Senate Majority Leader Bill Frist
Broadcasts AIDS Misinformation
Senate Majority Leader Bill Frist, Republican of Tennessee, who is a physician, insists on being addressed as Dr. Frist. But his misstatements on ABC News This Week last Sunday (December 5th, 2004) about HIV and AIDS caused the Liberal Oasis Web site to claim that Frist is in violation of the American Medical Associations Code of Medical Ethics that require doctors to be honest in all professional interactions and make relevant information available to the public.
ABCs George Stephanopolous, questioning Frist about the inaccuracies in many abstinence-only sex education curricula that were brought to light this week by California Democratic Rep. Henry Waxman, asked whether tears and sweat can transmit HIV. Frist first said, I dont know, then later said, You can get the virus in tears and sweat. But in terms of the degree of infecting somebody, it would be very hard.
The Centers for Disease Control Web site says, Contact with saliva, tears, or sweat has never been shown to result in transmission of HIV, though it does say, HIV has been found in saliva and tears in very low quantities from some AIDS patients. It is never present in sweat.
Frist also asserted that condoms have a 15 percent failure rate. When used properly, the failure rate is actually, at worst, only between 2 and 3 percent.
"Senator Bill Frist (left), he's a doctor and he says that AIDS
could be transmitted from sweat and tears.
Not unless your penis weeps while you're fucking somebody."
by Jon Stewart from Comedy Central's The Daily Show
mirrored from Liberal Oasis :
Senate Majority Leader Bill Frist's egregious violation of medical ethics
while on ABC's This Week, which should result in the loss of his
medical license (and what you can do to make that happen).
Frist's Ethical Violation
Before we continue, keep in mind that the American Medical Association has a Code of Medical Ethics and offers guidelines on how to report ethical violations.
Two of the nine principles that make up the foundation of the Code are:
2. A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
5. A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
On This Week, George Stephanopoulos pressed Frist about the Henry Waxman report on federally-funded abstinence-only programs.
(Crooks And Liars has a video clip of the interview.)
Stephanopoulos set up the segment by noting that the report found "11 of 13 of these programs are giving out false information."
Here's a (long) transcript of what followed:
STEPHANOPOULOS: One of programs [said] "the actual ability of condoms to prevent the transmission of HIV/AIDS, even if the product is intact, is not definitively known."
Another: "The popular claim that condoms help prevent the spread of sexually transmitted diseases is not supported by the data."
A third...suggested that tears and sweat could transmit HIV and AIDS.
Now you're a doctor. Do you believe that tears and sweat can transmit HIV?
FRIST: I don't know. I can tell you --
STEPHANOPOULOS: You dont know?
FRIST: I can tell you things like, like --
STEPHANOPOULOS: Wait. Let me stop you there. You don't know that, you believe that tears and sweat might be able to transmit AIDS?
FRIST: Yeah, no, I can tell you that HIV is not very transmissible as an element, like compared to smallpox, compared to the flu, it's not.
But, the first line -- because I think it's dangerous to show that, and then sort of walk away...
...About condoms for example, we know there's about a 15 percent failure rate.
You know, this is a deadly virus. And you know it is directly transmissible, with a relatively high degree of infectivity by sexual relations.
If there's a 15 percent failure rate in condoms, itself --
STEPHANOPOULOS: But this is suggesting that they don't work even if the condom is intact.
FRIST: No, no. But let me just say, because the whole success, if you look in Africa today, where as you know, 28 million people are infected today, is on this A - B - C:
"Abstinence," which is sort of the initial thrust itself, which is the only way to prevent, only way to prevent --
STEPHANOPOULOS: Only sure-fire way.
FRIST: That's right. Only sure-fire. Very hard culturally, and [there are] lots of approaches.
"Being Faithful." Again, one partner, and in certain cultures, that's very hard.
And then third, "Condoms."
If you take out, just condoms, and say that is the answer, with a 15 percent failure rate, with a highly infective virus through sexual relations --
STEPHANOPOULOS: But not "that's the answer," these [programs] are suggesting that they're really "never the answer."
FRIST: No, well that's, clearly -- I'm telling you that the program that the federal government supports, is officially, this A - B - C approach.
We put $15 billion into this, what I would regard as one the great moral and public health tragedies of the last 100 years, fighting HIV/AIDS.
STEPHANOPOULOS: But do you think these abstinence programs should be reviewed, and that they should be required to be give out scientifically accurate information.
FRIST: Oh, I think of course they should be reviewed...
[But they can be scientifically inaccurate? --ed.]
STEPHANOPOULOS: ...Let me just clear this up though, do you or do you not believe that tears and sweat can transmit HIV?
FRIST: It would be very hard...for tears and sweat to -- I mean, you can get virus in tears and sweat.
But in terms of the degree of infecting somebody, it would be very hard.
So, what's wrong with this picture?
