Money for AIDS prevention used for sexually explicit workshops

WASHINGTON -- The advertisements addressed to gay men were provocative: Learn to write racy stories about your sexual encounters, choose toys "for solo and partner sex" or share tales of erotic experiences.

All of it was done at government expense, in the name of preventing AIDS.

These expenditures -- along with other recent allegations of fraud and abuse of federal money to fight AIDS -- have upset some AIDS activists and lawmakers.

"The tragic consequences are that people die when they don't get their vital medical services," said Wayne Turner, spokesman for the AIDS activist group Act Up in Washington. "The days of the AIDS gravy train are numbered."

Added Iowa Sen. Charles Grassley, the senior Republican on the Senate Finance Committee: "We don't have money to burn when people are suffering and dying."

After learning of mismanagement of AIDS money, Grassley won a commitment from the Health and Human Services inspector general for increased audits of federal treatment funds.

The sexually provocative prevention programs run by San Francisco AIDS groups are funded in part from the $387.7 million the federal government is spending this year on AIDS prevention.

The government also spends $1.8 billion for medical treatment of low-income victims of AIDS and $257 million for housing for low income and homeless sufferers of the sexually transmitted disease that attacks the body's immune system.

Kansas City allegations

Allegations of mismanagement or poor administration of the AIDS treatment funds have arisen in the Kansas City area, Indiana and the District of Columbia. The housing assistance program was criticized in Los Angeles. An AIDS clinic operator in Dallas was sentenced to prison for using federal AIDS funds to pay a psychic.

Federal officials who administer the AIDS funds say they rely primarily on state and local governments and -- in the case of prevention program content -- citizen review boards to ensure the money is spent properly.

Lisa Swenarski, spokeswoman for the Centers for Disease Control and Prevention, said the sexually provocative materials "have been brought to our attention and we are looking into it." Under CDC guidelines, prevention programs cannot promote or encourage sexual activity.

"We defend the process of having the local review panels make those decisions," she said.

Douglas Morgan, a director in the AIDS bureau of the Health Resources and Services Administration, said state and local governments that receive AIDS prevention grants "have been very good in identifying these issues. We expect them to notify us" of fraud and abuse.

But those who run the federally funded workshops on writing sex stories and using sex toys say that was the only way to draw gay men into discussions about AIDS prevention.

"Many who are at risk experience AIDS-prevention burnout," said Brian Byrnes, director of prevention services for the San Francisco AIDS Foundation -- the group that conducts the "Hot Writing" workshop.

Must 'attract the target'

"Like the marketing of any product, you need to find language that will attract the target population: Men at high risk for HIV infection or transmission," he said.

San Francisco officials, who distribute more than $40 million annually in federal treatment and prevention funds to community AIDS groups, agreed. "If you put out a flier saying, 'Please come learn how to prevent AIDS,' nobody shows up," said Steven Tierney, director of HIV prevention for the city.

Community organizations say prevention experts participate in events with sexually provocative themes, but promotions on the groups' Internet sites give no hint of a disease-prevention program.

"It was a dark and steamy night," began the advertising for the "Hot Writing" seminar in San Francisco. "This pens-on-paper workshop is for guys who like to write or want to finally get that sexy story down."

Another advertisement welcomed interested gay men "to our world of toys. Learn how to choose, use and care for toys for solo and partner sex."

Gay men were invited in another program to "share tales of intercourse," part of a "Sex in the City" series. Other programs focused on pleasing sex partners, meeting friends without paying cover charges and making sex more erotic.

On the treatment side of the federal AIDS effort, recent allegations of mismanagement of taxpayer funds have prompted investigations across the country.

An AIDS task force appointed by Kansas City, Mo., Mayor Kay Barnes is holding public meetings to determine whether funds were distributed fairly, especially to minority groups.

In Dallas, AIDS clinic operator Mythe Kirven pleaded guilty to paying $27,800 in federal funds to a self-proclaimed psychic. Kirven was sentenced to 18 months in prison and ordered to pay $262,828 in restitution.

California's state auditor found in 1999 that the Los Angeles Housing Department had not spent $21.8 million of prior-year federal housing funds for homeless and low-income AIDS victims.

Indiana officials terminated contracts last year with the company that processes claims for AIDS treatment services after learning that doctors, dentists and other providers were not paid. A new contractor has been hired.

In the nation's capital, an audit found no documentation for almost half the sampled disbursements of the HIV Community Coalition of Metropolitan Washington. Sundiata Alaye, the group's new executive director, said changes were made and "we've got an excellent control structure in place now."