STOP AIDS Project's social quarantine approach to HIV prevention

If this particular misuse of social network theory is the future of HIV prevention, I want no part of it, and I will do everything within my power to stop it.

by Michael Scarce

In their social network approach to HIV prevention, STOP AIDS Project in San Francisco has launched an attempt to segregate older and younger gay men to prevent new infections. Defined as "preventing disassortative mixing," the self-described community based organization has received a $200,000 research grant from the University of California to implement experimental structural interventions to "pull high risk and low risk men apart" in social environments such as bars and interactive web sites. Disassortative mixing refers to sex between men with differing characteristics such as race and age.

Jen Hecht, Education Director for STOP AIDS Project, and Dan Wohlfeiler, former Education Director, have stated, "Young men’s greatest risk of infection is having sex with older men, who are more likely to be HIV positive."

Although they assert a dedication to respecting human rights and freedom of choice, they liken their interventions to other public health prohibitions such as bans on smoking in public spaces. These comments are disturbingly reminiscent of conservative groups' recent call for restricting gay men's freedoms based on community-acquired staph infections. The groups based their argument on the notion that infected gay men pose a danger to the "general population," citing legal bans on smoking in public places and demanding similar legal intervention to prevent "second-hand sodomy."

In a meeting earlier this year, the collaborative research team described a scenario in which a door man turned away a group of younger men who attempted to enter a gay bar frequented by older gay men. The scenario was described as a positive and idealistic example of the kind of effect they hoped to achieve in their prevention of "mixing." In a recent national presentation to other public health organizations, Wohlfeiler displayed a slideshow containing a cartoon image of an older, Tom of Findland-like gay man with a mustache, leather jacket, and bulging crotch. He remarked:

"It's an older gay male icon, and the reason I put it there is: Years ago there were a number of young men who would come into the STOP AIDS Project and say, 'We don't want to have... If we want to be safe, we avoid having sex with guys who have leather jackets and mustaches,' by which they meant somebody considerably older. And of course we all laughed, and said, 'Oh, that's silly. That's not very protective.'

But in fact, one of the riskiest things a young person can do is have sex with somebody who is much older. And for gay youth, you know, and straight youth, that's been born out to be true, that age of partner is sometimes more important in terms of their risk than the frequency of condom use, their drug use, and other individual factors."Wohlfeiler fails to elaborate exactly how the age of one's sex partner is more important than condom use in becoming infected with HIV.

STOP AIDS Project's attempts to coerce and manipulate gay men's behavior escapes the oversight of the University of California's Human Subjects Research Review because it operates on a community level rather than directly affecting specific individuals. The research grant assures community involvement at each step by consulting with a number of community advisory boards for each of the social venues, despite the fact that the boards have never met monthly and none of them have met for nearly a year.

Their work relies on highly biased statistical data gathered during the course of street outreach to San Francisco gay men, and invokes the notion of "core groups" akin to the early days of the epidemic. In the early 1980s, the Centers for Disease Control identified a "4-H Club" of risk groups that included hemophiliacs, Haitians, homosexuals, and heterosexual prostitutes. The resulting stigmatization of certain populations based on demographic characteristics associated with HIV infection led to widespread discrimination, social isolation, and even violence against these groups of people. For these reasons, the Americans With Disabilities Act of 1990 included explicit protections against discrimination not only for those infected with HIV, but also for those who were wrongly perceived to be infected based on other characteristics or for associating with infected individuals. Other federal legislation guarantees fundamental civil rights that include equal access to public accommodations such as bars, regardless of one's HIV status or age.

Attempts to "fragment sexual networks" of gay men might sound like objective epidemiological science, but they ultimately serve to divide our community.

This cultivates ageism and the stigmatization of those infected, creates a false sense of safety equating youth with lack of risk, further socially isolates HIV positive men, prevents intergenerational mentoring, erodes our civil liberties, and destroys our collective access to forms of social capital and other assets that produce and protect our health.

I have left my position at STOP AIDS Project because I refuse to support work that damages gay men's health in these ways, and because I have been repeatedly harassed and disciplined by Jen Hecht and other members of STOP AIDS Project management for opposing what I believe to be unethical, illegal and discriminatory practices. If this particular misuse of social network theory is the future of HIV prevention, I want no part of it, and I will do everything within my power to stop it.


Read "Ask Gay Men What They Want and Need" - also by Michael.