Researchers Warned About AIDS Grants

winksmith writes "The NYTimes (free registration, etc.) is reporting that scientists researching STD's (including AIDS) must be careful in the wording of reports and particularly of grant requests. many have been verbally warned that phrases like: "sex workers," "men who sleep with men," "anal sex" and "needle exchange," may cause the government to withhold grant money."

Comments

Is this really news?

[Blaine Hilton]

This seems to be another example of politicians trying to double talk. When they are talking to a medical group they say how all the grants are going to AIDS research, but then when they are talking to anti research people they can go back and say the opposite. It seems like anything that is fine for medical terminology should be fine. Of course a lot of the grant process is subjective rather then objective so it may be the little things that get the application passed up, but this is just one of the many problems a grant request can face.

Go calculate something.

Good

[Anonymous Coward]

This is entirely appropriate.

Look, there are lots of diseases that affect human beings. Everything from the common cold to ebola. Some of them are very rare, some widespread. Some are deadly, some place a heavy burden on our health care system, and some are mere nuisances.

Medical science is a zero-sum game. Every dollar or minute spent trying to find a cure for disease X cannot be spent on disease Y. There's only so much money and effort to go around.

Diabetes, stroke, cancer, heart disease, and trauma all kill more people every year worldwide than HIV. Not a few more, either; we're talking about millions of people every year.

Now, every educated person knows that HIV is not limited to gay people, or to drug users, or to people who have anal sex. HIV is out there, and everybody is at risk of contracting it, though for the vast majority of people that risk is statistically insignificant.

But the notion, correct or incorrect, that HIV is confined to a particular group or that it's only transmitted by a particular illegal or socially unacceptable activity gives one pause. Is it really right to spend $X on AIDS research when one hundred times more people die of cancer or heart disease or stroke every year?

If you want funding for your AIDS research, you're going to have to convince the organization offering you the money that your research is more important than research that will help tens, or even hundreds, of millions of people over the long term.

Re:Good

[0x0d0a]

Be fair, though -- AIDS does have its own nastiness. Once it's in a population, you have tons of disease vectors. It can spread, and it doesn't just quickly and cleanly kill off its host.

Re:Good

[sam_handelman]

Are you in research, anonymous? I am.

Science is not a "zero sum" game. Studies of HIV have revealed important information about the immune system, for example, which may be of help in combating antibiotic resistant bacteria, or autoimmune diseases.

I'm a biologist but I don't study diseases at all. Is the pure knowledge I gain worth nothing?

Tens of millions of people in Africa DO have aids. Hundreds of millions of people in China COULD get AIDS - if we study how it spreads, which is what most of the NIH grants that mention gay people are actually about, we might prevent that.

Finally, there are serious diminishing returns in science when you tell the researchers what to work on.

1) There are only so many genuinely promising heart disease research projects for the NIH to fund. The bill to fund these projects (recall that the pharmaceutical industry provides a lot of funding, as well) is actually quite small - what should the NIH do with the rest of the money? Throw it at heart disease research projects which are NOT promising?

2) You can't just take an AIDS researcher, who presumably has come up with what he feels is unique insight into fighting AIDS, and move him into heart disease. He might accomplish something, but chances are he would have accomplished more doing the work he felt he was qualified to do. There is no question in my mind that science driven primarily by institutional goals is lousy science, but that science driven by the personal creativity of the scientists is good science.

3) The NIH exists to fund research that the pharmaceutical industry will not. In the long run, the pure knowledge gained has shown itself worthwhile, I assure you.

The article is not about avoiding AIDS research in favor of heart disease research. It is about avoiding "politically charged" AIDS research - research into how AIDS spreads, by and large, which is preventative research and has the highest yield per dollar spent - because of the politico-religious convictions of right wing zealots in congress who still think only gay people get AIDS.

Re:Good

[Anonymous Coward]

Actually, no. HIV has precisely ONE disease vector: blood-to-blood transfer. And it requires a HUGE viral load to sustain an infection-- on the order of hundreds of thousands of particles.

It's actually very difficult to get HIV.

My wife is a surgeon, and HIV transmission used to be a HUGE concern in the operating room. You're in a tight space with lots of sharp objects; sticks happen all the time. Now we know more about how HIV works, and it's just not a big worry. A concern, sure, but it's a hell of a lot easier to contract Hep C through a needle stick than HIV.

Re:Good

[sam_handelman]

How do you know that there is nothing we can do about AIDS in Africa? Most people with AIDS in Africa are not prostitutes - however, prostitution (which is ubiquitous) is how the disease is transmitted.

