County Plans Effort to Promote Safe Sex

The county Board of Supervisors voted Tuesday to launch a comprehensive media campaign to promote safe sex and aggressive condom distribution in response to a syphilis outbreak among gay men.

Supervisors also directed the county Department of Health Services to develop strategies for faster reporting of syphilis and other sexually transmitted maladies and to assess the role of public and commercial sex venues in contributing to the spread of disease.

“We need to ratchet up the level of education and information and remind the general public about the risks of unprotected sex,” said Supervisor Zev Yaroslavsky, who made the proposals and asked that they be completed in 14 days or earlier. “We need to address [the problem] in the crisis mode it deserves.”

Public health officials say the syphilis outbreak among at least 26 gay men--mostly in West Hollywood, Hollywood and Silver Lake--is an alarming signal that condom use and other safe sex practices are on the wane.

Many of the syphilis cases resulted from anonymous encounters in bath houses, sex clubs and parks or with male prostitutes. Two-thirds of the men are also infected with HIV, which causes AIDS. Syphilis, though easily curable in its early stages, facilitates transmission of HIV, which despite medical advances is essentially incurable.

Despite the urgency of Yaroslavsky’s tone, at least one AIDS prevention activist told the board that its response was “too little, too late.

Michael Weinstein, president of the AIDS Healthcare Foundation, said the county has known for years of a growing epidemic in unsafe sexual practices and that “ads should be running today” to warn both gay and straight people of the dangers they face.

He took aim at bar owners in West Hollywood as well, describing their compliance with the city’s voluntary condom distribution program as “abysmally low.”

“We need a total restructuring of our prevention efforts,” he said.

Weinstein is behind a highly controversial initiative in West Hollywood to make condom availability mandatory in both gay and straight bars. That measure, which will be voted on next March, asks that West Hollywood each year buy at least 500,000 condoms and distribute them, along with safe-sex literature, to about 70 businesses that derive more than half of their revenue from alcohol consumed on site.

Many West Hollywood business owners consider Weinstein’s proposal divisive and even counterproductive.

“If everyone is working together and everyone buys into it, [the current policy is] a very positive [prevention] program,” said Hillary Selvin, executive director of the West Hollywood Chamber of Commerce. By contrast, a mandatory program generates resistance, she said.

Selvin said Weinstein’s perception of low compliance with the voluntary program is “incorrect.”

Yaroslavsky indicated at a news conference before Tuesday’s meeting that he wants to work with gay businesses, saying they have a “proprietary interest” in cooperating with health authorities. He and health officials said that although complacency about safe sex appears to be rising, no one is suggesting--as in the mid-1980s--that bath houses and sex clubs be shut down.

“People are going to have sex wherever they are going to have sex,” said Dr. Robert Bolan, medical director of the Los Angeles Gay and Lesbian Center. “The issue is about safe sex, not the venue.”

Bolan and county health services Director Mark Finucane said Tuesday that they witnessed firsthand the rancorous debate over closure of San Francisco’s bathhouses in 1984. In the early throes of the AIDS epidemic, both supported the shutdown for public health reasons.

Now, both view such extreme measures as unwarranted, because they say the gay community is far more sophisticated and committed to working with health officials. For example, at least one West Hollywood spa owner offered syphilis testing to his clientele this weekend.

Weinstein isn’t pushing for closure of sex venues either, but he is insisting, as a number of well-known gay iconoclasts did in the 1980s, that gay men not “be afraid of a message of personal responsibility.”

He also said health officials need to invest heavily in halting the spread of HIV, emulating anti-smoking campaigns with smart, compelling messages.

The county spends about $15 million of its $75-million HIV budget on prevention. “We certainly think more [prevention dollars] would be better,” said Dr. Jonathan Fielding, county director of public health. “But it’s not only a question of getting out the message--it [has to be] persuasive.”