the Gay Life program in preventing new AIDS cases is problematic, in part because this four year period may be misleading due to the length of time involved between HIV infection and progression to an AIDS diagnosis. A more accurate indication of the efficacy of the Gay Life workshops might be to examine the number of new HIV infections that have occurred in the four years since this dubious programming was brought on-line.
However,
since California’s names-based HIV reporting is inadequately
implemented and hopelessly backlogged, few data have yet been
released on the number of new HIV infections, so it will take
many additional years (dating from this writing in December 2003)
to eventually evaluate whether the Gay Life programming is having
any measurable effect on preventing HIV/AIDS. Current anecdotal
reports emanating from SF DPH claim that HIV is on the rise among
gay and bisexual men, so questioning the efficacy of the Gay Life
workshops is a legitimate endeavor. If these programs aren’t
working, why are they being funded to the tune of millions of
dollars, with both public health funds and so-called “private”
donations to the San Francisco AIDS Foundation?
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And just what has this series of workshops billed as “prevention interventions” — with their plethora of so-called “facilitators” trained in everything other than voodoo witchcraft — cost taxpayers? Funded in large measure by contracts issued by the San Francisco Department of Public Health (SF DPH), using City General funds earmarked for HIV prevention, TheLastWatch examined contracts issued by SF DPH, DPH’s contract status reports, and SFAF’s tax returns and annual budgets. The contract status reports indicate that SFAF has received $2,547,073 between July 1, 1997 and June 30, 2002 for “prevention programs targeting behavioral risk populations,” including the Gay Life workshops. Toss in another $564,388 for the period between July 1, 2002 and June 2004 (the latter year is the end of the current fiscal year, which is nearly half over as of this writing), and the total amount of government funding SFAF has received for the Gay Life and Black Brothers Esteem events and workshops reaches a staggering $3.1 million for these dubious prevention interventions.
Notably, the Gay Life workshop contracts for the periods ending in June 2001 and June 2002 were funded at $514,955 annually (up slightly from the years ending in 1998, 1998, and 2000, when they were funded at $505,721 annually). However, DPH has confirmed that it awarded SFAF only $282,194 for the Gay Life program for the period ending in June 2003 — a cut of nearly 50% over the previous funding level — and that it has not yet “certified” (concluded issuing) the Gay Life contract for the period ending in June 2004, despite being half way through the current fiscal year funding cycle. Perhaps there is hope that DPH has finally wised up to the utter uselessness of the Gay Life course offerings being pushed by SFAF as “emotional and practical support”; if DPH cuts funding to the Gay Life workshops altogether, look for SFAF to drop them like a hot potato, unwilling to fund them using only SFAF’s so-called “private funds.” If SFAF can’t get a government contract for these workshops, they’ll probably eliminate them completely.
As an aside, what is also known is this: Across the six fiscal years between FY 98/99 and FY 03/04 (the current FY as of this writing), SFAF has budgeted a total of $7.6 million dollars for the budget row titled “Program Development.” Assuming that the “Program Development” row included actual delivery of the Gay Life workshops, and was not just costs developing programs, how much of this $7.6 million was for the Gay Life and BBE programs, and what are the other programs that would have gobbled the $4.5 million difference between the $3.1 million SFAF received from the City’s General Fund for the Gay Life and BBE programs to reach the $7.6 million figure it claims it has budgeted for program development? Alternatively, if the assumption is wrong that the program development row had included delivery of the Gay Life program, does that mean the entire $7.6 million included delivery of not one actual program and it only funded a bunch of SFAF employees sitting around a table talking about developing future programs?
The City contract for the period July 2000–June 2002 stated that the goal of funding the Gay Life and Black Brothers Esteem (BBE) project was “to eliminate new HIV infections in San Francisco.” After spending, at minimum, $3.1 million in public health funds on the Gay Life and BBE programs — and who knows how much of SFAF’s own funds — one wonders how many, if any, new HIV infections were prevented by these workshops at such great expense.
Just
how did SFAF spend the City’s grant of $514,955 a
year on these two programs in FY ’00–’01 and FY
’01–’02? First, for a total of 6 full-time
equivalent employees, (a total of 9 people, only three of whom
are 1.0 FTE’s and the remainder are 0.5 FTE’s), $297,418
was budgeted annually for salaries and $74,355 for fringe benefits,
for a total personnel expense of $371,773. Add in another
$42,519 for indirect expenses — for such such things as paying
a portions Pat Christen’s $200,000 salary and benefits, and
salaries and benefits of upwards of 11 other employees at a rate
of 9% through the contract’s indirect expenses — and the program
was left with $100,663 remaining from the $514,955 each year.
Of the $100,663 remaining annually, $27,010 was budgeted
for “professional facilitator fees,” $1,400 was earmarked
for the “Days of Our Gay Lives” video director’s
annual stipend, and $2,000 was budgeted for emcees paid $500 each
at four Gay Life “events,” which were distinct venues
separate from the Gay Life workshops. Between these three
expenses, $30,410 was budgeted annually using public health funds
to pay for SFAF’s Gay Life “meeting facilitators”
and for stipends for Gay Life video producers and event emcees,
and God only knows how much more SFAF shelled out for additional
workshop facilitators using its own so-called “private”
money raised at the AIDS Walk and at other fund raising schemes.
Yesiree, meeting facilitators and emcees are a big business …
which may be the real reason these workshops are held: Simply
to provide patronage jobs for friends and colleagues of SFAF’s
Executive Director, Pat Christen!
