The release quoted Dr. Hunter Handsfield, director of Public Health's STD program, as saying these three STDs are at "extremely high levels." But that's not what Dr. Handsfield originally wanted to say. What Dr. Handsfield wanted to say was that syphilis, gonorrhea, and chlamydia are at "epidemic" levels.
As the press release was being drafted, Dr. Handsfield's first choice of words was sacrificed for the sake of compromise and politics.
The director of Public Health's HIV/ AIDS program, Dr. Bob Wood, pushed for different language. Wood argued that the three STDs are "hyper-endemic." He explains: "'Endemic' means to me it's a constant, ongoing, smoldering type of a problem, and 'hyper' means it's much higher than one would expect to see in, say, the majority of the population."
Dr. Wood's word choice didn't win, either. The final compromise was the politically palatable "extremely high levels."
Here's what the data behind the debate show: In 1996, there were zero cases of syphilis among gay men in King County; this year, there are expected to be as many as 100 cases. Between 1997 and last year, the number of cases of gonorrhea in gay men at least doubled, and possibly quadrupled. In the same period, the number of gay men diagnosed with chlamydia in the county STD clinic more than tripled.
Dr. Handsfield looks at this data and sees an epidemic. Dr. Wood looks at the word "epidemic" and sees problems.
The first is technical: Wood doesn't think the three STDs are epidemic because he doesn't see them increasing exponentially. Gay syphilis rates, for example, spiked between 1996 and 1999, but then leveled off for three years (though they are projected to rise again this year). The upward trajectory for gonorrhea and chlamydia has also not been a smooth exponential increase.
The second problem Dr. Wood sees is political. "There are people who hate the gay community," Wood, who is gay and HIV-positive, says. "If I use terms wrong, I'm giving people ammunition." In short, Wood worried that Handsfield's option was politically dangerous.
Dr. Handsfield also sees political risks in the word. "If you call it an epidemic, are you in fact putting more pressure on us--the health department--to do more than we are actually doing?" he asks. (Absent more funding, he says, he can't imagine the department doing much more.) But Dr. Handsfield obviously argued for the accurate term "epidemic" because he thought there was legitimate cause for alarm--the risk was worth it.
Dr. Handsfield, who is straight, says, "[The problem] is controllable if, and that is if, we ultimately see substantial, and I mean really substantial, changes in sexual behavior among gay men. And I think that is in turn partly, and I mean only partly, dependent on a change in tone and style of leadership in gay communities."
Last week, at least one local gay institution appeared not to be changing its tone. According to an e-mail sent to The Stranger by Seattle Gay News columnist Beau Burriola, a recent piece Burriola wrote was spiked by the gay publication's editor in chief, George Bakan. Why? Burriola's column criticized local gay health leaders for failing to do more to stop the rising HIV rates. Bakan says he and Burriola are resolving "concerns" and the article will run when those are addressed. "It's called being an editor," Bakan says.
This is not the first time Bakan has been accused of throwing his weight around to promote his own gay health agenda, according to one source familiar with Bakan's tactics. Last year, when some young queer health activists were lobbying Lifelong AIDS Alliance to use in-your-face ads for a $60,000 media campaign, Bakan helped torpedo the edgy ads by saying he would refuse to print them, the source (who was on the ad campaign committee) says. The edgy ads lost to bland ads, which, as we noted last week ["The Immoral Minority," Eli Sanders, June 5], were highly ineffective.
Bakan said he was opposed to the edgy ads, but doesn't remember threatening not to run them. "We would have run any ad that the campaign came up with," he says.