Playing Politics with Sexual Health?, Part I - LONG

[Elspode]

You decide...from Salon.com .

No sex, please -- or we'll audit you

Why are some nonprofit organizations that don't agree with the Bush
administration's "abstinence only" philosophy repeatedly investigated by the
government, while faith-based groups get a free pass?

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By Christopher Healy

Oct. 28, 2003 | Saddam Hussein, Osama bin Laden, condoms: George W. Bush
has a lot of enemies. And the question is finally starting to be asked, just
what steps is his administration willing to take in order to silence them?
Network anchormen and coffee-break pundits alike were abuzz over the
did-they-or-didn't-they CIA leak scandal. But the outing of Valerie Plame
isn't the only instance where the federal government has been suspected of
using its resources in direct, if somewhat sneaky, retaliation against its
political opponents. Ruining the lives of CIA agents may make for dynamic
headlines, but recent evidence shows that the Bush administration also has
much smaller fish to fry.

Take Advocates for Youth, a national nonprofit organization that provides
teens with accurate and informative sex education. In 18 years as a federal
grantee, it has never been subjected to a government financial audit. That
is, until it was suddenly hit with three in less than a year (one by the
Centers for Disease Control back in October 2002, a second by the General
Accounting Office in early 2003, and the third just two months ago, by a
different arm of the CDC). The organization is crying conspiracy -- saying
that it's being unfairly targeted because of its negative views toward the
administration's abstinence-only education policies -- and the claims appear
to be more than just paranoia.

In July 2001 the Washington Post published a leaked memo from the Department
of Health and Human Services in which Advocates for Youth was described as
"ardent critics of the Bush administration." This charge apparently came as
the result of several Advocates for Youth press releases that railed against
the president's backing of the "global gag rule" that prohibited any funding
to foreign agencies that performed or facilitated abortions. In the leaked
memo, it was also suggested that the Advocates for Youth programs did not go
over well with the HHS because "the secretary [Tommy Thompson] is a devout
Roman Catholic."

While Advocates for Youth may be near the top of Tommy Thompson's Most
Wanted list, it is certainly not alone. After a group of activists booed
Thompson at an international AIDS conference in Barcelona last year, a cadre
of congressional Republicans called for investigations of the hecklers'
various organizations. The CDC has conducted three reviews in the past 10
months of San Francisco's STOP AIDS program in an effort to make sure that
none of its federal grant dollars have gone toward funding workshops that
may promote sexual activity. And the New York-based Sexuality Information
and Education Council of the United States (SIECUS) has been audited twice
this year (its first audits ever, despite a decade of receiving federal
grants), evidently because it created No New Money for
Abstinence-Only-Until-Marriage Programs, a Web site designed to educate the
public about the possible dangers of abstinence-only education and to call
for grassroots campaigns against the continued funding of these programs.

So far, Advocates for Youth, STOP AIDS and SIECUS have come through all of
their audits with flying colors. But last year, as it turns out, a number of
federal grantees were found guilty of misusing their government money. They
were faith-based organizations.

In Louisiana, a number of sex-education programs funded by Gov. Mike
Foster's Program on Abstinence were found guilty in a federal court of
openly violating the constitutional tenet of separation of church and state.
The American Civil Liberties Union sued the governor's program after
discovering numerous violations, including the use of grant money to teach
abstinence through scripture, to perform skits with Christ as a character,
to purchase Bibles, and to fund prayer vigils at abortion clinics. Though
those Louisiana nonprofits are now required to turn in regular reports to
the governor about their activities, none, to date, have been put before an
HHS audit.

"Our complaint is not with getting audited," says Advocates' president James
Wagoner. "Our complaint is with the selective and political nature of these
audits. Ideology is invading -- if not subverting -- science within the
Department of Health and Human Services [which houses the CDC], and we ended
up on the audit table because we are one of the organizations pointing that
out."

Advocates for Youth has continually stood behind its time-tested,
research-backed policy of comprehensive sex education and HIV prevention, as
opposed to adopting the Bush-backed method of abstinence-only education.
Through its varied and numerous programs -- ranging from peer counseling and
educator training to the creation of lesson plans and instructional
videos -- Advocates for Youth has worked nationally and internationally to,
as their mission statement reads, "help young people make informed and
responsible decisions about their sexual and reproductive health." This
includes providing them with information about contraceptives as well as
abstinence and brings with it a sensitivity toward all forms of sexuality.

Comprehensive sex education has, for years, had the backing of the
scientific community as an excellent preventive measure against teen
pregnancy and sexually transmitted diseases. Its proponents -- the American
Medical Association, the National Institutes of Health, and the American
Academy of Pediatrics among them -- will point to studies in publications
such as the American Journal of Public Health, the Journal of Adolescent
Health and the Journal of School Health, to back up their claims.