But what of the remaining $70,000 annually? Well, $35,780 was budgeted for additional meals, room rental charges, video production costs (including props, editing, and production), program promotional materials and advertisements, and event schedules — the latter of which involved printing 1,000 full-color event schedule “cards” at a cost of $4,000! The $35,780 included $14,400 for design, production, printing and placement of advertisements in the media (no wonder newspapers and graphic designers love the AIDS Foundation: They represent great business for the newspapers!)
Unfortunately, that left roughly $34,000 remaining annually from the $100,663, after paying for facilitator fees and various charges for actual workshops … and the $34,000 went to such things as paying rent at SFAF’s headquarters ($17,593), telephone charges and utilities ($3,090), office equipment leases ($5,070), office supplies and postage ($4,422), insurance ($1,166), off-site storage of program records ($516), and maintenance of office equipment ($2,616).
So there
you have it: Actual expenses under this City contract (ignoring
any “private” funds SFAF may have kicked in on top of
the $514,995 annually from the City’s two-year contact) to
conduct the Gay Life and BBE programs stands at a mere $66,190
annually for facilitators and other expenses for the workshops’
overhead and related event expenses. Yet by the time SFAF’s
organizational — not event — overhead
expenses (indirect salaries and benefits, telephones, rent, off-site
storage, etc.) were factored in, an additional $448,805 is required
to beef up the grab for public health funds for these two programs.
Just 12.8 percent ($66,190) of the annual contract goes
to actual Gay Life workshop expenses, and the rest goes to organizational
overhead! Couldn’t someone have simply cut
out the middle man (SFAF), and saved taxpayers $448.8K annually?
Indeed, the ’00–’01 and ’01–’02
contract dealt with just five Gay Life workshops held in multiple
sessions — “Growing Older” (a.k.a, “Oh My
God I’m 40! Now What?”), “Sex and Spirituality,”
“Fag Art,” “Gay Culture,” and “Intimacy:
The Final Frontier”— and the contract also threw
in the BBE “Afro Chat” (for four groups having four
sessions each), and also tossed in three “focus groups”
to develop an advertising campaign “targeting African American
men who have sex with men,” including paying the latter incentive
fees to lure participants to attend the focus groups.
[Note: The Gay
Life workshop expenses do not include other SFAF
funds it has used to emblazon the Gay Life logo onto beach hats,
tee-shirts, and lapel pins with flashing battery-powered lights
that SFAF distributed (at untold expense) for years that no self-respecting
gay man — at least no self-respecting gay man in San Francisco
— would be caught dead wearing, in part because of fears
of gay bashing or hate crimes (let alone accusations of poor taste
in wardrobe), particularly in communities of color where it may
not be safe to sport such sartorial garb announcing one’s
sexual preference in broad daylight.]
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Readers should note that there have been at least four separate versions of the Gay Life logo since 1999, and four separate ad layout styles used.
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Note Gay Life logo placed next to SFAF’s logo; freeform ad layout (this one is from 2002) |
Gay Life logo with crown in circle; photo imagery “puzzle pieces.” Possible designers: McCann-Erikson |
Gay Life logo drops the crown; “Vintage” photo imagery. Possible designers: Cabra Diseno |
Gay Life logo white-on-black; “Contemporary” photo imagery; Bidirectional headlines. Possible designers: Cabra Diseno |
The Gay Life advertising expenses are not completely funded by SF DPH contracts. Indeed, for FY 99-00, the City issued contract number POHC00000111 for the period July 1, 1999 to June 30, 2000 in which $31,941 had been budgeted for media advertising for both Gay Life workshops and an ad campaign called Assumptions (detailed elsewhere on this web site). However, on its tax return for the period ending June 30, 2000 SFAF reported to the IRS that it had paid a local design agency named Cabra Diseno $110,130 for graphic design —a discrepancy of approximately $78,000 in design fees above what the City had funded.
As noted above, for the two contract years (July 2000–June 2001 and July 2001–June 2002) the City had awarded only $14,400 each year in a misnomer inappropriately titled as “Health Communication/Media” for the Gay Life workshops and events, when in fact no discernible health communication messages — let alone HIV prevention messages — are ever included in the Gay Life print ads trying to drum up attendees for the workshops. Despite having been awarded only $14,400 for the Gay Life ads in each of the two years, again SFAF’s tax returns listed payments to Cabra Diseno of $250,712 for the period July 2000–June 2001 and $138,477 for the period July 2001–June 2002.
In total Cabra Diseno has been paid somewhere between $499,319 and $581,236 for design services (it is unclear whether an additional $81,917 in design fees for the Assumptions media campaign was paid for using funds from the July 1999–June 2000 tax year, since SFAF did not list Cabra Diseno on its tax return for the period ending in June 2000 and production of the Assumptions budget had started long before July 1999). That’s right: SFAF has received only $60,741 in City contracts for Gay Life advertisements, and it has dished out a half-million in design fees alone, and God only knows how much else in additional payments to newspapers to print the actual ads, as it is unclear whether Cabra Diseno was paid only for design services as SFAF reported to the IRS, or for placement of the ads as well.
