To Tell the Truth
ELI SANDERS responds to Gay City Health Project’s Fred Swanson.
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Why the hectic schedule? As this paper reported two weeks ago, HIV and STD rates are rising among gay men in the Seattle area, and Swanson's organization--which he calls the leading gay men's health organization in the city--has been way behind the curve in addressing the problem ["The Immoral Minority," Eli Sanders, June 5].
In his public statements and e-mails last week, Swanson sounded typically upbeat about Gay City. But the language he used in his cheery proclamations was vague and contradictory--even, in my opinion, downright deceitful. Swanson's letter to The Stranger is a perfect example of this obscurantist Swanson-speak, so let's go through it point by point.
Stranger Personals
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Swanson begins his letter to The Stranger with the assertion that despite criticism to the contrary, Gay City has been staying true to its mission. That mission is, first and foremost, "to promote gay and bisexual men's health and prevent HIV transmission."
If Gay City has in fact been staying true to this mission, as Swanson says it has, and local HIV rates are in fact rising anyway, then something is going very wrong at Seattle's leading gay men's health organization. Perhaps this is why Swanson spent so much time last week attempting to broaden Gay City's mission.
When he was on the local NPR station KUOW, Swanson pointed out that HIV prevention is just one of many things Gay City does. In the P-I, Swanson wrote that Gay City is "a multi-issue organization that addresses a multitude of health concerns," and noted that the newest Gay City pamphlet mentions health issues such as cancer, mental health, smoking, and heart disease, in addition to HIV and STDs. In an e-mail to a concerned member of the gay community, Swanson once again played the multi-issue card, and then added this lament: "There is never enough money, and we are careful to remember that we are a small organization with a small number of staff."
One is left wondering: Which is it? Is Gay City's mission to "prevent HIV transmission," as its mission statement clearly says (you can read it at www.gaycity.org), or is its mission to address "a multitude of health concerns," as Swanson says? And is Gay City the leading gay men's health organization in Seattle, the highly effective change-agent Swanson describes when he's bragging? Or is it the small, underfunded, understaffed organization that Swanson describes when he's taking heat and making excuses?
Also: If Gay City is so small and underfunded, why doesn't it focus exclusively on HIV and leave heart disease and cancer to larger, better-funded organizations?
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The second point Swanson makes in his letter to The Stranger has to do with Gay City's effectiveness. Swanson writes that his organization produces "real results"--that gay men involved in Gay City programs are "changing their behaviors." Swanson also made a point of bragging about Gay City's success in his op-ed in the P-I and on KUOW. At its core, the HIV and STD problem in Seattle is a problem fueled by unsafe sexual behavior that is common among a minority of gay men. This is why Swanson would want to claim he has data proving that Gay City delivers the "behavior change" Holy Grail of prevention work.
But it's hard for me to believe Swanson when he says this. As part of my reporting for "The Immoral Minority," I twice asked Swanson whether he had any data showing behavior change among men involved in Gay City's programs. Swanson twice told me that Gay City does not track behavior change. "We do not have the resources to track individuals over time," Swanson wrote in a May 15 e-mail. Six days earlier, at the national Gay Men's Health Summit in Raleigh, North Carolina, Swanson told me the same thing. If Gay City doesn't track individuals over time, then it can't possibly have meaningful data on behavior change.
Again, one wants to ask: Which is it? Does Gay City really have hard data proving behavior change, or is this just a Swanson deception? And on this question, The Stranger will do better than just ask. Fred, if you have hard data, hand it over and we'll publish it. You made the claim. Let's see the proof.
While Swanson is digging through his files, the rest of us--including Gay City's funders--might consider why it would be beneficial for Gay City not to have such data. Answer: Because that way you end up having to take Swanson's word on Gay City's success, and the organization can never really be held accountable for its behavior--the same way Gay City's ideology doesn't really hold gay men accountable for their behavior.
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Swanson's final point in his letter to The Stranger has to do with this permissive ideology. He says that telling sexually reckless gay men (i.e., HIV-positive gay men who knowingly expose other men to the virus) they should be ashamed of themselves--one of the potential tactics my article suggested, along with discussing morality, responsibility, and good judgment--simply doesn't work.
Reasonable people can debate this point, but what is not debatable is that Gay City's current approach to HIV prevention is failing. The fact remains that HIV rates are rising. This rise is driven by the same unsafe sexual practices that six years ago began fueling a rise in the rates of syphilis, gonorrhea, and chlamydia among local gay men. The six-year-long rise in gay STD rates was a clear sign that a rise in gay HIV rates was coming. And for six years, Gay City clung to its nonjudgmental, nondirective, nonstigmatizing prevention model. The result has been the agency's failure to accomplish its primary HIV-prevention mission.
But Swanson promises to keep on doing more of the same: information-based health initiatives that he says will strive not to be seen as "paternalistic" or as pieces of "propaganda." On KUOW, Swanson held up "Action," Gay City's new STD pamphlet, as a "perfect example" of such informative work.
In fact, "Action" makes no mention of the rising local STD rates. Instead it features sexy images of men and, in one section, oxymoronic advice on how to have safer unsafe sex. Gay men who read "Action" from cover to cover will have more information about STDs, but no context about the STD problem in Seattle. They will learn what syphilis is, but they won't learn how likely they are to contract it in this city--the kind of information that might lead a gay man to fuck more safely and fuck more selectively. They will get to look at all the hot male bodies in the "Action" guide, but they won't be told that STDs are not hot and sexy. If they interact with Gay City's other new initiative, an automated STD hotline that can be reached by dialing 267-STUD, they'll be given this subliminal message: If you have an STD issue, you must be a stud.
If Swanson doesn't want to be seen as "paternalistic," how about giving up on the condescending idea that gay men can't handle health messages that aren't soft-edged or sexualized? And if Gay City wants to be seen as disseminating something other than "propaganda," how about telling gay men in Seattle the truth? It could try saying, for example, that being an STD-courting, unsafe slut is not smart or sexy.
But Gay City and Fred Swanson won't say this because to do so would conflict with the nonjudgmental, nonstigmatizing ideology. To tell the truth about STDs--you don't want to have them, and you don't want to have unsafe sex with people who do--stigmatizes, as does telling the truth about where the real STD problem lies among gay men in Seattle. That Swanson and his organization won't tell the truth proves they still don't get it.
Swanson does appear to get one thing, however. In his P-I op-ed, he wrote, "As is clear from the HIV data, the community demands more." He's right on that point. But all Fred Swanson and Gay City offer the gay community is more of the same failed approach.
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