Sunday, February 27, 2005

 

NYT: Study Challenges Abstinence as Crucial to AIDS Strategy

as if these guys care about the facts...
 
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February 24, 2005

Study Challenges Abstinence as Crucial to AIDS Strategy

By LAWRENCE K. ALTMAN

BOSTON, Feb. 23 - A new study in Uganda challenges the importance of abstinence as a centerpiece of the Bush administration's international AIDS prevention strategy. The study was conducted by Ugandan scientists in collaboration with researchers from Columbia and Johns Hopkins Universities.

Health officials around the world have pointed to Uganda's success in reducing the prevalence of infections with H.I.V., the virus that causes AIDS, in recent years. President Yoweri Kaguta Museveni of Uganda, the Bush administration and some public health experts have credited the decline largely to a policy known as ABC, for abstinence, be faithful (monogamy) and condom use.

Although educational campaigns promoting abstinence and monogamy may have been effective and contributed to the decline, the study found no evidence that abstinence and monogamy explained the overall decline in H.I.V. prevalence, said the lead author, Dr. Maria J. Wawer of the Mailman School of Public Health at Columbia.

Partial explanations for why abstinence and monogamy did not play a bigger role in the decline include fatigue among residents in the Rakai district of Uganda in responding to educational messages and false expectations of the effectiveness of the antiretroviral drugs that are slowly becoming available in Africa, Dr. Wawer said.

She said that the number of men in the study who had two or more nonmarital sex partners increased significantly over the last decade. Condom use by men with their most recent nonmarital partner also increased substantially during the same period. Sexual abstinence remained constant.

The study did show evidence that condom use increased, particularly in nonmarital relationships, Dr. Wawer said, adding that "condoms are essential" in preventing AIDS.

The number of deaths among H.I.V.-infected people in Rakai each year was about 70 more than the number of newly infected people.

The researchers conducted the study in 44 communities in Rakai from 1994 through 2002. Team members went door to door to ask residents about their sexual histories and to obtain blood and urine samples for testing. The survey, conducted annually, included 10,000 people, ages 15 to 49, each year - from 85 percent to 90 percent of those asked to participate.

The findings apply strictly to Rakai and cannot be extrapolated to other areas of Uganda for many reasons, Dr. Wawer and a co-author, Dr. Ronald Gray of the Johns Hopkins Bloomberg School of Public Health, who is also her husband, said in interviews with reporters. One reason is that the age of first sexual intercourse varies in different areas of Uganda.

Dr. Wawer and Dr. Gray also said that their findings, from the same district over the study period, differed from three earlier Ugandan national surveys that suggested that many Ugandans were delaying the time they first had sex. The national surveys were conducted at five-year intervals and involved a smaller sample and people living in districts that varied with each survey, limiting the accuracy of direct comparisons.

Dr. Wawer and Dr. Gray seemed reluctant to address directly how their findings meshed with the Bush administration's ABC policy.

Roslyn Matthews, a spokeswoman for the federal Agency for International Development, which supports international AIDS prevention and treatment programs, said her agency had not seen or heard of the report and could not comment at this time.

Dr. Chris Beyrer, who directs the Fogarty International Training and Research Program at the Johns Hopkins Bloomberg School of Public Health, but was not part of the study, said the findings underscored the point that "condoms are the main preventive tool against H.I.V."

"Condoms have to be everywhere alcohol and sex are sold," Dr. Beyrer said.

But Dr. Beyrer, Dr. Wawer and Dr. Gray said there was now a condom shortage in Uganda because officials had found defects in condoms imported from a country that they did not identify. The Ugandan government has stopped distribution of that country's condoms and is testing all foreign-made condoms, including those made in the United States, they said, adding that the price of condoms in Uganda has risen.

In October 2004, the Bush administration announced $100 million in new grants focusing on abstinence.

In announcing the program, the international development agency quoted President Bush as saying, on June 23: "I think our country needs a practical, effective and moral message. In addition to other kinds of prevention, we need to tell our children that abstinence is the only certain way to avoid contracting H.I.V. It works every time."

Warren E. Leary contributed reporting from Washington for this article.


Saturday, February 19, 2005

 

NYT: A Zealous Prosecutor of Drug Criminals Becomes One Himself

 
February 15, 2005

A Zealous Prosecutor of Drug Criminals Becomes One Himself

By RALPH BLUMENTHAL

PAMPA, Tex., Feb. 9 - No one prosecuted the war on drugs in the Texas Panhandle more zealously than Richard James Roach. As the blustery and hot-tempered Republican district attorney for five counties overrun with methamphetamines, he had eked out an election victory in 2000 vowing a crackdown and was soon gleefully reeling off the harsh sentences he had wrung from juries: 36 years, 38 years, 40 years, 60 years, 75 years - even 99 years. "I think it's quite clear that the good citizens of this district are fed up with drugs," he said.

