White House AIDS shake-up: as one openly gay AIDS czar is replaced with another, activists are left to ask: What is Bush's AIDS strategy? (Health).

When President Bush tapped Scott Evertz to lead his the Office of National AIDS Policy just over one year ago, the political fallout was immediate. Right-wing groups scolded the White House for elevating an openly gay Republican to the high-profile post, Gay Republicans hailed the appointment as proof the White House would not use sexual orientation as a bar to employment.

In late July, Bush replaced Evertz with another out gay man, Joseph O'Neill, who had been acting director of the Office of HIV/AIDS Policy at the Department of Health and Human Services. But this time around, the reaction was far more muted, and AIDS activists were left scratching their heads about what the change signaled about the direction of national AIDS policy.

"Frankly, we don't know exactly what to think about these moves," says Robert Dabney, director of communications for the National Minority AIDS Council, a Washington, D.C., lobbying group. "On the surface it looks like a mere shuffling of bodies. But there may well be way more to it than that."

The personnel change could not come at a more crucial time in the AIDS epidemic. For instance, a recent report by the Centers for Disease Control and Prevention found that a majority of HIV-positive African-American men, many of them gay, did not know their HIV status.

The tumult in federal AIDS policy making was not limited to the Office of National AIDS Policy. At the time of Evertz's departure, media outlets reported that Patricia Ware, the executive director of the presidential Advisory Council on HIV/AIDS, had been fired from her post. One week later, however, the Whim House announced that Ware, who is often allied with conservative groups, would stay in the job. Evertz, meanwhile, was named special assistant to HHS secretary Tommy Thompson. (Evertz did not respond to repeated requests seeking comment.)

Advocates for people with AIDS expressed concern that the White House is veering erratically between the political demands of right-wing groups that seek abstinence-only education programs and the more established AIDS lobbying groups in Washington, which have long advocated comprehensive HIV prevention programs. "The thing that concerns us most is, How do we counter the problems we are having with HIV prevention if there is not a consistent message from the top?" Dabney says. "There is some sense among AIDS activists that the right wing is using the White House to try to defuse the message about comprehensive AIDS education."

Ware tells The Advocate that she briefly considered taking another job in the Administration. But she says she quickly decided to stay in her current post, leading to the conflicting press reports. "There have been a lot of rumors swirling around Scott and Dr. O'Neill and me," she concedes. "But I can honestly say that no one has been tugging at me [to leave her post]. The White House has been supportive, and I've gotten nothing but support from AIDS groups and even the gay groups during this difficult period."

Whatever the reason behind the job changes, there is little doubt about O'Neill's qualifications for his appointment. A former staff physician at Chase Brexton Health Services in Baltimore, which has a predominantly gay clientele, he has served in a variety of HHS posts, including a position administering the Ryan White act. (Through the White House press office, O'Neill declined several interview requests.)

"With the conservative bent of this administration and with continued emphasis on abstinence-only programming, Dr. O'Neill will have an important role within the White House and federal government if he is to help us do our job on the front lines of the epidemic," Dabney says.

Ware agrees: "Dr. O'Neill is a physician, so he has the medical background we need. And since he is a seasoned bureaucrat, he can help plug all of us into the federal government and Congress. If there is one thing everyone can agree upon, no matter what, their ideology, it's that he's the one for this job."