Some things are garden-variety political disingenuousness.
Like that Frist kept talking about abstinence programs in Africa, in order to dodge the questions Stephanopoulos was asking about programs in the US.
And like that we haven't exactly "put $15 billion" into fighting AIDS in Africa.
Bush proposed that much over a five-year period (only $10B of it actually being new money).
Yet, as the Denver Post noted on World AIDS Day, Bush has allowed Congress to skimp on the proposal each year, and what has been spent has been spent very inefficiently.
However, as you probably noticed, Frist said some other extremely misleading things that aren't just political in nature, but involve public health.
First, on the "tears and sweat" question.
Here's what the Centers for Disease Control said about it:
HIV has been found in saliva and tears in very low quantities from some AIDS patients.
It is important to understand that finding a small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid.
HIV has not been recovered from the sweat of HIV-infected persons.
Contact with saliva, tears, or sweat has never been shown to result in transmission of HIV.
For a doctor to say he doesn't know if tears and sweat can transmit HIV clearly perpetuates ignorance about the disease, and does not "advance scientific knowledge".
Saying that the virus can be found in sweat, when there has never been a reported case of it, does not provide "relevant" info to the public.
And it should not be a saving grace for him to say (after repeated grilling) that transmission would be "very hard," because it still leaves the impression that it has happened, when it never has.
His second ethical violation was his repeated assertion that condoms have a "15 percent failure rate".
Where he's getting that stat from isn't entirely clear.
The discussion was about STD transmission, not pregnancy.
Though it is standard for the anti-contraception crowd to say condoms have a 15% failure rate when it comes to pregnancy.
That makes it sound like the condoms themselves are defective 15% of the time.
But that is the approximate rate of failure when human error is taken into account.
When condoms are used properly, the failure rate drops to 2 or 3%.
Of course, that's why we have sex ed.
So people will know 1) how to use condoms properly, and 2) that you need to use two forms of birth control to best prevent unwanted pregnancies.
If Frist wanted to more specifically mislead about failure rates for STD or HIV transmission, he could have cited a recent UN AIDS report estimating a 10% failure rate.
But again, the failures were largely attributed to human error, not defective condoms. And again, that can be remedied with good sex ed.
(Waxman's report goes into much detail about failure rates.)
It should also be noted that what "failure rate" actually means is not as literal as it sounds.
Just like you don't get pregnant every single time you have unprotected sex, you don't contract HIV every time you unsafe sex with an infected partner.
(One study pegged a wide range of .01% and 30% infectivity for homosexual anal sex, depending on the stage of infection).
So if a condom is, say 95% effective at preventing HIV transmission, it doesn't mean you'll contract the virus 5% of the time, because most of the times the condom is ineffective, the virus doesnt transmit anyway.
This rigorous scientific study of studies, which estimated between 90 to 95% effectiveness, makes this same point using more mathematical jargon, concluding that:
...though imperfect, even 90 to 95% effective condoms provide substantial individual protection against HIV transmission.
So for Frist to crudely and repeatedly say on national TV that condoms have a "15 percent failure rate" without properly explaining what that stat really refers to, and what the full truth really is, amounts to nothing less than professional dishonesty.
And as all that is a violation of the AMA's Code of Medical Ethics, Frist should be reported.
The AMA says ethical violations should be reported to the state medical society.
And the Tennessee Medical Association says complaints should be directed to the president of the doctor's local medical society.
Frist's TMA records show his local society is the Nashville Academy of Medicine.
The president of NAM is Dr. Kenneth Lloyd. NAM's main contact info is:
205 23rd Avenue North
Nashville, TN 37203
FOR IMMEDIATE RELEASE: December 9, 2004
Health Organizations and AIDS Organizations Denounce Sen. Frist's Inaccurate and Harmful Comments about HIV Transmission, Condom Effectiveness
AIDS Activists Demand Apology and Retraction -- or Resignation
AIDS organizations and people living with HIV/AIDS today demanded Sen. Frist (R-TN), the Senate Majority Leader and a medical doctor, apologize for and retract inaccurate statements regarding HIV transmission made on ABC's "This Week with George Stephanopoulos" December 5, 2004. After telling Stephanopoulos he "didn't know" if HIV could be transmitted through tears or sweat, Dr. Frist went on to say that transmission of HIV through tears or sweat "would be very hard .... I mean, you can get virus in tears and sweat but in terms of the degree of infecting somebody, it would be very hard."
NOTE: full transcript pasted below.
But according to the Centers for Disease Control, 3[c]ontact with saliva, tears, or sweat has never been shown to result in transmission of HIV.2
"A doctor takes an oath to do no harm," said Waheedah Shabazz-El, a person living with HIV from ACT UP Philadelphia. "A simple 'no' was the responsible answer. We are working on the front lines, trying to correct dangerous myths about HIV transmission. But Dr. Frist's comments endorse these myths and undermine our efforts to protect people from HIV infection. He should be sent back to medical school if he can't get his facts straight about HIV transmission."
