Bush's war on sex.

Few of the public health workers who crammed into the back of a tiny White House conference room this March would have ever guessed they'd watch such a show unfold. There before them sat Oklahoma Republican Tom Coburn, quietly presiding over the inaugural meeting of the Bush White House's Presidential Advisory Council on HIV/AIDS. Coburn directed the proceedings with an eerie, atypical reserve, rarely interjecting, and then only to make statements such as, "My job here is to build consensus." It's an unlikely charge for the self-styled gadfly.

Most sexual health experts had discreetly sighed in relief when Coburn kept his vow to serve only three terms in the U.S. House of Representatives. Entering the political scene as part of the GOP'S conservative revolution in 1994, he exited in 2001 as the AIDS activists' staunchest foe. While in office, Coburn spent much of his time on Capitol Hill undermining HIV prevention programs and promoting sexual health campaigns that teach only abstinence until marriage. His parting shot was to order up a National Institutes of Health report questioning the effectiveness of condoms in preventing sexually transmitted diseases. Released last July, the document stated the obvious: that, when properly used, condoms dramatically reduce the chance of transmitting most, but not all, sexually transmitted diseases.

Coburn breathlessly declared it proof that "the term `safe sex' is a myth" and suggested that the U.S. Centers for Disease Control and Prevention was engaged in a criminal conspiracy to hide that fact. Now Bush has brought Coburn back to Washington to chair the nation's premier advisory body on federal AIDS policy. "When you look at the caliber of conservatives that Bush is appointing," groans Marcela Howell, public affairs director of Advocates for Youth, "what you get is people who really want to turn the clock back."

Few people realize just how far right the Bush Administration is moving on health. "Everyone knows that the Administration's not pro-choice," says National Family Planning and Reproductive Health Association policy director Marilyn Keefe. "What people don't know is the damage that could be done to the public health infrastructure during this Administration." Keefe notes the White House's "terrible overlap" with rightwing political groups whose ambitions stretch way past fighting abortion and into redefining our basic understandings of what constitutes sexual health, particularly among youth. Indeed, Bush's chief advisor Karl Rove made no effort to hide the political agenda in a March appearance before the Family Research Council, the religious right's leading public policy advocacy group. "We will share a heck of a lot more in common than we don't," Rove said. "And we'll win if we work together far more often than the other side wants us to."

Rove's vow could be dismissed as pandering if it wasn't for the growing roster of religious right stalwarts that have begun to people the Bush Administration in the posts that their movement have long coveted. By handing the reins of sexual and reproductive health policy over to Coburn and his cohorts, Bush offers the religious right an even greater boost than the appointment of John Ashcroft did.

Health and Human Services Deputy Secretary Claude Allen leads what one activist calls a "Virginia cabal" of social conservatives that have infiltrated the agency. While presiding as Virginia's health secretary under Governor Jim Gilmore, Allen guided the state's crusade to reinvigorate the "Just Say No" perspective of the 1980s. He and Gilmore partnered with the rightwing group Institute for Youth Development to launch a statewide campaign focused on teaching children to fear rather than understand sex.

The institute bills itself as a profamily group that's working to promote "risk avoidance" rather than "risk reduction." These phrases are codes used by both sides of the national culture war to indicate a simple yet crucial philosophical difference. Those who promote risk reduction argue youth should be given all information necessary to prevent doing harm to themselves, such as instructions on how to properly use condoms or advice on preventing drug overdoses. Those who oppose this concept have responded to its established popularity by coining the "avoidance" phrase, arguing that anything other than an absolute message against sins such as sex and drugs only encourages young people to engage in them. "It really is a paradigm shift," Allen declared during a glitzy conference championing Virginia's partnership with the Institute for Youth Development in 2000. But it's a shift supported by almost no credible research. In fact, research overwhelmingly suggests exactly the opposite: The more information youth have about both safer sex and abstinence, the less likely they are to contract diseases or have unplanned pregnancies.

Nevertheless, the Bush Administration has now charged Allen with steering a national realignment in thinking on the subject. As Allen recently told a Congressional Hispanic Caucus meeting on the AIDS epidemic, "We need to have very strong messages for young people, and that is the message of abstinence until marriage, that the only safe sex is no sex, and a mutually monogamous relationship." The deputy secretary had no advice on how gay youth are supposed to have healthy sex lives.

Allen and Coburn are far from alone in this mission. Washington Times columnist Wade Horn, another "family values" movement leader based in Virginia, joins Allen at Health and Human Services as Assistant Secretary for Children and Families. He's currently leading the drive to strengthen aspects of the welfare "reform" bill that dole out benefits for being married. He sees heterosexual marriage as inextricably linked to sexual and reproductive health. As he once wrote in his Washington Times column, "It's pretty hard to bear or father a child out-of-wedlock if you're sexually abstinent."