He had barely missed riding the issue to victory in an earlier race. "My campaign is centered around doing something with the dope dealers," he told a local newspaper in 1996, complaining that "it's kind of hard to fight drugs when you've got dirty law enforcement."

But of all the quarry brought down by drugs in the district's 4,600 square miles of achingly flat oil fields and cattle rangeland northeast of Amarillo, the biggest by far was the stunned figure clapped into handcuffs by F.B.I. agents in the Gray County courthouse here one morning last month: the $101,000-a-year prosecutor himself, Rick Roach.

Even as he was hounding drug offenders into jail, it turned out, Mr. Roach was sinking into his own hell of drug addiction, by his own account stealing methamphetamine and other drugs from police seizures to cope with depression and sexual impotence. Equally astonishing was that his taste for drugs was hardly a secret: it had come to light in two election campaigns.

In a chain of events that Mr. Roach said in an interview "makes absolutely no sense," he injected himself with methamphetamine in the presence of his office secretary, who was secretly working with the Federal Bureau of Investigation and Drug Enforcement Administration and who, he has since learned, was wired with a hidden recorder.

"I just sort of, you might say, went nuts; I made irrational and wrong decisions," he said in several hours of often rambling narrative, part confessional, part defensive, after a reporter knocked on his door with a question on almost everyone's lips in the Panhandle: what could explain his astonishing downfall?

"There's no excuse," he said. "I've gotten what I deserve."

He was ill, he said; drug addiction was an illness, "but there's no defense for taking an illegal substance to treat mental illness."

"Who in their right mind would inject themselves in front of an employee?" he said.

Asked if he was looking to be caught, he replied, "There's some truth to that."

Government officials said they had also been investigating him for pornography and weapons possession - two guns were in his briefcase when he was arrested on Jan. 11, and 35 others were found in his home and office, along with stashes of drugs. Officials also were looking into his handling of millions of dollars in cash confiscated from drug traffickers along the Interstate 40 corridor that skirts the sparsely populated counties of Gray, Wheeler, Roberts, Hemphill and Lipscomb, where only 33,500 people live, fewer than 8 per square mile.

A Guilty Plea

Last Tuesday, in a deal with the United States attorney's office, Mr. Roach pleaded guilty to possessing a firearm while using illegal drugs, a charge that could send him to prison for up to 10 years and carry a fine of $250,000 when he is sentenced in coming months. Three other drug charges were dropped. He also resigned the office to which he had just been elected to a second four-year term.

Some said that given Mr. Roach's turbulent history - hardly a secret from the voters, who seemed perversely forgiving - they were less than shocked. "He's a damned outlaw, he's always been an outlaw; the rules were made for him," said John Mann, a Pampa lawyer and district attorney from 1993 through 2000 who feuded with Mr. Roach, his political archrival and eventual successor.

Now Mr. Roach, 55, is under house arrest, confined to his mother's and stepfather's home in Canyon, an electronic monitoring bracelet signaling the authorities if he strays more than 200 feet beyond the door.

"If I'm ever a prosecutor again, which will never happen," he said, "I would be much less Rambo-ish and more compassionate in the way I handle an offense, particularly for users."

Although some defense lawyers and drug defendants he prosecuted have voiced outrage, officials said it was unlikely that any of Mr. Roach's cases would be overturned merely on the basis of his conviction, without specific evidence of prosecutorial misconduct.

A Rough Road

Mr. Roach's road to the district attorney's office was hardly smooth. He came from nearby Plainview, where his father, Lavern, was a rising star in the boxing world, voted rookie of the year in 1947. On Feb. 22, 1950, his 24th birthday, Lavern Roach was felled in the 10th round of a fight with Georgie Small at St. Nicholas Arena in Manhattan and died in the hospital the next day.

"He had been scheduled to fight Sugar Ray Robinson the next month," said Mr. Roach, fiddling with his father's prize gold ring. His mother remarried, and the family moved to Pampa, the Gray County seat, where Rick went to school and entered the Army, serving in Korea. At Texas Tech University in Lubbock, he studied accounting and earned a law degree.

But he was plagued for years by alcoholism and drug addiction, at times openly, his estranged wife, Cindy, said in a separate interview at the Yellow Rose, a restaurant they once frequented. She said that made it particularly astonishing that he would ever have sought, and been elected to, a top law-enforcement position.

While Mr. Roach was district attorney, his wife said she repeatedly found narcotics and drug paraphernalia in their barn and threw them away. Last year she found a tin of drug crystals in one of his coat pockets, she said.

"I was furious," she said. "He had promised me."

