By Julie Davids

Ever had sex with someone of the same gender or exchanged sex for drugs or money? The U.S. government now wants to know about it if you get an HIV test or participate in a group discussion on safer sex that's supported with any federal dollars.

Starting on Jan. 1, 2007, the federal Centers for Disease Control will require a first wave of states to start reporting an unprecedented range of information from federally funded HIV prevention programs. It's called "PEMS" (Program Evaluation and Monitoring System), and it's a mandatory computerized database with hundreds of questions designed to evaluate and monitor HIV prevention efforts.

Isn't it reasonable for the CDC to collect information about the effectiveness of the programs it funds? Yes, we all want to know how HIV prevention works, and to make sure the scarce dollars are spent well. But PEMS won't give us the answers we need.

Universal outcome evaluation is a huge, and perhaps impossible, challenge. Any hope to get accurate data would require better training, funding, and support than the CDC now provides. Many prevention providers remain in the dark about what PEMS will involve or mean for them. It is likely that frustration will only continue to build as these new requirements roll out.

Even though the CDC has demanded that funded programs follow pre-approved intervention models, providers have also warned that PEMS may, instead, become the intervention. Not surprisingly, many prevention programs emphasize building a rapport with people before plunging into explicit or invasive topics -- but PEMS mandates questioning on sex and drug use from the very first meeting.

Also, the more time it takes to collect this data, the less time there is to actually discuss HIV risk-reduction strategies. Clearly, PEMS will place a major burden on already strained HIV prevention programs that have experienced several years of budget cuts.

In addition, serious legal questions have not been answered. "Prevention with positives" services for people living with HIV will document that individuals know their serostatus, and then will track their reported sexual behavior -- and people with AIDS can be charged with a crime in all 50 states if accused of "exposing" another person. The CDC has not publicly clarified if and when it would crack the database code and turn over information to outside authorities.

So what can be done? The CDC should act swiftly to answer the concerns of all the AIDS community -- both those people who are providing services, and those targeted by these programs.

To start, separate out the "E" from the "M": The CDC can make PEMS less burdensome by simplifying the collection of data to monitor services. Evaluation could be done in representative sites, rather than everywhere, with adequate support to do the quality research it takes to get real answers. The CDC should convene a community-driven panel to figure out how to do this right.

The CDC should immediately and publicly declare that sensitive personal data will be separated from any identifying information about a client so that, whether through accident or legal procedure, no one will be able to access information to use in criminal proceedings.

Finally, we are not going to significantly improve HIV prevention unless there's enough funding to transform and expand the reach of prevention efforts. President Bush and Congress need to back any new reporting requirements with new money to help implement them, and to commit to addressing the current shortfall in prevention dollars by increasing funding by $600 million when the budget process starts again in 2006.

Julie Davids is the executive director of the Community HIV/AIDS Mobilization Project (www.champnetwork.org).