In 2004 alone the Bush Administration's spent $170 million in the U.S. and $86 million in developing countries on "abstinence only" prevention programs. Recent analysis by Rep. Henry Waxman (D-CA) has shown these programs teach inaccurate and misleading information.
According to the activists, Dr. Frist was so unwilling to be seen calling the veracity of those Administration-endorsed programs into question, he refused to provide a clear answer. "Unfortunately the Bush Administration is not only using public money to spread inaccurate HIV prevention information at home and abroad--politicians like Dr. Frist are also bending over backwards to reinforce these dangerous myths," said Jodi Jacobson, Executive Director of the Center for Health and Gender Equity (CHANGE).
During the interview Dr. Frist also stated that condoms have a "15% failure rate," another inaccurate comment. According to peer-reviewed studies, consistent and correct condom use is associated with a much smaller failure rate, about 2%. For people who use condoms inconsistently or incorrectly, failure rates can reach 13%.
For more information, contact:
Asia Russell, ACT UP Philadelphia, (267) 475-2645
Julie Davids, Executive Director, Community HIV/AIDS Mobilization Project (CHAMP), (646) 431-7525
Jodi Jacobson, Executive Director, Center for Health and Gender Equity, (CHANGE), (301) 257-7897
--BEGIN TRANSCRIPT [REDUX]--
(Off Camera) Okay, let me switch to another subject. There was a bit of an
uproar in Washington this week about this issue of these abstinence programs
that are funded by the Federal government, the funding has doubled over the
last four years but there was a report by the minority staff at the House
Government Affairs Committee that showed that 11 of 13 of these programs are
giving out false information. I want to show some of the claims they
identified in the curricula. One of them was, one of the programs taught
that "The actual ability of condoms to prevent the transmission of HIV/AIDS,
even if the product is intact, is not definitively known." Another, "The
popular claim that condoms help prevent the spread of STDs is not supported
by the data." A third suggested that tears and sweat could transmit HIV and
AIDS. Now, you're a doctor. Do you believe that tears and sweat can
SENATOR BILL FRIST
I don't know. I can tell you ...
(Off Camera) You don't know?
SENATOR BILL FRIST
I can tell you things like, like ...
(Off Camera) Well, wait, let me stop you, you don't know that, you believe
that tears and sweat might be able to transmit AIDS?
SENATOR BILL FRIST
Yeah, no, I can tell you that HIV is not very transmissible as an element
like, compared to smallpox, compared to the flu.
(Off Camera) No, let's talk. I want to talk about all of it.
SENATOR BILL FRIST
But about, about condoms, for example. We know there's about a 15 percent
failure rate. You know, this is a deadly virus and you know it is directly
transmissible with a relatively high degree of infectivity by, by sexual
relations. If there's a 15 percent failure rate in, in condoms ...
(Off Camera) But this was suggesting that they don't work even if the condom
SENATOR BILL FRIST
Oh, I know. But, but let me just say because the whole, the whole success,
if you look in Africa today where as you know 28 million people are infected
today is on this ABC, abstinence which is sort of the initial thrust itself
which is the only way to prevent, only way to prevent.
(Off Camera) Only surefire way.
SENATOR BILL FRIST
That's right. Only surefire. Very hard culturally in lots of approaches.
Being faithful. Again, one partner and in certain cultures that is very
hard and, then third, condoms. If you take out just condoms and say that is
the answer with the 15 percent failure rate with a highly infective virus
through sexual relations ...
(Off Camera) These are suggesting that they're really never the answer.
SENATOR BILL FRIST
No, well, clearly. I'm telling you that the proposal that the Federal
government supports is officially this A, B, C approach, we put $15 billion
into this, what I would regard as one of the great moral and public health
tragedies of the last 100 years, probably HIV/AIDS.
(Off Camera) But do you think these abstinence programs should be reviewed
and that they should be required to give out scientifically accurate
SENATOR BILL FRIST
Oh, I think of course they should be reviewed, I mean, and that's in part
our responsibility to make sure that all of these programs are reviewed but
whether it's abstinence or whether it's condoms or whether it is better
education on the infectivity of how washing hands in terms of the flu, all
of these are public health challenges that we need in terms of better
education, yes, the government has a role, especially if we're gonna be ...
(Off Camera) Let me just, I wanted to move to another subject, let me just
clear this up, though. Do you or do you not believe that tears and sweat
can transmit HIV?
SENATOR BILL FRIST
It would be very hard. It would be very hard for tears and sweat, I mean,
you can get virus in tears and sweat but in terms of the degree of infecting
somebody, it would be very hard.
(Off Camera) Okay, let me turn to one final subject, steroids...