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L.A. County may shake up sexually transmitted diseases program

The proposed reorganization has angered physicians and AIDS activists, who are concerned the effort could weaken efforts to halt the spread of HIV in L.A.'s adult film industry.

June 02, 2011|By Rong-Gong Lin II, Los Angeles Times
  • Dr. Jonathan Fielding, director of the L.A. County health department, shown at a March news conference, said the reorganization of the sexually transmitted disease program was intended to increase its efficiency and effectiveness.
Dr. Jonathan Fielding, director of the L.A. County health department,… (Damian Dovarganes / Associated…)

In a move that has angered physicians and AIDS activists, Los Angeles County may shake up the management of its sexually transmitted disease program, which has aggressively investigated the spread of HIV among porn performers.

Critics say the proposed change could weaken efforts to halt the spread of HIV in the Los Angeles-based, $12-billion-a-year porn industry.

"This appears to be a political move which could significantly interfere with disease control activities," said Dr. Gary Richwald, who headed the STD program between 1989 and 2000.

The director of the county Department of Public Health, Dr. Jonathan Fielding, said the reorganization is solely intended to increase the program's efficiency and effectiveness. "What I hope it will do is give more bang for the buck."

A number of doctors and AIDS activists fear the change could sideline Dr. Peter Kerndt, who has headed the STD program in L.A. County for more than a decade. He has overseen investigations of STD and HIV outbreaks and is well-respected by disease experts across the country. Under Fielding's plan, Kerndt's STD program would be taken away from Dr. Robert Kim-Farley, who heads communicable disease control, and put under Mario Perez, who runs the Office of AIDS Programs and Policy, which distributes grant money to AIDS programs. Perez is not a physician.

Dr. George Ma, president of the Los Angeles County Medical Assn., is among those objecting to the plan. "There should be a doctor in charge of the department instead of a layperson," Ma said.

Michael Weinstein, president of the AIDS Healthcare Foundation, said he suspects Fielding and county supervisors may be uncomfortable dealing with public health issues among porn performers because of the "ick factor." He and other critics of the reorganization also believe Kerndt's vigorous investigation of HIV outbreaks in the industry has put him at odds with Fielding.

Fielding declined to discuss Kerndt, but said the county has "been very clear that we're very concerned about the lack of adequate protection of performers in the adult industry."

"I think we have a good STD program," he said. Kerndt declined to comment.

Fielding has said condoms should be used during filming. But last year, he rebuffed demands made in a lawsuit by the AIDS Healthcare Foundation that the county compel porn companies to require condoms during filming in L.A. County. Fielding said he would not send health officers to raid porn film sets, a stand backed by Supervisor Zev Yaroslavsky.

But HIV infections in the porn industry have continued to surface, and Kerndt has continued to investigate them. Late last year, porn actor Derrick Burts was infected with HIV, triggering a temporary suspension of production in the industry and prompting a review that found the threat of infection was continuing.

Dr. Ronald Hattis, president of Beyond AIDS, a national advocacy group, and former Riverside County health officer, praised the current structure of the STD program. The proposed reorganization "might detract from that competence and leadership," he said, speaking as an individual and not on behalf of Beyond AIDS. "Sometimes the politics isn't very transparent, and you can't tell who is making the complaints, and who is pulling the strings."

Fielding's proposal must be approved by county Chief Executive Officer William T Fujioka.

ron.lin@latimes.com

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