Jocelyn Kaiser
News of the Week

Studies of gay men, prostitutes come under scrutiny

Last month, the Department of Health and Human Services (HHS) conducted a site visit of an investigator at the University of California, San Francisco (UCSF), whose studies of sex workers have been the target of a recent inquiry by Congress. Although there is no hard evidence that the inquiry and the site visit are linked, the events have concerned researchers at UCSF and some in government who worry that the Bush Administration and congressional Republicans are intensifying their scrutiny of research on sensitive topics.

Program staff at the National Institutes of Health (NIH), for example, have warned grant applicants to cleanse certain terms, such as "transgender" and "prostitutes," from their grant applications. The reason, according to an NIH staffer who asked not to be identified, is to reduce the projects' visibility. "What's frightening" is that NIH staff feel grantees need to disguise their work, says Alfred Sommer, dean of the Johns Hopkins Bloomberg School of Public Health in Baltimore.

HHS spokesperson Bill Pierce denies that the department is targeting research on certain topics. "We do nothing like that," he says. John Burklow, NIH spokesperson, says that the site visit was for "administrative issues," not "scientific content," and that there was nothing unusual about it.

The controversy centers on research by AIDS researcher Tooru Nemoto, whose projects include preventing HIV infection in Asian sex workers and in "transgender" men who are planning or have had a sex change operation. HHS officials inquired about Nemoto's research in early January, according to Regis Kelly, UCSF vice chancellor for research. Kelly says that Nemoto also had support from another HHS agency, the Substance Abuse and Mental Health Services Administration (SAMHSA), and that HHS apparently wanted to be sure there was no "double dipping." UCSF supplied information to clarify that there was no wrongdoing, Kelly says.

A few weeks after HHS's call, NIH told the university that several agencies planned a site visit to discuss Nemoto's grants. That step was "very unusual," according to UCSF grants and contracts manager Joan Kaiser, who says normally such questions are addressed by phone or in correspondence. In late March, four officials from NIH and SAMHSA spent 2 days at UCSF asking about procedures and going "all over San Francisco" to hear scientific talks by Nemoto's team, Kaiser says. She says that UCSF officials "haven't heard back" but assume the grants were in compliance.

UCSF officials thought no more of it until they learned last week about a memo from the House of Representatives to NIH. The 13 March e-mail memo, from staffer Roland Foster of the House Subcommittee on Criminal Justice, Drug Policy, and Human Resources chaired by Representative Mark Souder (R-IN), raised concerns about two NIH- funded studies of sex workers — Nemoto's and another led by a researcher in Miami. The memo, which HHS routinely forwarded to NIH director Elias Zerhouni, argues that by attempting to protect the health of sex workers, the studies "seek to legitimize the commercial sexual exploitation of women." This runs counter to a February directive from President George W. Bush to reduce international sex trafficking, the letter claims.

Foster's memo asks for detailed information about the two grants, including the names of study section members who approved them and the scores they gave. It also requests information on all NIH studies of prostitutes over the past decade. HHS is now asking the Centers for Disease Control and Prevention (CDC) to list studies it funds of sex workers, a CDC spokesperson says. Foster says he played "no role" in the UCSF site visit but is "interested in what may be found."

NIH program officials who handle grants in these areas are worried about the rumored surveillance. Four staffers contacted by Science declined to be interviewed. But one NIH scientist confirmed that some program staff have been telling grantees to reword grants to avoid terms such as: "needle exchange," "abortion," "condom effectiveness," "commercial sex workers," "transgender," and "men who have sex with men."

Changing words in proposals may not shield researchers from scrutiny, however. On 11 April, Foster fired off another letter to NIH raising questions about a UCSF grant to prevent HIV in gay men and demanded a list of all HIV-prevention studies.