Despite having doled out at least a half-million bucks to Cabra Diseno since July 1999 for graphic design services, all San Franciscan’s have seen since mid-2001 (when the Assumptions media campaign was cut short by a year and vanished prematurely when SFAF launched its global “affiliate,” Pangaea) are advertisements for the Gay Life workshops — not any HIV prevention social marketing media campaigns conducted by SFAF. It has been over two years since the end of SFAF’s last two media prevention campaigns: its Assumptions ads and its ill-fated The New Epidemic that ran for a mere six ads, one of which was titled “Who Gives a Fuck?” that had enraged local activists over SFAF’s insensitivity. Two long years have dragged by without any new sustained, consistent, or credible media HIV prevention media campaign having emanated from SFAF, despite its having thrown a half-million in business to graphic designers. All San Franciscans now get from SFAF in the way of prevention advertising are come-on’s to attend the virtually useless Gay Life workshops!
TheLastWatch wonders how many new seroconversions in San Francisco have occurred as a result of SFAF’s failure to conduct a prevention ad campaign in the past two years.
What
a sad, sad end to SFAF’s HIV prevention media ad campaigns,
which had spanned a 16-year period, and which history is detailed
on page 9 in the Assumptions ad campaign
report
located on this web site [launch Acrobat Reader before clicking
on this hyperlink].
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Turning to attendance, SFAF reported the number of Gay Life workshop attendees on only one of its tax returns, for the period ending in 1998, reporting 204 participants. In subsequent tax filing years, SFAF lumped together the Gay Life workshops with the BBE workshops, reporting an aggregate number, so determining attendance trends for only the Gay Life workshops is difficult to ascertain. That said, it is troubling that SFAF’s tax returns show that the number of gay and bisexual men receiving (apparently one-to-one) prevention case management has dropped every year: From 177 gay/bi men in 1998, to 157 (1999), 116 (2000), 105 (2001), and 101 (2002) — which is particularly troublesome since the 2000 to 2002 contract stated that for 2001 and 2002, 125 clients would be served with prevention case management (being short by 20 and 24 clients according to its tax returns, respectively, in those years, for an approximately 19% gap in the number of clients to be served). That’s right: Contracted to have provided case management services to 125 clients, SFAF appears to have been able to locate only 101 dalmations (err … 101 clients) in 2002 interested in having their gay lives case-managed by SFAF. As well, the 2000–2002 contract stated that 1,160 clients would be served by other non-case management components of the BBE and Gay Life programs each year, yet SFAF’s tax return for the period ending in June 2002 boasted in Statement 6 that only 649 — not 1,160 — had received these services, leaving a reasonable person to wonder whether 511 clients (44% of those projected in the contract) simply went unserved. How can SFAF be reporting one set of data to the IRS, and possibly other data to DPH hoping to bypass the scrutiny of DPH’s contract compliance officers’ antennae?
TheLastWatch — concerned about the number of unduplicated clients contracted to have attended Gay Life programming and attendance anomalies reported on SFAF’s tax returns — presented public testimony at the San Francisco Health Commission urging that body to audit SFAF (see agenda item 3.5 in the Commission’s December 16, 2003 minutes).
One
of two things seems to be occurring: Either gay and bisexual
men have finally wised up to the utter uselessness of the Gay Life
workshops and individual counseling suggesting that SFAF has oversaturated
the likely number of people interested in these interventions
… OR … SFAF
has
cut the number of staff providing these services, resulting
in fewer case management “treatment” sessions being
available to Bay Area clients. Indeed, since releasing its
tax return for the period ending June 2002, SFAF has reportedly
laid off at least 48 employees (or approximately half of its staff)
due to purported
budget
difficulties (which difficulties are untrue, given the $6.4 million
in its increased revenue), resulting in part from SFAF’s
diversion of funding from the Bay Area to launch SFAF’s affiliate
non-profit, the Pangaea Global AIDS Foundation in Africa. It
will be instructive to see the tax return for the period ending
2003 when it is released in May 2004 to learn how many gay and
bisexual men received prevention case management counseling in
FY July ’03–’04 (unless SFAF simply stops reporting
those numbers on its tax returns, just as it has stopped reporting
other data it doesn’t want its charity-donating public to
know about readily, or obtain easily).
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As for the number of managers responsible for the Gay Life program , why is it that in the past five years SFAF has had such a high turnover in managers of this program? There have been three or four (or more?) Gay Life managers in just five years. Is the stress level so high in pulling together some semblance of “gay life” into these workshops that it has contributed to staff burnout? Joe Headlee was director of Gay Life in 1999, and one his staff was Scott Moore. Joe Fera was Gay Life’s “special projects manager” in charge of the Gay Culture workshop series. Fera, who was later the SFAF liaison to its Board of Directors, is now the manager of Shanti’s department providing administrative support to San Francisco’s local Ryan White CARE Council, a community advisory body mandated for receipt of federal Ryan White CARE Act funds. Currently, the Gay Life program manager happens to be a guy named William Bland, and before him, it was Scott Moore, who had replaced Headlee when he became the fall guy in 2000 and was possibly let go (as the low man on the totem pole) in order to prevent further embarrassment to SFAF over the potentially $1.4 million spent on the Assumptions media ad campaign; it is always so much easier to finger a fall guy (like Headlee) than to hold senior managers at SFAF responsible for fiscal mismanagement of programmatic boondoggles like the Assumptions ad campaign.
As to SFAF’s misguided ethics in hiring Ouchy the Clown — either paying him a stipend to be a facilitator or to be an emcee — who uses a straight razor to perform full-body shaves on his patrons, did it never occur to SFAF (as it concerns TheLastWatch) that precisely because Hepatitis C prevention information suggests sharing any kind of razors could transmit microscopic particles of blood containing either HIV or Hep C, that Ouchy would be the very last person SFAF should hire, given his sideline business performing full body shaves? After all, SFAF’s hiring of Ouchy for its second Gay Life “Too Taboo” workshop held in 2002 at the San Francisco Gay and Lesbian Center (another facility it had to pay rent for, which “prevention” event TheLastWatch attended) may have legitimized Ouchy as a worthy “meeting facilitator” for other AIDS service organizations to also hire. SFAF may have also inadvertently legitimized gay and bisexual men hiring Ouchy for private parties to have their bodies shaved using a straight razor.
