Like many of his colleagues on the Minnesota Department of Health's HIV STD Prevention Task Force, Nick Metcalf came to the group with a background in social services. For the past four years, Metcalf has been the executive director of Minnesota Men of Color, a nonprofit organization that works with gay minority men. But Metcalf was an ideal candidate for the task force for another reason. As a gay man--who also happens to be HIV-positive and Native American--he met one of the task force's most pressing needs: He fit a profile.
Under guidelines from the federal Centers for Disease Control and Prevention, state HIV planning groups are supposed to reflect the demographics of the epidemic. The idea is based on a simple principle: People from populations most affected by HIV should have a voice in coming up with prevention strategies. But since its inception in 1994, the Minnesota task force--which currently boasts 23 members, down from a high of 35--has struggled to find and keep members from the affected demographics, and has been largely dominated by social-service professionals. In a 2001 review of a Health Department HIV grant application, CDC officials stated that the state demonstrated "a genuine effort" to reach the diversity goal for the task force but noted that "there is concern the process has not facilitated the full attainment of the objective."
Acknowledges Metcalf with a sigh: "Right now it seems we've got a bunch of white women planning services for gay men."
As of March 1, when the group did its last membership review, 14 of its members were women, while just 5 were gay or bisexual men. That fell considerably short of the task force's targeted goal of 11 to 13 gay or bisexual men--who, in Minnesota, still represent the core of the HIV-positive population. And despite the much-noted "colorization" of the HIV epidemic here and elsewhere, the group contained no black men, Hispanics, or Asian Pacific Islanders. "For a community planning group, we're sorely lacking," sums up Metcalf, who was recently elected co-chair of the task force.
Lucy Slater, a planner with the Department of Health who works with the task force, acknowledges that achieving membership balance has long been a problem. But, she adds, it's not for a lack of trying. "I can't tell you why we haven't succeeded, except that it's hard to find anybody who has the time and energy to be a part of the process," Slater says. Perhaps, she surmises, it has to do with the time commitment required. Task force meetings are held during workday hours, which accommodates the task force's social-service professionals but can prove a hindrance to people who don't work in the field and can't get time off.
Lorraine Teal, a task force member and the executive director of the nonprofit Minnesota AIDS Project, says reaching targeted membership goals for community planning groups like the task force is a common problem. "This isn't anything out of the ordinary. There's no jurisdiction in the country [where the planning group] meets the profile of the epidemic," Teal asserts. "The CDC has had some comments, but it isn't like they are saying, 'You guys are doing a terrible job.'" (Karen Willis, the CDC's project manager for Minnesota, did not return City Pages' calls seeking comment.)
Helen Reed, the task force's outgoing co-chair, says she has been frustrated in her efforts to recruit new members. "I've been trying to get African-American gay men involved for a long time, but a lot of the people I've interviewed seem to feel it would just be a waste of their time," Reed says. In part, she surmises, the disinclination she has encountered is driven by a chronic "distrust" of institutions among people of color. But then, Reed adds, there is another factor: The task force's monthly, six-hour-long meetings typically are contentious and laden with race and gender politics.
Reed's view is shared by Bob Tracy, a policy analyst with the Minnesota AIDS Project. "I attended their meetings on a regular basis, and after a while it drove me crazy," says Tracy. "As a gay man, to be in this group you were made to feel that you were privileged, that your community had already been serviced. If you raised an issue around gay men's needs, it would get yelled down. So gay men just stopped getting involved in the process."
Tracy contends that the imbalance on the task force is reflected by an imbalance in the ways prevention money is spent in the state. While gay and bisexual men still constitute 60 percent of the total cases of HIV infection in the state (and 50 percent of the new ones), only about 30 percent of the Department of Health's $5 million HIV-prevention budget is targeted at that demographic. "The priorities they set last year didn't even include targeting HIV-positive individuals," Tracy complains. "Last time we checked, every new infection involved some person who was [HIV-]positive. You'd think they would be targeting them."
Given budget constraints, tensions over how her agency allocates prevention funds are inevitable, responds health department planner Slater. "There are always going to be disagreements, because you are always going to have people from very diverse communities making sure the needs of their communities are met," she observes. And that, she adds, is why it is important to have a lot of voices at the table.