Support for the other side comes mostly from non-science sources, like
Robert Rector of the conservative Heritage Foundation. In a much quoted
April 2002 diatribe against comprehensive sex education, Rector cited a
study from the Journal of the American Medical Association to back up his
claims that abstinence-only programs work. He pointed out that the results
of this study showed that teens who take "virginity pledges" exhibited a
delay in their initiation of sexual activity. He failed to include, however,
information from that same study that also reported that virginity pledges
did not work for children under 14 or over 17; that they didn't work in
communities where more than 30 percent of the teens took the pledge; and
that teens who broke their pledges were far less likely to use
contraception.

There is a clear lack of scientific data to back up the efficacy of
abstinence-only programs, yet they have the full and complete support of the
federal government. Hence James Wagoner's fears about ideology interfering
with public health.

Wagoner is not the first one to charge the CDC with manipulating science for
ideological purposes. In 1999, the CDC posted a page on its Web site listing
sex-education "Programs That Work" from around the country that had
curricula proven to be effective. All of the cited programs were
comprehensive and included information about both abstinence and
contraception; none were abstinence-only programs. Despite repeated outcries
from proponents of abstinence-only, the list remained intact. That is, until
George W. Bush came into office.

That Web page has vanished from the CDC's site, as have positive statements
about condom use. Research results showing that abortions have no definitive
link to breast cancer were taken off the National Cancer Institute's Web
site, which is part of HHS. And now with these suspiciously motivated
audits, it appears that HHS has graduated from simply hiding scientific
information that offends the religious right, to retaliating against groups
that disseminate that information.

There are three streams of revenue from which the federal government has
chosen to award grant money to abstinence-only education programs: the
Adolescent Family Life Act, started by President Reagan in 1981; the Welfare
Reform Act of 1996; and the newly developed Special Programs of Regional and
National Significance, which puts federal money directly into the hands of
community-based organizations. All of these initiatives share a strictly
delineated eight-point definition of "abstinence-only" that any program must
meet to receive funding. Basically, this amounts to teens being taught that
the only way to avoid pregnancy or STDs is to abstain from any and all
sexual activity until marriage. For a program to comply with the eight-point
definition, it must teach students that "a mutually faithful monogamous
relationship in the context of marriage is the expected standard of sexual
activity." Teachers in these programs are not allowed to endorse the use of
condoms or other forms of contraception. However, they are apparently
allowed to use instructional texts containing lines such as, "Is it fair to
make a baby die because of a bad decision his or her parents made?" and
"What if a girl came to school in a crop top, just barely covering her bra,
and shorts starting three inches below her navel? What 'game' would she be
playing?"

[Elspode]

The abstinence-only drive was labeled a priority for HHS almost immediately
after George W. Bush stepped into office. Starting in 2002, Congress has
granted more than $100 million each year to organizations that sponsor
abstinence-only programs; the average spending on these programs during the
Clinton administration was about $60 million a year. Currently the only
avenue through which organizations supporting comprehensive sex education
can acquire federal grants is the Department of Adolescent Sexual Health, a
division of the CDC that offers money strictly for HIV/AIDS prevention and
gives out approximately $10 million a year divided among more than 40
organizations.

SIECUS' No New Money Web site urges people to contact their representatives
and demand that funding to abstinence-only programs be stopped. That call to
arms is what provided all the fodder the right wing needed to begin its
retribution.

Only a few weeks after No New Money went live last August, 24 House
Republicans, led by Joseph Pitts, R-Pa., jotted off a letter to HHS
Secretary Thompson asking that both SIECUS and Advocates for Youth (which
was listed on the site along with more than a hundred other "supporting
organizations") be investigated. The letter pointed out that current law
forbids the use of grant money for lobbying and explained that this group of
congressional representatives just wanted to be absolutely sure no
government dollars had gone into the construction or maintenance of No New
Money. "I requested the audit of Advocates for Youth because I was concerned
that the group was using taxpayer money to engage in political activities,
not to help people," Pitts said in an e-mail to Salon. "And I intend to
continue keeping an eye on how taxpayer money is spent, both here in
Washington and by private groups."

Pitts has eagerly taken on a crusade against what he has called the "waste
of taxpayer money." In a statement last month on his official Web site, he
even called for an investigation into the spending practices of the NIH,
suggesting that funding should perhaps be pulled from the venerable
institution if it could not "provide a clear accounting and explanation for
how it spends taxpayer money." He voiced his fears about "government
agencies engaged in clearly useless activities" and illustrated this with
examples from the NIH, such as research on female sexual arousal, gays and
lesbians in the Native American community, and methods for better promotion
of the morning-after pill. He insists that he is "not criticizing the
objectives of these studies" but is "questioning the wisdom of using
taxpayer resources to engage in research that has, at best, spurious
benefits to our nation."

It isn't difficult to find a pattern in the type of programs that Pitts has
targeted for possible defunding: The two specific Advocates for Youth
programs that are funded by federal grant money -- and that are therefore at
risk of being shut down by the findings of these audits -- are HIV
prevention for young women of color and HIV prevention for gay, lesbian,
bisexual and transgender youth.