TheLastWatch cringes, imagining a straight razor roaming the City, possibly with microscopic blood particles in tow, performing body shaves.
Even as study after study is conducted on the unmet needs of people with HIV/AIDS in San Francisco — with housing and direct financial assistance placing as among the greatest unmet needs in study after study, and workshops like these as the lowest need — SFAF barges ahead nonetheless, spending millions in AIDS funds year in and year out on program development to revise its Gay Life programming mix.
Notably, so unsure of its programmatic content just two years of the launch of Gay Life in 1998, SFAF contracted with UCSF’s Center for AIDS Prevention Studies (CAPS) for an efficacy analysis of the Gay Life programming. According to the May 2001 CAPS newsletter, CAPS performed at least the first phase (the Castro Evaluation Study, or CES) of the Gay Life efficacy study and the second phase was “in the field” as of November 2000. In a summary of the first phase, CAPS claims that the study is funded by “the University AIDS Research Program,” but CAPS is not forthcoming as to whether that Research Program is funded in whole or in part with federal funds, nor does CAPS indicate in the newsletter whether the “collaboration” between SFAF and CAPS to evaluate the Gay Life program was possibly a subcontract of other contracts SFAF has with UCSF.
Of note, CAPS concluded that “while a modest proportion of men said they have heard of the Gay Life program, few had attended [any of the workshops]” [emphasis added]. According to this newsletter, the CES study is to be utilized not only by SFAF, but also by other community-based organizations and service providers; to that extent, if other HIV prevention organizations who are receiving federal funds will be using the CAPS analysis to design programmatic content, the contents of CAPS’ analysis of SFAF’s Gay Life program deserves to be released to the public, but has not been, as far as TheLatchWatch knows. Reasonable people wonder whether CAPS recommended in 2001 that SFAF utilize Orgasm Coach Frank Strona and Ouchy the Clown (see below) to increase Gay Life program participation, or whether CAPS recommended just the opposite (that SFAF stop using orgasm coaches and other irrelevant workshop facilitators).
Notably, at some point in late 2001 or early 2002, possibly after the CAPS analysis may have concluded, SFAF redesigned the Gay Life logo, eliminating the offensive “gay crown” from the logo, and changing the letter “i” to have a star above it, rather than the dot. [Even later, the logo was changed again to remove the star, restore the dot above the “i,” and add “sf AIDS foundation” below the Gay Life logo.] Did it take a review by university researchers to determine that a silly logo may have lured only a “modest proportion” of potential attendees, and that SFAF wised up to the possibility that the logo was having an untoward impact on workshop attendance only after it had the program and its logo “scientifically” studied by trained researchers?
In “AIDS agencies receive vituperative Valentine,” an article that appeared in the Bay Area Reporter on February 21, 2002 (located on the Media Coverage page on the SFAF main page of this web site), five Bay Area AIDS organizations were reported to have been taken to task in a report titled “AIDS Programs: An Epidemic of Waste.” SFAF was among the five organizations named in the report issued by Citizens Against Waste, a taxpayer group; the report noted that SFAF’s Gay Life workshop “Sex on the Net, 2001: A Sexual Odyssey (highlighted below) was conducted during the same time San Francisco’s public health officials were shrieking that Internet chat rooms were the source of a purported increase in sexually transmitted diseases among gay men who were using the Internet to find sex partners. However, widely respected AIDS accountability activist Wayne Turner, of ACT-UP/DC, thanked the taxpayer group; Turner vowed to continuing questioning “how AIDS agencies spend federal money.” Officials from the five agencies reportedly “dismissed the report as being inaccurate and outdated.” These agency officials’ denial is completely untrue, as Gay Life “outdated” workshops presented in 2001 — Like “Hot Writing,” “Sex on the Net,” and “Oh My God I'm 40! Now What?,” among others — were repeated in 2003 long after the Valentine’s report critical of the programs was released in 2002. Many of the workshop titles on this page have been repeated year after year after year, so the programs are not considered “outdated.” The reports’ authors were correct: These useless workshops are still being conducted today, so the Valentine reports’ information was accurate on February 14, 2002, just as it is accurate now. The epidemic of wasteful spending on such things as flirting classes, retooled as a workshop to prepare personal gay “dating plans,” keeps right on rolling, plopping $150-per-hour facilitator fees right into Orgasm Coach Frank Strona’s and other people’s checking accounts.
And it was not just the private organizations who were seeking to dismiss the Valentine’s Day report using false statements. Even-steven Steven Tierney, EdD, a public health employee who is director of HIV prevention for SF DPH, also “dismissed the report as merely old news” in the B.A.R. article, trying as desperately as the organizations had to put spin control on the Epidemic of Waste report critical of SFAF’s “Sex on the Net” workshop. Tierney’s statement was disgraceful for its misinformation, because 15 months later SFAF repeated the “Sex on the Net” workshop. Surely as the City’s HIV prevention director in charge of issuing contracts to SFAF, Tierney — before issuing a statement to the Bay Area Reporter — could have confirmed whether SFAF had plans to repeat the “Sex on the Net” workshop (which SFAF ultimately did in May 2003 ) so the workshop was hardly “old news.” By May 2003 SFAF had finally wised up and removed the words “A Sexual Odyssey” from the workshop’s title, possibly on advice from Tierney’s program materials review committee charged with monitoring HIV prevention programmatic course content. If nothing else, before issuing a quote to the Bay Area Reporter, Tierney had an ethical obligation to have placed a phone call to SFAF’s Pat Christen, who is located a mere eight blocks down Market Street from Tierney’s office, to learn whether SFAF had plans on re-running the “Sex on the Net” workshop again, before he blabbed a misstatement dismissing valid criticism of the workshop as simply “old news.”
