Sophie Godley, MPH BUSPH CEIT Conference March 25, 2010

 Four credit class in the School of Public Health  No prerequisites: very mixed student body including final semester MPH graduate students and juniors  Temptation with this topic: we all agree! All the time!  Ongoing theme in class: avoid false dichotomies

  sex_drugs_and_hiv_let_s_get_rational_1.html sex_drugs_and_hiv_let_s_get_rational_1.html  Elizabeth Pisani uses unconventional field research to understand how real-world behaviors influence AIDS transmission -- and to overhaul antiquated, ineffective prevention strategies.

 W. W. Norton & Company (September 21, 2009)

 Tech specs: Skype on laptop, emergency # to reach folks if needed, speakers, good internet access  Person specs: engaging speaker, predetermined questions, time (remember time change!)

 When you wrote your book, who was your audience? Who did you want your message to reach?  What has been done since the publication of 'The Wisdom of Whores'? Has there been any policy changes directly or indirectly linked with the book? (What impact has the book had?)  In general, how do you feel the book was received by the public? By others in similar fields?  What are some projects you have planned for the future or are you working on anything now?

 One of your more controversial discussions in the book is different patterns of sexual behavior across cultures and countries. Are we allowed to address a different sexual behavior in a different culture as a problem that leads to the spread of HIV? How do we do this effectively?  Dr. Pisani says that the source of the spread of HIV is "common" sexual behavior in Southern and Eastern Africa, but "unusual" sexual behavior (predominantly anal sex) in Western societies. The solutions for her, however, are the same: Condoms (and clean needles). Why is that?  With regards to human sexuality, is it not possible/reasonable/legitimate to start a behavioral change program?  One student was struck by your recommendation against the idea of “everyone at risk”. for HIV infection, especially with the CDC recommendations for routine screening for adolescents and adults in the U.S.. Could we hear more from you about this issue, and why "everyone at risk" is inaccurate, and potentially dangerous for reducing the epidemic.

 Another student was intrigued by your discussion about needle exchange problems. She was explaining the concept to a friend, who asked at the end how anyone could be okay with having their tax dollars support an illegal activity and make it easier for drug addicts to take advantage of the hard work of the general population. What would be your rebuttal? She came up with only one, "Well, you're not going to stop the spread of HIV/AIDS if you let a bunch of dirty needles hang out on the streets."  What do you think needs to happen for needle exchange programs to become widespread in the United States, since only about half of states legalize them now?  You talk about HIV as "a roller coaster of triumph and despair" and work in public health in general as "not glamorous and not especially well-paid". What has kept you in the field over the years, and how have you overcome the challenges that have made you question your commitment to both public health and HIV?  One of your more controversial areas in the book is about the use of HIV positive peer leaders. How can we address this ongoing problem in the States?

 Sorry I was late in hooking up. I enjoyed the talk, and your students gave me new perspectives and things to think about. I know I sound like a broken record, repeating the same pleas for the triumph of common sense over ideology again and again. The only part of the drum banging of which I am 100 percent confident is my contention that it is time for dinosaurs like me to move over, and to leave free passage for a new generation. Your students have strengthened that conviction. Please thank them very much on my behalf. Bests, ep