Washington Blade - August 11, 2006
Lou Chibbaro Jr

The appointment of Atlanta gay physician David Malebranche, an assistant professor at Emory University's School of Medicine, and D.C. gay attorney Robert Kabel, former chair of the national gay group Log Cabin Republicans, brings the number of open gays on PACHA to four.

Phill Wilson, executive director of the Los Angeles-based Black AIDS Institute, called Malebranche a nationally recognized leader in efforts to curtail the spread of AIDS among African-American men, including gay men and men who engage in gay sex but don't identify as gay.

"I'm pleased and more than a little shocked that they made this appointment," said Wilson, in discussing Malebranche. "He is a remarkable person. This is something the HIV/AIDS community should be very happy about."

Kabel's experience in working on public policy issues in the Reagan administration and as a Senate staffer on Capitol Hill, and his work on AIDS in recent years with two AIDS-related advocacy groups, make him highly qualified to serve on PACHA, according to Patrick Sammon, executive vice president of the gay GOP group Log Cabin Republicans.

"We think he will do an excellent job," Sammon said.

Malebranche and Kabel join gay PACHA members David Reznik, an Atlanta dentist who specializes in dental care for people with HIV, and Troy Benavidez, a member of the national board of directors of Log Cabin Republicans. Benavides also works as director of national and state alliances at the Philadelphia office of the international pharmaceutical company AstraZeneca.

Dybul confirmed to AIDS post

The PACHA appointments came one week before the Senate on Aug. 3 voted by unanimous consent to confirm gay physician Mark Dybul as U.S. global AIDS coordinator, a post that has the rank of ambassador.

Dybul had been serving as acting coordinator and chief medical officer at the multi-billion dollar global AIDS office, which operates as an arm of the State Department, since last fall. At that time, President Bush appointed his predecessor, Randall Tobias, as head of the U.S. Information Agency. Bush announced his decision to nominate Dybul for the global post on July 17.

Dybul's sexual orientation did not surface as an issue during his Aug. 1 confirmation hearing before the Senate Foreign Relations Committee, when both Republican and Democratic senators praised him for his experience in domestic and international AIDS issues.

Prior to his work at the global AIDS office, Dybul served as assistant director of medical affairs at the National Institute of Allergy & Infectious Diseases at the National Institutes of Health, where he worked on AIDS-related issues.

Although Leavitt of HHS is charged with appointing PACHA members, Bush administration insiders have said all prospective PACHA appointees are vetted and cleared by the White House.

AIDS and public health activists praised the administration's appointment of Kabel and Malebranche. But some activists expressed concern that Leavitt named two more advocates of sexual abstinence until marriage to the 21-member PACHA panel, bringing the total number of abstinence advocates on the panel to at least five.

Four are affiliated with the Medical Institute for Sexual Health, a conservative, abstinence-until-marriage group founded by former PACHA member Joe McIlheney, an obstetrician-gynecologist. McIlheney served as an adviser to President Bush while Bush was governor of Texas.

One of the new members, Barbara Wise, co-founder of the Colorado-based pro-abstinence group Wise Choices, spoke recently at a fundamentalist religious conference that included a workshop on "overcoming homosexuality."

Although Wise did not participate in the workshop on homosexuality, Bush administration critics involved in public health issues have said she and the other pro-abstinence appointees would transform the panel into a socially conservative body that likely would act as cheerleaders rather than independent advisers to the Bush White House.

Wise did not return a call seeking comment by press time.

"Created under the Clinton administration ... PACHA once reflected the national face of AIDS," said William Smith, vice president for public policy for the Sexuality Information & Education Council of the United States, or SIECUS, which advocates condom use as a means of curtailing HIV transmission.

"Now, however, PACHA reflects Texas and the hyper-moralism that has come to characterize every social issue on President Bush's agenda," Smith said.

According to Smith, many PACHA members appointed under the Bush administration have backgrounds "only tangentially relevant" to AIDS and "would sooner see a return to chastity belts and closeted queers than see another condom distributed with taxpayer dollars."

Smith noted that two of the seven new PACHA appointments announced on July 25 by Leavitt - pediatrician Marilyn Maxwell of St. Louis University School of Medicine, who was named PACHA co-chair; and gynecologist Freda McKissick Bush of the University of Mississippi Medical Center - are members of the board of directors and advisory board, respectively, of the Texas-based Medical Institute for Sexual Health.

Two existing PACHA members - Harvard University senior research scientist Edward C. Green and Baltimore AIDS researcher and physician Robert Redfield - are also members of the Medical Institute's advisory board.

Philadelphia minister Herbert Lusk, whom Leavitt named to PACHA in February, serves on the board of a group that advocates for a constitutional amendment to ban gay marriage. Lusk, a former Philadelphia Eagles football player, also works closely with the anti-gay group Focus on the Family to promote faith-based and abstinence programs related to AIDS.

The Medical Institute for Sexual Health, founded by McIlheney in 1995, promotes abstinence until marriage as one of the main methods of preventing the spread of HIV and other sexually transmitted diseases.

"Science clearly shows that the behavior choices necessary for optimal health are sexual abstinence for unmarried individuals and faithfulness within marriage," a statement on the Institute's website says. "By informing and encouraging the up and coming generations, it is our belief that truly healthy sexual behavior can lead to the eradication of STDs, better emotional health, and the preservation of the family as the center of our society," the statement says.

Discouraging condom use?

Critics have said MacIlheney's group has discouraged condom use as an effective means of preventing AIDS, stressing condom "failure rates" and the certainty of safeguarding against HIV infection by abstaining from sexual intercourse except for a monogamous relationship within marriage.

Rebecca Haag, executive director of AIDS Action, a national AIDS advocacy group, has said her group does not object to sexual abstinence as one of many methods of preventing the spread of HIV. But Haag and Carl Schmid, government affairs director of the AIDS Institute, another national advocacy group, have said government and private agencies carrying out AIDS prevention programs should also promote the use of condoms as a key means of curtailing the spread of HIV. The two cited studies showing that proper use of condoms succeeds in halting the transmission of HIV in population groups that don't practice abstinence.

Gay activists have also criticized the Bush administration for promoting abstinence only until marriage programs that have little relevance to gay men, especially young gay men who, except for the State of Massachusetts, are barred by law from getting married.

Officials with the U.S. Centers for Disease Control & Prevention, the government agency leading AIDS prevention programs, has disputed criticism that it downplays condom use, saying the government continues to fund programs by private, community groups that advocate condom use in AIDS prevention.

In addition to the appointment of Malebranche, Kabel, Maxwell, and McKissick Bush, Leavitt also named as new PACHA members Shenequa Flucas, an HIV-positive AIDS prevention outreach worker with the Port Arthur, Texas-based Triangle AIDS Network; and John C. Martin, president and CEO of Gilead Sciences, Inc., an international pharmaceutical company that has developed AIDS-related drugs.

Reznik, the gay PACHA member from Atlanta, praised the decision to appoint Malebranche to the panel, saying he knows first hand of Malebranche's work as a medical school professor and physician treating patients with HIV.

Reznik said he could not comment on the other appointees, saying he does not know them and prefers to reserve judgment on claims by critics that they have a bias in favor of abstinence programs over condom use.

He said that in most instances, all of the current PACHA members have been open to his proposals addressing issues such as condom use and HIV prevention for gay men, among other issues.

"Look at all the bad write-ups about Rev. Lusk," Reznik said. "He is full of compassion, and I don't think he is homophobic at all."

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