Disappearing Ink

Left Field by Patricia Nell Warren

In old-time spy thrillers, certain vital information is encrypted in disappearing ink. Soak the piece of paper in the right pH indicator, and hidden information reappears. Today, disappearing ink is technologically passé, known best to fans of Agatha Christie novels. But recently it seems to have been reinvented by the CDC.

In late October, when the Centers for Disease Control and Prevention (CDC) published its 2002 HIV/AIDS Surveillance Report, accountability activist Kevin Nuttall noticed that some vital figures had disappeared. They were: male adult/adolescent AIDS cases; male adult/adolescent HIV infection cases; female adult/adolescent AIDS cases; and female adult/adolescent HIV infection cases—all broken down by exposure category and race/ethnicity. The omission left remaining figures focused mainly on men who have sex with men (MSM). Nuttall, who is in charge of legislative affairs for the North Carolina AIDS Policy Center, e-mailed a Congressional contact. He said: “This is newsworthy! For the first time ever in thirteen consecutive years, the CDC did not supply [these] four items.”

Nuttall sent an action alert to his e-mail list, commenting, “Without these four stratified reports for 2002, CDC has ‘turned off the AIDS clock’ for every population and subpopulation, including a segment of the MSM population....Withholding this data from the public is not sound public health policy. Rather, the CDC has basically assured that people of color will be officially ‘under the radar.’” Acting on Nuttall’s alert, a Wall Street Journal reporter applied the pH factor of a few phone calls to the CDC. Voilà—the agency quietly posted the missing figures on its Web site, but as an “addendum.”

Still curious, Nuttall discovered that some of the CDC figures don’t add up. In 2001, the CDC reported 12,230 new HIV cases among males in the No Identifiable Risk (NIR) category, plus a total cumulative number of 37,675 new HIV cases among NIR males. Now, in 2002, the CDC reports 7,880 new HIV cases among NIR males and a cumulative NIR total of 37,046. Well, 37,675 + 7,880 adds up to 45,555, not 37,046…meaning that 8,509 American adults and minors seem to have vanished into thin air. What is the CDC up to?

On July 28, just in time for the National HIV Prevention Conference in Atlanta, a CDC press release trumpeted its big news. Not a word about ethnic concerns. Instead: “Data from 25 states with long standing HIV reporting show the number of new HIV diagnoses among gay and bisexual men increased by 7.1 percent, from 2001 to 2002, supporting recent findings that this population remains at high, and

perhaps increasing, risk for HIV infection.” Nuttall told me that, according to his calculations, 7.1 percent was 980 cases.

And what happened to those missing 8,509 NIRs? Well, today’s public-health policy is based on behavioral models. “No identifiable risk” means that you can’t point a finger at any particular group’s sexual behavior. So the CDC spent some taxpayer dollars on “investigating” NIR cases. According to Nuttall’s number-crunching, 196 whites, 598 blacks, 176 Hispanics, and sixty-eight Asian-Pacific Islanders may have been reassigned from NIR to MSM—enough to make the 7.1 increase. Indeed, the CDC’s addendum page states that the agency intends to investigate NIRs in hopes they can be reclassified. (NIRs whose identities are on record through names-based testing may be alarmed to learn that they could be scrutinized in this matter.)

Some MSMs are not openly “gay” or “bisexual”—they lead a closeted sex life that keeps them off the radar screen. The CDC knows this, which is why its stats don’t have separate categories for “gay” and “bi.” Yet the CDC’s press release focused on gay and bi men, not MSMs. The media didn’t bother with this important distinction either. Result: a lot of alarming stories that more gay and bi men are getting infected. Reuters even let the word “bisexual” magically disappear in its headline “HIV Cases Rise Among Gay Men.”

So there it is, folks. Those of us who believe that CDC figures scientifically represent living human beings out there can ponder the fact that HIV figures may shade into Agatha Christie fiction. Among other things, the numbers drive federal funding. You can’t design a fundable prevention program for NIRs. Without “increases in gay and bisexual infection,” the money goes away. GLBT organizations whose funding depends on these statistics might ask themselves if disappearing ink is real science—if it truly benefits the

populations they’re committed to serve.