Pitts happens to be an ardent supporter of providing federal funding to
faith-based charities. ("Rather than preempt these organizations with a
government program that would never be as effective, we want to partner with
them," he said in a September press release.) It shouldn't be too hard to
see why groups like Advocates are feeling singled out.

The letter about No New Money that Pitts and his colleagues sent to HHS was
cited to both Advocates for Youth and SIECUS as the impetus for all of their
audits thus far. Strangely, CDC itself seems somewhat confused about exactly
what they've been doing to these nonprofits, both of which were given the
disclaimer that the investigations they went through in September were not
audits. "In this case, CDC does not have official audit authority,"
explained CDC spokesperson Kathryn Harben. "So what we're doing is referred
to as a 'business and financial review evaluation.'"

However, Enrique Tessada, president of Tessada & Associates, the independent
firm contracted by the CDC to perform its most recent "business and
financial reviews," wrote in his company's Spring 2003 newsletter that his
staff was "auditing community-based organizations... [that] receive grants
to conduct HIV/AIDS prevention and training nationwide."

Semantics aside, no one can disguise the fact that, regardless of results,
these audits can have a punitive effect on nonprofits. "Each one of these
rounds costs our organization enormous amounts of time and money," says
Wagoner. "In many ways it can grind you to a halt if you have to go back
through every book, pull every piece of paper, and so on."

When asked why Advocates and SIECUS were being subjected to so many reviews
in such a short period of time, Harben said she thinks "it was really more
poor planning [on the government's part] than anything else." When asked if
every grantee organization was equally subject to CDC review, Harben said
that "the history of that is probably not consistent." She also indicated
that the reviews "could take anywhere from a couple of days to four or five
days," but the groups under investigation report a lengthier time
commitment. Preparation included, Advocates for Youth says it lost almost
four weeks to its last audit, and SIECUS about two weeks.

"If they can't bury our heads in the sand about abstinence-only," says
Wagoner, "they're going to try to bury our organization in audits."

Rep. Henry Waxman, D-Calif., fearing an abuse of federal audit power, has
emerged as Advocates for Youth's greatest defender in this struggle. He and
a contingent of 11 other congressional Democrats have voiced their concerns
about the motivation behind these audits in letters to Tommy Thompson. In
those letters they ask that HHS provide information about its auditing
criteria in order "to determine whether there is sound scientific foundation
for HHS' actions." Waxman's first letter received a response that was both
delayed and abbreviated and left most of his questions unanswered. His
follow-up letter, sent on Aug. 14 and requesting answers by Aug. 29, has yet
to receive any response.

While attempting to get a response out of Tommy Thompson has become a
Sisyphean task for Henry Waxman, it appears that all Joseph Pitts needs to
do is mutter something under his breath and HHS will jump into action. On
October 2nd, Pitts and some of his Republican colleagues presented the House
Energy and Commerce Committee a list of 10 scientists whose work is funded
by NIH grants, including some of those whose projects he questioned on his
web site. The NIH has already made calls to these researchers, along with
over 100 others, whose names turned up on a longer list –– one which
apparently originated with the Traditional Values Coalition , an
ultra-conservative organization dedicated to fighting the "evils of
abortion" and the "homosexual agenda." So far, no action has been taken
against any of these NIH grantees and they have only been notified of their
inclusion on what Waxman has referred to as the "hit list," but several have
contacted the California Democrat to tell him that they now fear the loss of
their funding. On Monday, Waxman picked up his pen once again, demanding
that Thompson take a stand and denounce this "scientific McCarthyism."

The true danger is, as Waxman says, "that some organizations will stop
offering comprehensive education programs as a result of these audits,
causing public health to suffer."

That is also the biggest fear of Advocates for Youth. "This is not about the
left vs. the right," says Deb Mauser, Advocates' vice president. "It's about
what works at keeping young people safe and healthy. It's a human right to
have effective science-based strategies available to young people who are
facing an [AIDS] epidemic. Ultimately, Advocates [which receives only a
third of its total funding from government grants] will survive. Whether
young people will get the service they deserve is questionable."

"On one level, we feel vindicated by the audit process," says Wagoner, "but
on another, we can not deny the impact of this kind of tool being used on
nonprofits, and not just the intimidation on a group like ours -- we're
going to wake up in the morning, come to the office, do the work we're
always going to do -- but there's the residual intimidation of other
organizations in this field. There are lots of them that get government
money, that don't have diversified funds. And they may look at Advocates and
say, 'There but for the grace of God go I. And if it's because Advocates is
raising concerns about the subverting of science and research, if it's
because they're raising their heads up a little too high, well, that tells
us we'd better keep ours down real low.'

"You cannot convince me that this campaign isn't aimed at making an example
out of us for the rest of this field," he continues. "My only hope is that
it backfires, that those who have committed their lives to this field and to
young people or to any other group that needs good quality public health --
we will not take it lying down. We will go back to work. We will do what's
right."

[xoxoxoBruce]

Fear and loathing in Amerika.