The research *under discussion* is substantially social - do you think that it's impossible to study social trends, find which *educational* techniques successfully promote lower risk behavior and translate that information to China or Africa? I assume that you did not mean to suggest that we should avoid such an effort because of the genetic background of Africans.

Your cost/benefit analysis is flawed. Cardiovascular disease is the #1 killer; it does not follow that every single medical research dollar should be spent on it. You are mistaken about the ability of a scientist to productively switch research focus; even between what might seem to be related fields. Yes, we can have everyone, including me, work on heart disease research. People have been trying this for decades with cancer and it is NOT a good strategy.

The proposals discussed in the ORIGINAL ARTICLE are social in nature. They are VERY CHEAP, and can be quite effective. There is no way that a $25 million dollar search for anti-HIV compounds would mention who was gay!

Social studies are already being run and funded for most other diseases - sexually transmitted diseases are more complex, as social phenomena, than the flu, so studying their role in society is likely to be more productive, and more dollars should be spent. I'm all for maximising lives saved / $, but a lot more goes into that analysis than simply funding whichever disease kills the most people.

However, even the more expensive sort of HIV research ought to be done, if the research itself is good and will enable us to learn something. The quality of the science should be the controlling factor - because good science will teach us more about other disease conditions, down the road.

This is also true of the social research that was the focus of the *original article* - HIV is not the first sexually transmitted disease in human history, it won't be the last.

I don't think homosexuals, drug users and prostitutes form a single community, although of course there is considerable overlap here in NYC.

the simple fact is that AIDS will largely take care of itself if left alone.

Really? So, the infection rate among straight, non-drug using people who don't employ sex workers is going down? Oh, wait, it's not! It's going UP.

Even if it were not, I do not regard all these individuals death's as AIDS "take care of itself." Once they're dead, the problem becomes unsolvable, not solved. Saving their lives - that is taking care of AIDS. Do you see a crucial distinction between our assumptions here? In the future, we can screen embryos and no-one will ever have cystic vibrosis again. Ask someone who has it and see if they think the problem is taken care of.

I never mod anyone down but I can see how the moderator thought that was flamebait.

Sorry about my double post - it didn't show up for two hours so I posted again.

Re:Good

[Bowling Moses]

Sorry, but AIDS simply isn't the most significant public health problem out there. Everything you said is more true of cancer, stroke, heart disease, diabetes, and trauma. Our efforts should be spent where they will do the most good."

Except that it isn't at all. The old get the lion's share of cancer, stroke, and heart disease, not the most productive age bracket in society which AIDS hits. Stroke and heart disease are often synonyms for old age--when my 97-year-old grandfather and survivor of multiple strokes eventually passes away hopefully a good number of years from now, when the obituary lists cause of death it could just as easily put in old age for either stroke or heart attack. An estimated 150 million have diabetes, most commonly middle aged persons, but only in a handful of small isolated populations does its penetration level ever become comparable to Zimbabwe's 1 in 3 adult AIDS cases. In these small populations current research has implicated drastic recent changes in diet and excercise to be the dominant factor in diabetes cases.

Let's get back to that 1 in 3 level of adult AIDS penetration in Zimbabwe. Go out to the mall or to the university or anywhere people 15-45 are found in numbers. Now imagine that 1 in 3 is carrying a disease that will kill them unless something else gets them first. Now multiply that out to cover an entire nation. Factor in the low education levels and social stigma of AIDS that help it spread to even higher levels. Imagine what it's like when you're a 8-year-old kid who's got a 1 in 3 chance of in the next 5 years of having your teacher die, your mom die, your dad die, aunts, uncles, cousins too. This isn't some "won't somebody think of the children" crapola either. These kids if they grow up at all will have lower education levels plus whatever value you get from parenting and family, plus a society in ruins--things that foster the continuing spread of AIDS.

Imagine it spreading to the nations next to you. Imagine that prevailing attitudes about AIDS have allowed people with HIV to donate blood, which is then mixed according to blood type with many others, contaminating 10's or 100's of units of blood--blood that is later used for transfusions, infecting the nation at large. This probably went on for years in China, where prevailing attitudes about medicine may be a culprit in the spread of SARS recently. It is an incontrovertible fact that AIDS is a contender for the next worldwide plauge. Heart disease, stroke, diabetes, cancer, and trauma are a pinprick even when combined in comparison to having 1/3 (and rising!) of your nation's workforce infected with something that will kill them. It'll be really interesting and I expect terrifying to see what happens to sub-Saharan Africa when it gets the coming population crash.