Not to be outdone, the Stop AIDS Project’s Executive Director Darlene Weide weighed in, suggesting in the B.A.R. article that eliminating these workshops would “devastate people’s lives.” Hogwash, Darlene! The only people who are going to be “devastated” will be aging queens who don’t get to attend the “Growing Older” (a.k.a, “Oh My God. I'm 40! Now What?”) workshop, but would missing such a workshop be life-threateningly devastating? I take that back: Other people who might be devastated are workshop facilitator’s like Frank Strona and Ouchy the Clown who might be oh-so-devastated that they would be unable to pocket $30,000 (or much, much more) annually earning facilitator fees from the gravy train known as HIV prevention funding.
Returning to scientific soundness, another study that appeared in the British Medical Journal and reported in the Bay Area Reporter (“Study questions effectiveness of safer sex workshops,” Bay Area Reporter, July 26, 2001), at just about the same time that CAPS was performing its analysis of the Gay Life program for SFAF), concluded that safer sex workshops may be counterproductive and lead to more unsafe sex. “The potential for behavioural interventions to do more harm than good needs to be taken seriously, [emphasis added] the British researchers noted.” The B.A.R. article quoted Kevin Robert Frost, vice president for clinical research and prevention programs at the American Foundation for AIDS Research (AmFAR). Frost noted that “The biggest lesson in [the BMJ] paper is that we have to figure out how to target our prevention efforts using effective validated tools. What the survey really highlighted … is that we can’t just assume that just because we’re providing some intervention, that the intervention is going to be effective [emphasis added].” Frost reportedly “… applauded the [BMJ] study’s authors for challenging conventional wisdom.”
Yet that is precisely what Dr. Tierney and Ms. Weide did just seven months after the AIDS Programs: An Epidemic of Waste report was released on Valentine’s Day 2002: They both assumed that just because SFAF was providing the Gay Life workshops, that the events were effective. Tierney and Weide appear to be unwilling to challenge conventional wisdom, perhaps because in doing so, it might be revealed that many of the then-current and currently-current crop of prevention workshops being conducted in San Francisco are of absolutely no benefit. Having to face the fact that they have funded years of of-no-benefit workshops would spell disaster for Tierney’s and Weide’s careers, which must be protected at all costs. The BMJ article also noted that “… [the behavioral intervention studied] did not reduce the risk of acquiring a new sexually transmitted infection among these gay men at high risk. Even carefully designed interventions should not be assumed to bring benefit [emphasis added]” … and Tierney and Weide simply can’t face the probability that many of the workshops described on this page contain zilch in the way of benefit in preventing people from acquiring HIV/AIDS; the programs appear to benefit only the program development staff and contractors raking in millions in fees for prevention programming development, as well as workshop facilitator fees.
Which leads us to CAPS’ now former but then current director, Thomas Coates, PhD, who was simultaneously also the director of UCSF’s AIDS Research Institute. In the November 29, 2001 issue of the Bay Area Reporter (“Coates drops HIV prevention bombshell”), Coates suggested that “Maybe we should just make lots of condoms available, keep informing people where the STD centers are, and just accept that every year there will be a certain percentage of people who will get HIV. … Maybe we should just stop [prevention programs].” The opening paragraph of this B.A.R. article by Matthew S. Bajko read: “Conceding many prevention programs geared at men who have sex with men are not stopping the spread of HIV in the gay community, the director of a San Francisco AIDS research center says it may be time to scrap those programs altogether.” Fully two years have passed since Coates dropped his “bombshell,” and almost two years have now passed since the report An Epidemic of Waste was first released, and the workshops have not been scraped — they have simply been repeated over and over and over.
Coates also stated, “What I am calling for is simply to open up the discussion and think about the full range of options before us. Stopping these programs is one of those options [emphasis added].” He also said “One has to allow the discussion to go where it will go. If we are fearful of discussion then we are fearful of open thinking and frank talk, and that is not what we [CAPS] are all about [emphasis added].”
Is the bureaucracy in the San Francisco Department of Public Health’s AIDS office so top heavy and inertia-laden that in the two years since Coates dropped him “bombshell” that Tierney has failed to convene a community forum to hold an “open and honest discussion” about HIV prevention options that may prove more efficacious than these useless Gay Life workshops? Is Tierney incapable of laying his hands on the CAPS report to find out what Coates’ researchers had recommended be done — other than the possible recommendation to redesign the Gay Life logo and the look and feel of the Gay Life ads, each three times — with the Gay Life program and the future of HIV prevention in San Francisco? For all we or Tierney may know, Coates’ researchers may have recommended scrapping the Gay Life program completely.
… or Just More Business As Usual?
