Anti-AIDS Forces Fire at Supervisors

Bruce Decker, a veteran Republican political consultant and one of Gov. George Deukmejian’s key advisers on the AIDS epidemic, was having a difficult time controlling his temper.

“I’ve worked hard privately to try and avoid this battle,” said Decker, who co-chairs the statewide AIDS Advisory Committee, during a recent interview. “I laid low on this whole thing until Schabarum laid that cheap shot.”

Triggering Decker’s wrath was a highly publicized attack by Los Angeles County Supervisor Pete Schabarum on a privately funded, sexually explicit AIDS prevention pamphlet called “Mother’s Handy Sex Guide.” After assailing the literature as “hard-core pornography,” Schabarum won backing for a review of $1 million in county contracts with gay organizations. The clear implication of the review, supported by a 4-1 board vote, was that those contracts are in jeopardy.

The controversy forced into the open a heretofore publicly suppressed conviction by Decker, medical experts and others on the AIDS front line that the Board of Supervisors’ majority is unwilling to become a major force against the spreading, and usually fatal, disease. The supervisors’ stand also reaffirmed for the AIDS-fight proponents the wisdom of a recent state Department of Health decision--unanimously recommended by Decker’s committee--that $1.25 million for AIDS education should go directly to private community agencies instead of through the county.

“The County of Los Angeles has the second-largest AIDS population in the state. It borders on criminal neglect for the Board of Supervisors and the county Department of Health Services not to have initiated education programs,” Decker said.

Decker, 35, is an avowed homosexual with a self-deprecating manner--he likes to get a laugh from new acquaintances with the explanation that he is “Deukmejian’s House Fairy.” A conservative Republican who performed advance work for President Gerald Ford, Decker has worked for a host of California’s GOP officeholders, including Sen. Pete Wilson and Deukmejian. Last year Deukmejian named Decker, of San Francisco, to the nine-member AIDS Advisory Committee that was formed by special legislation to advise the governor and Legislature on the epidemic.

Decker’s concerns are underscored by the fact that with 1,129 cases reported as of Aug. 31, Los Angeles County ranks behind only New York City and San Francisco in numbers of known cases of AIDS, or acquired immune deficiency syndrome. Of those reported cases, 584--or 52%--have ended in death since the epidemic began in 1981. Health experts predict that at present rates of people contracting AIDS--about 70 new cases a month--Los Angeles County will surpass San Francisco at an undetermined point in the future simply because of the county’s much larger population.

Those fighting AIDS contend that public education is vital to halt the spread of AIDS, for which there is no known cure or prevention. AIDS education, these advocates say, should focus not only on the high-risk populations like sexually active gay and bisexual men and intravenous drug users, but also on low-risk groups that have also been afflicted with the disease.

Because a person may have the disease for years without knowing it, there is no accurate way to gauge how effective education can be in checking the spread of AIDS. But health experts say that in the absence of an effective medical weapon in the AIDS-fighting arsenal, education should be encouraged by elected leaders as a matter of responsible public policy.

As evidenced by recent publicity over the controversial anti-AIDS pamphlets, however, educational materials containing explicit language and illustrations can spark highly emotional debates when the material enters the public domain. Health officials differ on the propriety of distributing certain material, but they agree that in a situation like the AIDS epidemic, they cannot afford to pass up any method--controversial or otherwise--to halt its spread.

The struggle cited by Decker between the conservative-dominated Board of Supervisors and those dealing directly with the AIDS crisis combines fiscal, political, philosophical and religious considerations that center less on AIDS as a disease from which the public at large needs protection than on the small portion of the public hit hardest: the county’s homosexual population.

The fact that gays have been hit hardest by AIDS is so volatile an aspect of the epidemic, for example, that county health officials decided long ago to surrender much of the controversial AIDS education efforts--those dealing directly with sexual activities--to the gay community.

Dr. Shirley Fannin, assistant director for the county’s Communicable Disease Control center, said: “The Health Department taking a direct role in advising high-risk groups is fraught with problems. From the very beginning we felt that education would be more effectively done by that (homosexual) community. That’s why we promoted the creation of the Gay and Lesbian Services Center.”

Crisis Proportions Noted

But officials of those private organizations said that the four-year fight against AIDS has now reached crisis proportions that the county cannot ignore.

“There’s got to be more money allocated by the county of Los Angeles for public education,” said Hugh Rice, director of the Gay and Lesbian Services Center. “We can’t do it all. The supervisors have done little or nothing in the wake of this incredible problem.”