One of the AIDS movement's central goals has been to reduce irrational fears surrounding the disease and to stress the way in which the epidemic impacts and even binds us all, regardless of HIV serostatus. Coburn showed his disdain for this notion in an interview with MSNBC.com just days after his appointment as council chair, in which he warned people with positive partners to never again have sex with that person, with a condom or otherwise.

Bush's AIDS Advisory Council is littered with several others who share its leaders' philosophy. And if these appointments are an indication of where the Administration plans to move policy, the palpable sense of alarm that has permeated the AIDS community since the February announcement of the council's appointees is understandable.

In addition to making Coburn chair, the White House tapped Patricia Ware, another religious right icon from Virginia, to serve as the council's executive director. Also a devotee of "risk avoidance" strategies, Ware has declared in Congressional testimony that the only way to halt the epidemic is through teaching "sexual restraint tempered with morals and values, and a rebuilding of the two-parent family." Somewhat of a freelance black conservative activist, Ware has been most closely associated with the group Americans for a Sound AIDS/HIV Policy. This organization has listed among its most important policy goals backing Coburn's repeated Congressional efforts to mandate HIV testing and partner notification. Under this policy, "HIV positives"--as Coburn has called people living with the virus--would be forced to supply names of past sex partners so that local health department workers could warn those people that they may be infected.

Given the lingering stigma associated with the disease, both ideas are steps that broad swaths of those working in HIV prevention have long believed would ironically discourage both testing and disclosure of HIV status by pushing those most at risk for infection further away from the health care system.

Allen and others at Health and Human Services have already begun making their mark. Allen is leading a top-to-bottom review of all of the health department's HIV/AIDS programs. Coburn and his religious right lobbyists, who are convinced that federally funded HIV prevention programs do more to "promote" the "gay lifestyle" than to prevent disease, have long cried out for such a review. So White House AIDS czar Scott Evertz, a gay Republican activist, has led the public relations effort to calm folks nervous about the outcome.

"I'm here to tell you that you need not fear that review," Evertz assured a February gathering of AIDS service providers. Few are comforted by these pleas.

"While the intent may not be to damage, they can do damage just the same," warns Ernest Hopkins, policy director for the San Francisco AIDS Foundation, one of the groups social conservatives have most heavily criticized.

Skepticism seems justified, given some of the harassing steps Health and Human Services bureaucrats have taken.

In 2000, Advocates for Youth used a Centers for Disease Control grant to develop materials to aid parents in talking about sexual health. The materials went through a routine review, were deemed appropriate, and were passed on to Health and Human Services last year for official approval. When months went by without Health and Human Services signing off, Howell and her colleagues got worried. Then they discovered an internal e-mail in which a health department staffer registered his disapproval of the program. "You should know that the secretary is a devout Roman Catholic," he warned his colleagues. That was the last Howell heard from HHS about the $200,000 initiative.

Meanwhile, as of March 1, all Centers for Disease Control grantees for Web-based HiV prevention campaigns were required to post notices on their sites warning visitors of content that "may not be appropriate for all audiences." The Centers for Disease Control is also in the process of redrafting its recommendations on the role of condoms in disease prevention as a result of the Coburn-prompted National Institutes of Health report.

And at May's United Nations conference on children, the U.S. delegation joined forces with Iran, Libya, Pakistan, Sudan, and the Vatican to oppose any language in the conference declaration that supported the use of condoms in stopping the spread of HIV.

Last fall, the inspector general made an example of the San Francisco-based group Stop AIDS Project. Prompted by criticism from rightwing members of Congress, Health and Human Services investigated the organization's outreach programs targeting gay men, and in November, amid much fanfare, declared that they fit the legal definition of obscenity. Inspector General Janet Rehnquist's complaints focused on two of Stop AIDS Project's workshops, titled "Booty Call" and "Great Sex." But having never actually attended the programs, the inspector general, who is Chief Justice William Rehnquist's daughter, could only quibble over the workshops' titles and printed advertisements that discuss, in her words, "the taboos of anal eroticism." HHS failed to return requests for comment on the matter for this article, but at the time both Secretary Thompson and the inspector general explicitly tied the Stop AIDS Project investigation to the upcoming review, assuring everyone that there was more to come.

"The only thing that's really obscene is that people's lives are at stake," scoffs Stop AIDS Project Executive Director Darlene Weide, who notes that her programs have all passed local review boards for years without a problem. Why the scrutiny from Washington now?

"The investigation is a red herring. A few Republicans want to stop effective prevention for gay men," Weide charges. "And ultimately it's a recipe for the care and feeding of the Christian right."

Kai Wright is a Washington, D.C.-based freelance journalist. You can find out more about his work, and read past articles, by visiting www.kaiwright.com.