Secretary of State Colin Powell’s frank talk about safe sex and AIDS caused a bit of a flap last week. The Bush administration, to its credit, supported Powell when some conservatives fussed over his remarks.
But another move on the AIDS front still leaves the Bush administration’s approach open to question.
President Bush has decided to name former Oklahoma congressman Tom Coburn to co-chair the Presidential Advisory Council on HIV/AIDS, along with Dr. Louis Sullivan, who was secretary of Health and Human Services for the first Bush administration.
Sullivan is a good choice. Coburn, however, is someone who’s had trouble separating science and sound public health policies from his personal beliefs.
The council was created in 1993 to help shape White House policy on AIDS research and prevention efforts. Its role is purely advisory but its significance ought not be underestimated: In the past, for example, its reports and statements advocating clean-needle programs helped shape debate and draw attention on this critical issue.
Coburn is an obstetrician and gynecologist, and served as a Republican congressman from Oklahoma for six years until he retired in 2000. During his term in the House, he backed reauthorization of funding for AIDS treatment and research.
Yet his vehement opposition to campaigns promoting condom use and safe sex–he advocates sexual abstinence and monogamy instead–and to harm-reduction programs to reduce new AIDS infections, make Coburn the wrong choice to co-chair the presidential council. The continuing battle against AIDS ought to pivot on science and realistic, proven prevention methods, not on personal beliefs, deeply held though they may be.
In a recent interview in Newsweek, Coburn described himself as a “realist” who recognizes that condoms break, slip and can otherwise fail. In some cases that is so, but to exclude condoms from the government’s AIDS prevention pitch is the height of unreality.
According to a Kaiser Family Foundation study last year, two-thirds of all high school seniors said they had had sexual intercourse. Nearly half of all new AIDS infections yearly affect people 25 years old or younger. Abstinence should be part of the AIDS prevention effort, but hardly the only item on it.
Coburn also opposes distribution of clean syringes to intravenous drug addicts to prevent the spread of AIDS through contaminated needles. Coburn regards clean-needle programs as a tacit endorsement of drug use, despite evidence that clean needles do not promote drug addiction and do reduce the risk of HIV infection.
The first AIDS death was reported about 20 years ago, and since then public debate over how to prevent the disease has evolved from sermonizing and condemnation to realistic public health measures with the best chance of reducing new infections.
Now 40,000 new infections are reported each year in the U.S.–down from 150,000 at the height of the epidemic. Prevention programs are working.