Or are Tierney et al. just stuck in the business-as usual-rut? Tierney shared in a private communication that he had been inspired by an e-mail from Patrick Monette-Shaw concerning the Institute of Medicine’s (IOM) report No Time To Lose: Getting More From HIV Prevention, issued in January 2001, in which the IOM recommended moving away from the old business-as-usual approaches to HIV prevention. The IOM report should have inspired Tierney: Among the IOM’s Liaison Panel was none other than Tierney’s colleague, one Tom Coates. Or perhaps Tierney was inspired by the quote at the front of the IOM report:
Inspired, Tierney issued a “No More Business As Usual” RFP of his own for competitive bidding for $12 million in prevention funds that were awarded in late 2001. Despite having been ranked at number 10 out of 27 proposals awarded Tier 1 HIV prevention projects, the San Francisco AIDS Foundation was awarded $276,888 (although that may have climbed to $282,194 for the Gay Life contract for the period that ended in June 2003) to continue providing programming to men who have sex with men under Tierney’s no-more-business-as-usual vision.
Sadly, several funding cycles later, SFAF is still being funded by Tierney’s office to conduct these everything-is-business-as-usual Gay Life workshops, although to be fair, the annual Gay Life contracts were reduced from $514,955 to $282,194. If Tierney really believed there should be no more business as usual, he would stop funding (using the City’s General Fund) the Gay Life workshops completely.
Nothing has changed! Two years after Coates’ bombshell, two years after Tierney’s “inspiration,” almost two years after the Epidemic of Waste report, and nearly three years after the IOM No Time To Lose report, nothing has changed and it’s still business-as-usual. And Tierney should be ashamed of himself for his lack of inspiration, his lack of determination, and his lack of resolve in failing to finally pull the plug completely on SFAF’s business-as-usual Gay Life approach to HIV prevention, rather than simply reducing the amount of the contract award.
Tierney
may have known, but he did not apply. Tierney may have been
willing to confront no-more-business-as-usual, but he failed to
do
no
more business as usual!
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Does anyone else now connect these dots?: Just six months after the May 2001 CAPS newsletter reported that CAPS was conducting a review of the Gay Life programming, Coates was blabbing to the media in November 2001 — possibly just as additional data was becoming available from the first phase of the Castro Evaluation Study examining efficacy of the Gay Life program and as data from the second “field” phase started to roll off of the analyses computers — could Coates have been sending a clue that the results of this contractual analysis may have possibly concluded the Gay Life workshops yielded no benefit in preventing additional HIV infections? The coincidence in the timing between CAPS’ analysis and Coates’ bombshell may not have been coincidence at all: The “bombshell” may have been a direct outgrowth of the efficacy research and a conclusion the data analysis could not have avoided reaching. [This may potentially explain why the analysis has not been released to the public: It’s conclusion may not have been able to whitewash the underlying data.]
If Coates had not concluded that the Gay Life workshops, among others, may be entirely useless, why would Coates have been further quoted in the B.A.R. article criticizing “AIDS Inc.” — a collection of AIDS prevention and service agencies of which SFAF is a prominent member — as “almost beating on the community to get it to change its behavior. They [AIDS Inc.] are not perceived as part of the community.” How could Coates have possibly reached that conclusion — that SFAF, among other AIDS Inc. pork barrel agencies, is not viewed as part of the community and that SFAF may be beating up on its own clients — if he had not possibly uncovered this not-so-new “news” while he was in charge of conducting CAPS’ Gay Life program efficacy research?
Sadly, a public discussion of stopping the frivolous Gay Life workshops has never been held at an open community forum, in part because SFAF, Dr. Tierney, Pat Christen, and Darlene Weide appear absolutely fearful for their livelihoods, afraid that open thinking and frank talk in the community could put them out of work, and that a simple open discussion might point out that the community does not perceive any of them as being part of the community. Instead these people and SFAF avoid frank talk like the plague, preferring instead to muzzle any and all forms of legitimate public dissent of these failed prevention workshops (or SFAF would not have so brazenly tried to deny me permission to attend the “Too Taboo” workshop to observe the events’ so-called “programmatic content”).
And unless and until the CAPS efficacy analysis of the Gay Life program is made public, SFAF can and should be rightfully accused of censoring responsible and open discussion about the Gay Life workshops as dubious programming. After all, this research was paid for by either AIDS government funding or AIDS fundraising dollars (or possibly both), which belong in either case only to SFAF as stewards of the public’s — our — trust. The CAPS analysis of the efficacy of the Gay Life workshops does not belong to SFAF! It belongs to the public, where it deserves to finally be aired openly and completely.
And if SFAF continues to deny releasing the results to the public, the charity donating public should do two things: First it should demand that Pat Christen be fired by SFAF’s Board of Directors. And second, the public should simply stop donating money to SFAF until the efficacy results of the Gay Life program are released to the public, and it should tell SFAF in no uncertain terms why the public believes this report could very well save additional human suffering caused by HIV/AIDS.
That
SFAF continues to operate, instead, in secret speaks volumes about
how little it trusts its own public.
