News Slant	News Slant Archive

Sexually transmitted diseases supposedly can't tell if they are infecting a person of the homosexual, heterosexual, or any other orientation on the sexual spectrum. Epidemiologists are committed to containing STDs without prejudice.

Why then does the Centers for Disease Control's general news publication, the Morbidity and Mortality Weekly Report (MMWR ), seem to employ an editorial rule identifying gay men when they run a story about STDs in the gay community, while simultaneously failing to mention the sexual orientation of non-gay populations when they are the subject of an STD specific story?

View our poll archive

Two stories in the September 10, 1999, MMWR persuasively illustrate this point.

The lead story that week, "Resurgent Bacterial Sexually Transmitted Diseases Among Men Who Have Sex With Men-- King County, Washington, 1997-1999," examined a small increase of syphilis and gonorrhea cases among gay men in the county that encompasses Seattle. It was written by several leaders from the Washington Department of Health Division of STD Prevention.

The second article, "Inadvertent Use of Bicillin C-R for Treatment of Syphilis-- Maryland, 1998," didn't once refer to the orientation of the patients who received the wrong drug. If there were a single gay man among the patients, past practice suggests his orientation would have been stated in the headline.

The Maryland story, authored by Dr. Diane Dwyer, that state's chief epidemiologist, ostensibly looked at how syphilis patients at several clinics were administered the incorrect brand of penicillin because of a mix-up by health care workers unfamiliar with distinguishing two similar package designs. It was also a prime example of wide disparities in how STD epidemiologists react to STDs in assorted communities.

"Sixty-three patients, including five pregnant women, might have received [the wrong treatment]. The clinic attempted to contact and treat all patients with [the proper drug]," reported Dwyer-- the presumption being the 63 patients were not cured by the wrong treatment and possibly infected additional sex partners with syphilis. But Dwyer never explicitly raises this aspect. Had she, the sexual orientation of the patients and methods authorities used to meet sex partners would have needed to be discussed.

Adding to the coy nature of Dwyer's piece is her decision not to specifically tell readers in which counties the drug mix-up occurred. She simply alludes to "county A" and "county B." Dwyer, by the way, is a graduate of the CDC's Epidemic Intelligence Service, the eyes and ears of the CDC.

Maryland health officials understandably likely wished to avert a public health panic, or in any way wanted to jeopardize their reputations with the public and press.

Seattle researchers analyzed "data on infectious syphilis, chlamydia, and gonorrhea... [along with the] sex, stage of disease, racial/ethnic group, age, and in some cases sexual orientation, and anatomic site of infection. Persons with these diseases were interviewed by [King County health workers] for partner management. Data collected included number and sex of sex partners, sexual orientation, and other risk factors." To drive the point home that gay men are treated in special ways regarding STDs, data on sex partners were provided by 63 MSM [men who have sex with men], 80 percent, of the 79 MSM with infectious syphilis." No such data was gathered in Maryland.

Basic geographical, sexual, and social differences in approaches for respective locations around the country by separate health departments? On one level, yes. However, consistency in STD prevention and control is the mandate of the CDC. This policy stems from the public health belief that bacteria and viral agents can't distinguish the orientation, gender, or morals of their human hosts. An STD is contracted, you treat it. Except when a gay man contracts a disease, researchers ponder the why's, where's, and how's to such a degree it may feel as though a ten-foot microscope is zeroing in on a germ.

In the Seattle story, the phrases "men who have sex with men," more commonly referred to as "MSM," "homosexually active," or "gay men" appeared a whopping 40 times. Somewhat surprisingly, "heterosexual persons" was not even mentioned once. Compare that to the occasions when sexual orientation was included in the Maryland article, and you get zero, zilch, and zip . Since the orientation of the patients is missing, I am assuming they were heterosexual.

A spokesperson for the CDC, Laurie Flatt, said in a phone interview, "We don't have different rules for various sexual orientations as they impact a particular MMWR story."

But there's an abundant emphasis on gay men, gay sexuality, and STDs in the gay community in MMWR articles. Has the CDC conferred a special status on homosexuals? Flatt says otherwise: "The CDC does not have a bias against MSM. MSM are not singled out by us. We don't judge any populations mentioned in MMWR articles. The author's views are their own. We don't impose ourselves on their studies, and these were two diverse studies."

But on past occasions the CDC has claimed "gay bowel syndrome," "gay cancer," and "gay related immune deficiency" were rampantly out of control among gay men, and diseases the "general population should fear."

Flatt did not see any problem with one article mentioning MSM or gay men 40 times, versus no references to the presumed heterosexuality of patients in another story, even though both were about STDs and the ramifications of their control.

Both MMWR stories were of interest to the Associated Press wire service, whose own articles strongly reflecting the tone of the CDC. "STDs on Rise for Gay Seattle Men" was the headline for the first AP story. The word "gay" appeared seven times in it. "Incorrect Type of Penicillin Given to Syphilis Patients" is how the AP sent out its second article about STDs that week. There was no mention of heterosexuals. The AP did report "some of the syphilis patients... had resumed sexual activity, raising the possibility that they would pass on the disease to their partners."

Two AP wire stories were shared with the world and only one made specific reference to gay men. Thanks to the MMWR, average readers seeing both stories may conclude gay men in Seattle, and elsewhere, are irresponsible deviants spreading illnesses, and oh, there was a bureaucratic treatment snafu involving unspecified people in Maryland.

The CDC's extra attempts to minutely dissect gay sex habits, meeting places, frequency of sex, number of partners, and anatomical areas of infections, among other things, while heterosexuals escape such scrutiny, should be worrisome, some gay activists think.

In her article's prophetic closing words, Dwyer said mistakes in Maryland "may undermine the credibility of and trust in health departments on the part of affected patients and the broader community." The credibility factor is on the radar screen where it belongs.

The task facing gay men, especially sexually active ones, is to shake off the not so subtle stigmatization heaped on us by the CDC and MMWR. Both entities have a long way to travel before they are treating us equally when it comes to sexually transmitted diseases.