Supervisor Ed Edelman is the exception. Edelman, who represents the Hollywood area where most of the AIDS victims live, has won high praise from the anti-AIDS forces for his various efforts to focus attention on the disease. It was Edelman and Los Angeles Mayor Tom Bradley who organized the City/County AIDS Task Force that is monitoring the AIDS crisis locally and working for additional funding to fight it.

Edelman was the board’s lone voice against the recent moves to halt distribution of the two controversial anti-AIDS pamphlets. He also opposed the Schabarum-inspired review of the gay organization contracts.

‘Issue Affects Everybody’

Asked why his colleagues have not joined him in fighting for AIDS education funding, Edelman said: “I guess they (his colleagues) don’t want to accept a particular life style. I don’t see how if you tell (homosexuals) how to prevent AIDS, you’re promoting a gay life style. This issue affects everybody.”

AIDS is transmitted in a variety of ways, but generally it is contracted through the exchange of bodily fluids, such as blood, semen and urine, in such activities as anal and oral intercourse. Other activities identified as high-risk include the use of dirty needles in taking narcotics by injection.

In discussing local government help in the fight against AIDS, comparisons between San Francisco and Los Angeles invariably are made. San Francisco’s county supervisors, who have a politically powerful gay constituency, have earmarked $2.2 million this year for AIDS education, of which $800,000 is from local funds and the balance from state and federal sources. Jeff Amory, coordinator of San Francisco’s AIDS programs, said that last year $975,000 of a $1-million education effort was financed by local funds.

Less County Spending

Los Angeles County’s supervisors, meanwhile, expect to spend only about a fifth of that amount, or about $400,000, for AIDS education this fiscal year. While the exact amount of local funds included in that total was not available, county health officials said most of the money spent on the Los Angeles County efforts would come from state and federal sources.

Supervisor Deane Dana said that Los Angeles County lacks San Francisco’s authority to raise additional taxes for AIDS education programs--for example, by levying a special sales tax. Consequently, in Los Angeles County, anti-AIDS organizations “are competing just like everybody else for funds,” said Dana, a member of the board’s conservative majority. San Francisco’s Amory said that no such local tax increase has so far been necessary.

Los Angeles County is indeed in a budget crisis of sorts, having recently lost a potential $44 million in state funds it was counting on for employee salary increases. It also faces a loss of $60 million in federal revenue-sharing funds next year and might have to pay $50 million or more in overtime costs to employees as a result of a U.S. Supreme Court ruling earlier this year.

Treatment More Expensive

Peter Scott, chairman of the AIDS Project in Los Angeles, answers the can’t-afford-it argument by saying that the cost of funding new educational programs is minor compared to the $100,000-plus spent on long-term treatment in county hospitals for each AIDS victim. This fiscal year, the county has budgeted $8.9 million for hospital-related costs involving AIDS victims. Last year the county spent $3.9 million.

Recent attempts to line up county funding for AIDS educational efforts were unsuccessful. Dr. Neil Schram, chairman of the Los Angeles City/County AIDS Task Force, asked the board during budget talks for $1.5 million for AIDS education, but the request never came up for a vote.

Recently, after publicity about Rock Hudson’s fight against AIDS, Supervisor Edelman sought $500,000 for AIDS education. That request, made July 29, is still under study.

The financial crunch apparently is only one reason for the supervisors’ perceived reluctance to become more than passive observers of the AIDS battle.

Risking Alienation

Politically, the supervisors risk alienating their more conservative, and certain religious, constituents by voting public funds to fight what many in the heterosexual community still apparently believe is an illness afflicting only homosexuals--a minority still fighting to win acceptance outside its own circles. Such an attitude was evident when the city’s passage of an anti-discrimination law protecting AIDS victims was met with angry letters and phone calls to the law’s City Hall supporters, including Mayor Bradley. Although 93% of the county’s AIDS victims are gay, that percentage is not reflected in statistics nationwide, where the rate of homosexuality is much lower, about 73%, according to the Centers for Disease Control in Atlanta.

Anti-AIDS advocates also suspect that because most of the county’s AIDS victims live in Edelman’s Hollywood-area district, there is no real political incentive for Edelman’s colleagues to actively join the battle against the dreaded disease. Edelman shares this view.

Potentially Volatile

Although the supervisors have never publicly acknowledged the political risk of being identified with helping the gay population, comments by conservative Supervisor Mike Antonovich, for example, indicate that the potential volatility is not far from the surface.