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Nine of Thirty-One Useless Gay Life Workshops (presented in no particular order) …
 May 20, 1999 Ad |
Gay Prom Summer 1999 Ad Narrative: “This time you get to choose. Corsage or Boutonniere… [Thought bubble reads ‘Queen’].” Commentary: Launched in 1998, but not fully operational until 1999, one of Gay Life’s inaugural events was by hosting a prom as one of its first forays into providing “emotional and practical support” to gay men by hosting social events to bolster participant’s self-esteem. [The photo is of a man.] The “prom” occurred at about the same time that other HIV prevention programs in town featuring boat cruises on the San Francisco Bay, trips to art galleries, flirting classes, and bowling parties were all the rage in San Francisco as the preferred and often-touted “best” prevention interventions money could buy using government-provided public health funds. Notice the Gay Life logo, which had initially used a crown above the wording; that version of the logo existed between 1998 and 2000 when it was redesigned to drop the crown and added a star to dot the letter "i" in “Life.” One wonders what kind of feedback — and how many complaints — SFAF received before it finally removed the offensive crown from the logo Top |
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November 27, 2001  May 28, 2003 |
Sex on the Net 2001: A Sexual Odyssey November 27, 2001 Sex on the Net May 28, 2003 Facilitator: Deb Levine, MA, Sex Educator and author of The Joy of Cybersex and the creator of the web site www.goaskalice.org (November 2001); Mark Rumpler, Sex Educator (May 2003) Ad Narrative 2001: [Text dropped or changed in 2003 below is marked in red]: “The cyberworld is not only for geeks and nerds! Hey, we know the cyberworld can be hard to navigate, so come together with Deb Levine, in a three-part interactive workshop designed to enhance your sexual forays. Together, participants will learn how to establish healthy online relationships, join fringe and fetish communities, find sexuality resources, and negotiate the new sexual frontier.” Ad Narrative 2003: [Text added in 2003 is marked in green]: “The cyberworld is not just for geeks and nerds. So limber up your fingers and get to this four-part interactive workshop lead by Mark Rumpler. Enhance your sexual forays as you learn to establish healthy online relationships, explore fringe communities and find health & sexuality resources, and negotiate this sexual frontier.” [See “A Penny for your Thoughts” below ... discussing 2,500 pennies … for further information regarding Mr. Rumpler.] Number of Ad Versions: At least 2 Commentary: At the very same time that the San Francisco Department of Public Health was blaming a purported rise in the number of syphilis cases in The City on gay men who had purportedly found sexual partners on the Internet, the San Francisco AIDS Foundation was teaching them how to hook up with sexual partners via the same Internet … as if gay and bisexual men in San Francisco don’t know: a) How to find sexual partners on their own, or b) How to use the Internet without non-profit resources being used to teach basic Internet surfing skills. After receiving negative national attention in a Citizens Against Government Waste report entitled “An Epidemic of Waste,” for sponsoring a workshop using government funds to teach people how to link up via the Internet to locate sex partners, SFAF subsequently dropped the phrase “A Sexual Odyssey” from the workshop’s title. In a further move to tone down the workshop, the ads wording dropped “fetish” and added “health” in order to make it appear that the workshop was more about public health issues and less about learning how to find fetishist resources. Notice that as late as November 2001, Gay Life ads continued to use the crown in the programs logo. Also note the major design makeover to the ad layouts that occurred between 2001 and 2002. Top |
 October 25, 2001 January 23, 2002 September 9, 2003 |
Hot
Writing October
25, 2001; January 23, 2002; Facilitator: Len Sanazaro, a poet and instructor
of English at City College of San Francisco |
 May 22, 2001  April 1, 2002 To view a picture of Ouchy, click here See Disclaimer to the right |
Do
You Taboo? A Sexual Health Fair: May 22, 2001
A Sexual Health Fair: Too
Taboo? (Exploring Gay Sex Myths and Other Misnomers) April 1, 2002 |
 March 28, 2001  January 17, 2002 September 8, 2003 “Oh My God I’m 40" Workshop Is Now Supplemented by a “50 Plus” Workshop |
Oh
My God, I'm 40. Now What? March 28, 2001; Note the rhetorical question “Now What” in the headline of the March 2001 advertisement. The SF DPH contract for the Gay Life prevention
workshops contained Exhibit B-1a prepared by SFAF referred to
this workshop as the “Growing Older” group! TheLastWatch
has — correctly — referred to this workshop all along
as an “aging gracefully” boondoggle, and the DPH contract
confirms this event is about nothing more than soothing fears
about aging! Just what kind of public health fund exceptionalism
is involved in holding aging gracefully workshops only for the
AIDS community, but not for other disease groups? Where
are the publicly-funded aging gracefully workshops for breast
cancer survivors? And where are the public-health funded
workshops for residents of Laguna Honda Hospital and Rehabilitation
Center, which has a large population of senior citizens over
the age of 65; are they not worthy of a “growing older gracefully”
workshop, too? |
 March 13, 2003 |
Gay Dating Makeover March 13, 2003 Facilitator: Michael MacDonald, Wellness Coach; and Frank Burgoyne, Life Coach Ad Narrative: “Are you too busy, too shy or just too fed up to find Mr. Right? No matter what your romantic roadblock there is a man out there for you. Topics covered: • Overcoming your internal roadblocks to successful dating • Making dating fun • Techniques to meet men that fit your personality • Developing communication skills to handle the sticky situations • Creating a personal dating action plan.” Number of Ad Versions: 1 Commentary: First, when gay men need someone to teach them how to develop an action plan in order to find a date, they’re in big trouble, and they don’t need the San Francisco AIDS Foundation offering a government-funded class to help them develop dating “action plans.” TheLastWatch wonders whether Gaetan Dugas — the AIDS “patient zero” widely accredited with knowingly spreading AIDS in the late 1970’s — had attended any useless dating workshops sponsored by the San Francisco AIDS Foundation, or other organizations, as he circled the globe spreading AIDS, possibly with a “personal” dating plan stashed inside his little black address book. Second, in how many other jurisdictions are there “wellness coaches” and “life coaches” being employed with public health funds to stop new cases of HIV — with or without employing dating action plans? Or is this an only-in-San Francisco phenomena? Top |
