When good guys lie: misleading the public is no way to make the world a better place - baseless, alarmist statistics in publicizing social concerns

Washington Monthly, Jan-Feb, 1997 by Glenn Hodges

If I Can Get AIDS, Thank the CDC

But it's when the federal government - the closest thing we have to a final authority on everything from budget numbers to-information on crime and disease - lies in the service of a greater good that the policy consequences are perhaps most severe, and the betrayal of trust most pronounced. In May 1996, The Wall Street Journal revealed that the U.S. Centers for Disease Control (CDC) had since 1987 deliberately misled the public about the threat of AIDS. Concerned that a disease that primarily threatened gay men and intravenous drug users would fail to garner public concern and congressional largesse, the CDC made a conscious decision to cast the disease as an equal-opportunity threat. "As long as this was seen as a gay disease or, even worse, a disease of drug abusers, that pushed the disease way down the ladder [of people's priorities]," said Dr. Walter Dowdle, a virologist who helped create the CDC's anti-aids office in the early eighties. Public-service announcements featured the clean-cut son of a Baptist minister saying, "If I can get AIDS, anyone can." But they left out the fact that he was gay. Similarly, the CDC neglected to mention that a young woman featured prominently in its ad campaign had been an I-V drug user.

Meanwhile, as Americans came to see AIDS as the nation's single greatest health threat (despite being only the number-11 killer), according to a 1992 Gallup poll, the disease made no significant inroads into the general heterosexual population. It did continue spreading, however, among homosexual men and intravenous drug users and their partners.

In its defense, the CDC says there were still a number of unanswered questions about the direction AIDS was taking in 1987. But many of those questions have been resolved now. According to the Journal, unpublished CDC research concludes that "the most effective efforts to reduce HIV infection will target injecting drug users in the Eastern seaboard, young and minority homosexual and bisexual men, and young and minority heterosexual women and men who smoke crack cocaine and have many sexual partners" Yet the CDC is still focusing much of its public education campaign on people with the lowest risk of the disease: middle-class heterosexuals.

The most devastating consequence of the CDC's errant public information campaign has been the misdirection of AIDS prevention money. In California, only 9 percent of the state's AIDS prevention funds targeted gay men between 1989 and 1992, despite the fact that they represented 85 percent of all AIDS cases, according to a University of California - San Francisco study. And a UCSF epidemiologist concluded that $1 million can prevent 150 new infections if targeted toward high-risk groups, versus only two or three if targeted to low-risk populations.

Now, the CDC is finding itself caught in a trap of its own creation. Though it can no longer escape the conclusion that the most effective prevention efforts will target the most at-risk groups, 10 years'worth of programs designed to target the population as a whole don't want to go gently. Oregon's HIV program manager, Robert McA]ister, told the Journal that many of the state's community AIDS workers "are unwilling to acknowledge that youth who are truly at risk [arel young gay men." As a result, most prevention funds are still targeted at low-risk heterosexuals. Twenty percent of the CDC's $584 million AIDS prevention budget goes toward HIV testing. But of the 24 million federally funded tests given in 1994, only 13 percent were for gay or bisexual men or I-V drug users.