In a statement attacking a pamphlet advising intravenous drug users--an AIDS high-risk group--to make sure their needles are clean, Antonovich, a prospective GOP candidate for U.S. senator, said the literature was “another example of radical liberals using taxpayers’ dollars to subsidize deviant behavior. . . .”

Distribution of the pamphlet, financed partly by county funds, was halted after Antonovich and Supervisor Kenneth Hahn objected that it was encouraging drug use.

(Antonovich declined to be interviewed about the AIDS controversy.)

For what are viewed by anti-AIDS advocates as largely religious grounds, Hahn--Edelman’s traditional liberal ally--has not joined Edelman in the championing of the anti-AIDS fight. Hahn, who often quotes Scripture at board meetings, is a devout member of the Church of Christ, which believes that homosexual activity is sinful.

Hahn’s Voting Record

“Hahn has never been a solid vote on issues dealing with the gay and lesbian community,” said Larry Sprenger, co-chair of the politically oriented Municipal Elections Committee of Los Angeles (MECLA), a gay rights organization.

Hahn declined to be interviewed on the subject, but in a brief statement called for an “all-out public education campaign by television, radio, newspapers and pamphlets on how to prevent AIDS and warnings about the dangers of the disease.” He made no reference to his religious beliefs in the statement.

Dr. Michael Gotlieb of the UCLA School of Medicine, who is actor Hudson’s doctor and a top AIDS researcher, said that “the Board of Supervisors has not come to grips with this (AIDS) issue.”

What the supervisors need to recognize, Gotlieb said, “is that every case of AIDS prevented through public education will result in savings to the community in the long run.”

No More Money

Gotlieb is a member of the statewide AIDS advisory panel that lobbied the board for more county funding for AIDS education. Their reception, several members said, was sympathetic, but firm. There would be no more money.

That negative response prompted the advisory panel to recommend unanimously that the state bypass the county in the allocation of $1.25 million for AIDS education. That decision in turn was partly responsible for Schabarum’s move to oppose legislation to provide about $5 million statewide for AIDS education--unless any money sent to Los Angeles County is funneled through the Department of Health Services.

Deukmejian, who is a political ally of Schabarum, Saturday indicated that he would support that legislation, which comes up for a key Assembly vote later this week. Schabarum’s condition that money be funneled through the county is not expected to be part of the legislation.

Schabarum said in an interview: “I’m not aware of the basis on which that (statewide AIDS) task force arrived at their conclusions. I’m not aware of their view on the amount of dollars and/or what those dollars might be put to as a suggested or appropriate level of attention.”

Need for Information

The conservative supervisor said that before the task force made its recommendation, he had asked county health officials to “put together some appropriate, properly prepared informational materials. We don’t have enough instructional information to sift the fact from the fiction on (AIDS).”

County Health Services Director Robert Gates said that part of the controversy over the AIDS program appears to be a lack of communication, both in the public and on the county government level. Gates’ department will present its case to the statewide AIDS panel in hearings later this month.

“We’ve been doing quite a bit (in AIDS) education, but we haven’t been very public about it,” Gates said. He added that he has briefed the health deputies of the five supervisors on the AIDS crisis, but then conceded that “it could be that we should be working harder to make sure the supervisors (themselves) know the situation.”

AIDS officials are convinced that most of the supervisors have taken an ostrich-like approach to the epidemic and do not want to confront the problem head-on. They cite the recent flap over the drug pamphlet and the “Mother’s Handy Sex Guide” as evidence that the board is not willing to work with those fighting the disease to defeat it through education.

Not Condoning Drug Use

“(The drug pamphlet) certainly was not condoning drug use and anyone who thinks that way is a fool,” said Dr. Martin Roth, a Santa Monica allergist who co-chairs the statewide advisory panel with Decker.

Virtually the same reaction was heard in reference to the other, more controversial pamphlet, “Mother’s Handy Sex Guide.” That seven-page booklet uses eroticism and vulgarities to encourage sexually active gay and bisexual males to engage in only “safe” sex through the use of condoms or avoidance of high-risk activities.

An exasperated Dr. Schram of the City/County AIDS Task Force, who has defended the use of the controversial materials, said the flap over the pamphlets should never have happened.

“It is not a moral issue,” Schram said. “It’s a matter of life and death. I don’t know of any written word that’s killed people.”

But Schabarum stressed that despite arguments that sexually explicit materials--such as the ones he attacked--may be effective in combating AIDS, he is unconvinced.

“It is an argument from their point of view, but they don’t represent the public. I do,” Schabarum said.