 October 4, 2001 |
Sacred Bodies/Sacred Geography October 4, 2001 Facilitator: Dr. Eliyahou Farajaje, Dean of the Faculty and Professor of Cultural Studies at the Starr King School of the Graduate Theological Union, Berkeley, CA Ad Narrative: “Join Dr. Eliyahou Farajaje in a journey toward erotic wholeness. We’ll explore the erotic in the sacred and the sacred in the erotic. We will examine how erotophobia maps repression onto our sacred geography (our bodies) and find ways to create our own sex-spiritualities. Breathing exercises, meditation, and massage will open up pathways for moving our sacred erotic energies.” Number of Ad Versions: 1 Commentary: So where are the “sacred erotic energies” moving to? To Washington, D.C.? Does this workshop imply that people contract HIV because they lack erotic “wholeness”? And what’s up with “erotophobia”? TheLastWatch wonders whether Dr. Farajaje pulled in Madonna to do a live erotic demonstration with her crucifix again to help gay men overcome internalized erotophobia? Oh, if only people dying of AIDS in the early ’80’s had known that if they simply breathed correctly or had not been plagued by internalized erotophobia they could have prevented acquiring HIV and dying prematurely. Top |
 October 10, 2001 |
Men at Work: Building a Community October 10, 2001 Ad Narrative: “What does it take to build gay community? Can our bodies, our stories and our spirits be the building blocks? Kirk Prine and Jim Mitulski explore new approaches to community through ritual, play, risk taking in safe environments, and touch. A six-part workshop/experiment [emphasis added].” Number of Ad Versions: 1 Commentary: Around the time of this workshop, Religious Righters were alleging that the gay community was using public health funds to build community, and elsewhere on this web site, local activist Hank Wilson proudly announced during the Stop AIDS Project’s HIV Prevention Awards ceremony that “they [the Religious Right] were right; they’re very, very right [we are doing community building with HIV prevention funds]. ” Could it be that the criticism over using HIV prevention funds to “build community” was the reason that this workshop was only conducted in 2001 and has not been repeated since then? Was SFAF so concerned about having its funding pulled that it wised up and shelved this workshop in the dustbin of failed workshops? Top |
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For Web Space Reasons |
The Meaning of Sex in Gay Men’s
Lives January
23, 2001 Ad Narrative: “Anonymous sex, role-playing, your sexual past, what feels good. In a safe, comfortable and open environment talk about sex, wants and desires. A four-part workshop designed to help gay men find meaning in their sexual lives.” Number of Ad Versions: 2 Commentary: Any gay man that has to have the San Francisco AIDS Foundation help him discover the meaning of sex in his life, and in particular the meaning of anonymous sex, is in deep trouble. After all, the majority of SFAF’s staff in recent years have been heterosexuals who don’t even live in The City, they live across the Bay. Top |
Related Media Coverage on Safe Sex Workshops
| Study
questions effectiveness of safer sex workshops Article, Bay Area Reporter, July 26, 2001 by Ed Walsh Reprint permission courtesy of the B.A.R. |
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Safer sex workshops for gay men may be counterproductive and lead to more unsafe sex, according to a new study published in a recent edition of the British Medical Journal. The survey of 343 gay men in London found that 31 percent of men who attended a daylong safer sex workshop contracted a sexually transmitted disease over a 12-month period, compared with 21 percent of men who were given just a 20-minute counseling session. The men were recruited from STD clinics in London and were considered “high risk” because at the start of the study, about a third reported that they had unprotected anal intercourse in the previous month. “The potential for behavioural interventions to do more harm than good needs to be taken seriously,” the researchers wrote [emphasis added]. The scientists said they were surprised by their results and theorized that the men who attended the workshop may have developed “a misplaced sense of confidence in their ability to negotiate high risk sexual situations [emphasis added].” The researchers called for more study and challenged the conventional wisdom of the effectiveness of safer sex workshops [emphasis added]. “This behavioural intervention was acceptable and feasible to deliver,” they wrote, “but it did not reduce the risk of acquiring a new sexually transmitted infection among these gay men at high risk. Even carefully designed interventions should not be assumed to bring benefit [emphasis added].” The study’s lead author, John Imrie, of the Royal Free and University College Medical School in London, told the Bay Area Reporter that his study was unique because it was the first to judge the effectiveness of safer sex counseling for gay men using STD transmission rates. Imrie cited a 1998 study on the general population that found that brief counseling sessions were just as effective in curtailing STD transmission rates as longer counseling sessions. That report, published in the October 7, 1998 edition of the Journal of the American Medical Association, found that there was some benefit to counseling overall. The STD rate was reduced by 20 percent for those who received either the brief or longer-term counseling. Kevin Robert Frost, vice president for clinical research and prevention programs at the American Foundation for AIDS Research, told the B.A.R. that he applauded the study’s authors for challenging conventional wisdom. “The biggest lesson in that paper is that we have to continue to figure out how to target our prevention efforts using effective validated tools,” Frost said. “What the survey really highlighted for me is that we can’t just assume that just because we’re providing some intervention, that the intervention is going to be effective [emphasis added]. Rather, we ought to be validating the prevention tools we have at our disposal to make sure that, in fact, they are going to be the most effective tools out there.” Frost cautioned against jumping toward any conclusions to explain the study’s results. “There’s a lot of that shoot-from-the-hip analysis going on,” he said. “Frankly, we’re talking about sex, and sex is a very complicated thing.” Frost also praised the British Medical Journal for publishing the study despite its negative results. |
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