Linking Science, Policy and Programs

For too long, sound science has taken a back seat to politics in a worsening pandemic. Over the past several years, ideological and religious convictions have overtaken scientific evidence and programmatic experience in HIV prevention and care. Federal monies have been deployed to fund "abstinence-only" HIV prevention curricula that lack serious proof of efficacy, while researchers who compete for financial support from the National Institutes of Health and the Centers for Disease Control and Prevention have been cautioned to avoid using phrases like "gay men," "anal intercourse," and "commercial sex workers" in the titles of their grant proposals.

This kind of interference would be troubling in any political climate. But in an environment where 40,000 people in the United States become infected each year, it's imperative that HIV prevention programs be based on the best available scientific evidence. Communication with and about the populations that are most vulnerable to HIV infection must move forward unimpeded by misunderstanding, prejudice, or hatred.

Here in San Francisco, anywhere from 800 to 1,000 new HIV infections occur annually. Although this city has been a leader in devising successful interventions to prevent the spread of HIV, we still face an unacceptable rate of new infections. Given the current culture of interference, we must do more to prevent new infections, to detect infections when they occur, and to get people into treatment when appropriate. We must address unanswered questions about HIV transmission directly, even if our investigation leads us into controversy.

The San Francisco AIDS Foundation is reinvigorating the conversation about prevention, care, and treatment, putting public policy and research side by side. Following the success of our 2006 World AIDS Day forum, SFAF is calling attention to what works, gathering the community together to discuss topics in the epidemic that often fall below the radar. (Learn more about our World AIDS Day forum.)

One venue for such discussions will be an SFAF forum series focused on evidence-based solutions to issues of interest to the general public. SFAF will gather experts from different sectors -- including research, policy, business, medicine, and community -- to lead discussions of key topics in HIV/AIDS prevention, treatment, and care. Some of these topics will be divisive; some are at the forefront of research and policy. The Foundation's aim is to provide a public venue for the respectful airing of diverse views, and in every case, community input and wisdom will be sought.

SFAF also will issue Policy Statements summarizing key developments in timely science and policy areas. In December, the Foundation issued such a statement on "Adult Male Circumcision and HIV Prevention," distilling information from just-completed studies in African countries testing the effectiveness of male circumcision in preventing acquisition of HIV infection among men. (See related "HIV Health News" item in this edition of Outreach.)

The Foundation is uniquely positioned to facilitate community dialogue of this sort, given our strong relationships with researchers, community organizations, policy makers, service providers, and the media. By creating a space for safe discussion of often controversial issues, we will better link scientific evidence, program experience, and policy decisions on important topics related to HIV/AIDS disease elimination. In this way, we hope to help restore the rightful place of scientific evidence and community-based knowledge in leading the fight to end AIDS.