AIDS deserves heavy funding, and if you write a grant and have to worry that matter-of-fact descriptions like "sex workers" might be the factor in getting your grant rejected as opposed to its merits,that's just plain bullshit foisted upon the world by petty beaurocrats who are more interested in their myopic ideology than in fixing a major and growing problem.

Booooring

[jeramybsmith]

They're asking grant requesters to leave controversial topics out of grant requests to keep from having to answer questions like "did my tax money go to fund a study or whores?" or "did my tax money go to study buttsex?". If you look at the NYT article, it seems there is really no censorship going on. They are simple asking for discretion on the part of people requesting grants.

wording

[Per Wigren]

many have been verbally warned that phrases like: "sex workers," "men who sleep with men," "anal sex" and "needle exchange," may cause the government to withhold grant money.

Instead they were requested to use phrases like "hookers", "faggots", "buttfucking" and "junkies".

Complete and total ignorance

[dh003i]

Your post displays a complete and total ignorance of how science works. The simple fact is, we never know what's going to lead to what. Prof. Gorovsky at the University of Rochester has spend years researching a single-celled Eukaryote, Tetrahymena, which doesn't superficially appear to have any relation to human problems. However, it is in Tetrahymena that telomeres and telomerase were discovered, which has major implications for cancer. It was in Tetrahymena that many advances in RNA-interference, a technique which may be useful for shutting down (for example) viral proteins in humans, have occured. Studying biology at a basic level on primitive organisms often has enormous impacts in other areas. And it works vica-versa too, as well as between different areas on a similar level. Research on HIV and AIDS doesn't just lead to more knowledge about how to stop HIV; it leads to information on our immune system, and all sorts of other biological processes in humans.

Of course, your post is exactly how these idiots in Congress think. In their puny little brains, somehow it makes sense that the research done in NASA has lead to many other good things, and it should be funded, even though it's direct goals are completely useless to human beings; while the same should not be true in the biological sciences.

Why the Government Dislikes Those Phrases

[Alethes]

The reason the government doesn't like phrases like "sex workers", "anal sex" and "men who sleep with men" is because they indicate that AIDS discriminates, which is not what the government would like you to believe. If people stopped doing the things that spread AIDS (it's not exactly airborne), it would eventually go away. Consequently, politicians and activist groups would lose a manipulation tool to siphon tax dollars away from issues that are a lot less preventable and affect more people.

I'm not trying to troll, but it's just common sense that if you're concerned about the risks that come with an activity, you either don't participate in that activity or you (not your fellow citizens) accept the risks. You like Big Macs? You accept the risk of clogged arteries. You like to smoke? You accept the risk of lung cancer. You like games on Windows? You accept the risk of Outlook viruses. You like sex with prostitutes? You accept the risk of AIDS. Even my dog understands that there are consequences for certain actions.

Re:Why the Government Dislikes Those Phrases

[Anonymous Coward]

Qualification: I'm a teenager infected with HIV.

Your logic is flawed. People don't make these decisions "to put themselves at risk" in a vaccum. As a sophemore in high school my biology teacher (the most respected teacher in the school) took it upon himself to convince us that condoms didn't work and that abstinance was the only choice. He used pseudo-scienctific terms and charts and graphics to convince us that condoms were incappable of blocking the virus. This was only a few years ago.

When I started becoming sexually active (and kids do, there's no denying it), I was completely under the impression that the use of a condom was futile unless attempting to prevent pregnancy.

Social research is imporantant in preventing this sort of FUD from being spread around.

Re:Why the Government Dislikes Those Phrases

[Anonymous Coward]

Thinking that you're safe from AIDS because you don't have sex with prostitutes is not only denagerously wrong, it borders on self-righteous arrogance.

A famous one-liner for those who can't form an argument is "any (creature) understands there are consequences of actions." Of course. But understanding exactly what the consequences are of what actions is the summary of our entire human intellect is for. We aren't precognitive. You could have sex with fifty prostitutes and be fine, or you could be a highschool junior who has sex with a classmate and now you're both infected. Who knows whether the infection started at a prostitute or homosexual at some point down the line... But what really puts you at risk is the frequency with which you have sex with different partners, not whether you were paid to have sex or your sexual orientation.

Re:Why the Government Dislikes Those Phrases

[peachpuff]

That was totally outrageous.

The reason the government doesn't like phrases like "sex workers", "anal sex" and "men who sleep with men" is because they indicate that AIDS discriminates, which is not what the government would like you to believe.

