LA County to Revamp STD Program

LOS ANGELES—According to a report in the Los Angeles Times, Dr. Jonathan Fielding, the current director of the LA County Department of Public Health, has announced an impending reorganization of his department which will include major changes in the county's STD program that may decrease the clout of Dr. Peter Kerndt, who's spent more than a decade at the head of the county's STD program.

In his article, reporter Rong-Gong Lin II stated that the reorganization "has angered physicians and AIDS activists," though the two "activists" referenced in the story, Michael Weinstein of the AIDS Healthcare Foundation (AHF) and Dr. Ronald Hattis of Beyond AIDS, have both been outspoken in their call for requiring adult industry performers to use condoms and other "barrier protections" in the filming of sex scenes—and both have been strong supporters of Dr. Kerndt, who shares their views. Indeed, AHF filed a petition with the California Division of Occupational Safety and Health (Cal/OSHA) Standards Board to amend the California Health Code to strengthen the "barrier" requirements, with discussion of that petition scheduled to continue on June 7.

"It seems as though Dr. Kerndt's political agenda has colored his judgment regarding sexually-transmitted infections in the adult industry," opined Diane Duke, executive director of the Free Speech Coalition, which opposes AHF's petition. "Some critics have raised serious questions regarding whether the data that the county's STD program has put forth as the basis for regulating the industry may have been misleading, and have called for an investigation into their accuracy."

The key point of disagreement within the medical community, however, seems to be Dr. Fielding's plan to take Dr. Kerndt's STD program away from his immediate superior, Dr. Robert Kim-Farley, director of the Division of Communicable Disease Control and Prevention—and also a vocal supporter of the AHF petition—and place it under the Office of AIDS Programs and Policy, whose mission is to "respond to the HIV/AIDS epidemic in Los Angeles County" through grants to organizations like AHF.

It would seem that AHF and Beyond AIDS should therefore favor the move, since the program's "vision" is to eliminate HIV infections in LA County "through the adoption of healthier behaviors," but Hattis told the Times that he objected to the move because it "might detract from [the] competence and leadership" of Drs. Kim-Farley and Kerndt, since the Office of AIDS Programs and Policy is headed by Mario Perez, a non-physician.

On the other hand, Weinstein opined to Lin that the reason for the reorganization might be attributable to Dr. Fielding's discomfort in dealing with adult performers' health issues, which he called "the ick factor," and suggested that Dr. Kerndt's unwillingness to discuss approaches to performer health other than condoms/barrier protections might have put him at odds with Dr. Fielding. The Times noted that Fielding has opposed a push, orchestrated by AHF, to have his department require adult producers to use condoms during filming, and to have county health inspectors raid adult movie sets to target non-condom use—a position in keeping with statements from LA City Attorney Carmen Trutanich that LA County had log ago ceded such enforcement authority to Cal/OSHA.

But the DPH director disagreed with Weinstein's assessment, saying that his department has "been very clear that we're very concerned about the lack of adequate protection of performers in the adult industry," and stated that the reorganization was intended to "give more bang for the buck" to the STD program.

"I think we have a good STD program," he told Lin, who noted that Dr. Kerndt declined to comment on the issue.