No, the government thinks those phrases look bad on a list of official government-funded projects. That's the obvious explanation, but I guess it doesn't play into your political view of the issue.

If people stopped doing the things that spread AIDS (it's not exactly airborne), it would eventually go away.

Yes, but what are the things that spread AIDS? Other posters have pointed out that blood transfusions and childbirth spread AIDS. It's also spread by sex. That includes non-anal heterosexual sex with a non-prostitute. If you're married and have 2.5 kids, you've done something that spreads AIDS. There are wives who have gotten AIDS from their husband and children who have gotten it from their mother. I'm sure they'd love to hear a little sermon from you about personal responsibility.

Of course, some activities are riskier than others, but we could never starve the disease of victims without killing off the human race.

Consequently, politicians and activist groups would lose a manipulation tool to siphon tax dollars away from issues that are a lot less preventable and affect more people.

You've just accused a whole lot of people of hiding the facts on a fatal disease in exchange for money. Why don't you type "AIDS" into Google and see what these people are actually saying?

Since you're a fan of common sense, consider this: If the government wanted to hide the fact that certain groups are at higher risk, they would reject requests to study those groups, regardless of the wording.

Another example

[Bowling Moses]

Another excellent example of this is good old polymerase chain reaction (PCR, natch.). The old enzyme that made it sooo much easier to do (insert DNA manipulation of choice here) came out, according to the dimbulbs who give out Golden Fleece awards, "a $1 million study on algae [sic] in warm water." A second example near and dear to my heart is green fluorescent protein (GFP). This tool vital to modern molecular biology eventually fell out of a study on why jellyfish glow when you poke them.

Preparing an abstract for the Bush administration

[MillionthMonkey]

ABSTRACT. Evidence of elevated HIV incidence and relapse to promiscuous fucking among young nonrecovering homosexuals in Vancouver Canada.

Objective: To determine HIV incidence among young faggots and investigate trends in unsafe buttfucking behaviours.

Methods: Beginning May/95, fudgepackers aged 18-30 who had not previously been punished by God for their immoral behavior were enrolled in a prospective study in Vancouver, Canada. At baseline and annually, pole climbers completed a questionnaire on their abhorrent lifestyle choices and had an HIV test. Behaviours pertained to the year prior to baseline, and baseline to first follow-up (mean: 15 mo.). HIV incidence density was calculated. Among bone smokers remaining HIV negative, we compared baseline and follow-up responses for raw poopushing with regular (> or = 1 contact per mo.) and casual (< 1 contact per mo.) poofter partners. Among rimadonnas reporting always using condoms during buttfucking prior to baseline, we defined 'relapse' as any filthy sexual deviant behavior reported at follow-up. Odds ratios (ORs) for relapse were tested using McNemar's test.

Results: Of 386 butthole surfers at follow-up, HIV incidence was 1.96 per 100 pyrs (95% CI: 0.74, 3.18). Of 10 seroconverters, 4 reported paying for hookers and 3 used drugs to support terrorism (including one pretty-boy hustler.). There reported having unprotected buttfucking with a sissy-boy they knew was going to give them AIDS. Among HIV negative poofters with regular partners (n = 266), odds of relapse were elevated for unprotected top (OR = 2.4; 95% CI: 1.5-4.4.) and bottom fudgepacking (OR = 2.1; 95% CI: 1.3-3.3). Among HIV negative men with no morals (n = 261), similar elevations were observed for unprotected top (OR = 1.8; 95% CI: 1.1-3.0) but not bottom anal crapshooting (OR = 1.2; 95% CI: 0.7-2.2). The true extent of incidence and relapse may be under-estimated, since homos who were eligible for follow-up but who had not yet returned were younger (p < 0.001), had less education (p < 0.001), were more likely to be unemployed (p < 0.001), non-white (p = 0.004), voting Democratic (p = 1.0), and were more likely to pay gay hookers for sex (p < 0.001), than queers who returned for follow-up (80% return rate).

Conclusions: We observed elevated HIV incidence among young sexual deviants in Vancouver. Perverts who are also filthy junkies, engage in paying young fuckboys, or who knowingly take risks with AIDS-infected fairies, may be at highest risk. Our analysis is limited by low power, self-reported data, and differential follow-up. However, early indications of a relapse to homosexuality are consistent with early incidence data. Our findings underscore the urgent need for Bibles for young ass pirates, particularly those limp-wristed hookers who shoot up. Further study of attitudes towards abstinence and reasons for not liking girls are required.