She said she dumped the crystals in the toilet and then confronted her husband. "He said he didn't know what I was talking about," she recounted.

But around the turn of the year, Mrs. Roach said, her husband had come to her distraught. "He thought he had almost overdosed," she recalled. "He had shot something in his arm. He was scared, crying. He never cried. He wanted to come home. He had thrown everything away. If he couldn't come home, he was going to die."

Janet Stone, a bartender at the Pampa Country Club, recalled that on Dec. 30, Mr. Roach was found lying on the floor in the card room, pale and shaking. He later insisted, she said, that someone had spiked his wine.

Mr. Roach disputed the account but said he had indeed come to a decision: "No more illegal substances." On Jan. 3, he showed up at work determined, he said, to apologize to the staff, and "say, 'Sorry, I've been out of it,' and turn over a new leaf."

But that was the day, the F.B.I. said, he injected himself with methamphetamine in front of an employee one more time.

Mr. Roach identified her as his secretary, Rebecca Bailey, and remembered having an uneasy feeling. "I told Becky I felt like something bad was about to happen; I know something's not right," he said.

"No," he said she had responded, "everything's fine."

Mr. Roach's first recorded brush with the law, according to a Lubbock police record, was in 1975, when he was arrested on charges of drunken driving and using abusive racial language. The charges were later dismissed. He was working in the town of Canadian when he and Cindy met, and they married in 1980. Their relationship was stormy from the outset, she said. "He drank a lot" and sometimes smoked marijuana, she said. She left him in 1987, filing for divorce, only to withdraw the papers because, she said, by then they had three boys, including twins.

Descent Into Drugs

In 1988, while they were living in Breckenridge, between Fort Worth and Abilene, he showed signs of drug use, Mrs. Roach said. Once, she said, he drove to Plainview and begged a relative to fly him to Lubbock "because he thought an ambulance was chasing him." He finally checked himself into a treatment center, she said.

Mr. Roach said he had suffered from depression since he was 13 and underwent treatments with a medicine chest of drugs, some self-prescribed and, recently, ordered over the Internet. "They were all debilitating on my libido, which created problems with my wife," he said. Viagra, he said, left him with a splitting headache. He said that in Breckenridge he had started injecting methamphetamine, finding eventually that, mixed with the sexual enhancer Levitra, it had the desired effect.

"I was going to patent it," he said with a hollow laugh. "I'm definitely a mixed-up person."

He said the pornographic images reported on his office computer had popped up unbidden, and that once he replied to be taken off the list to receive them, the solicitations multiplied. He said he had not stolen seized drug money or maintained an arsenal, describing the weapons as heirlooms and collectors' pieces.

Mr. Roach's first campaign for district attorney came in 1996. At the time he was the Roberts County attorney, prosecuting misdemeanor cases at $500 a month. His opponent, Mr. Mann, won the race by 500 votes and according to Mrs. Roach, the loss plunged her husband into depression.

It was a hard fought race, with a zesty local weekly, The Canadian Record, printing reports of Mr. Roach's drug abuse and legal problems.

Four years later Mr. Roach beat Mr. Mann by 6 votes in a Republican primary marred by charges of fraud, and then beat him again - by 21 votes - after a court ordered a new election. He went on to win the general election.

Mr. Mann said the voters were chiefly swayed by Mr. Roach's highly popular family, particularly his stepfather, Weldon Trice, a beloved high school football coach.

Mrs. Roach said their lives slid badly downhill in late 2003. She found glass smoking or snorting implements, foil packets with a burn hole, and white powder and a razor blade in their barn and spied on her husband sniffing something.

Mr. Roach said of his downfall, "It just presented itself."

He said that in July 2004 he had come across a glass pipe that Texas troopers had overlooked in searching a seized car. "A girl called it a crack pipe, so I assumed there was crack in it," he said. He took it home. "I happened to be having a bad day, so I smoked it in the barn," he said.

Soon after, he said, he found another stash of overlooked drugs. "I just remember how ecstatic I was when I found it," he recalled. He used that, too.

On Dec. 16, the F.B.I. said in affidavits for search warrants, one of Mr. Roach's employees found a syringe floating in the toilet of the office bathroom. Tests showed it contained residue of methamphetamine.

On. Dec. 20, Dec. 31 and Jan. 3, the F.B.I. said, he was seen by an unnamed witness injecting methamphetamine.

The only one who could have seen him, Mr. Roach said, was Ms. Bailey, who later went public as the named complainant in the lawsuit to remove him from office. Ms. Bailey, at her desk in the district attorney's office, did not dispute it, saying, "He trusted me." She declined to say more until the sentencing.

Mrs. Roach voiced no interest in a reconciliation but at one point sounded wistful. "He told me, 'There are some things you don't know about me,' " she recalled. "I wasn't patient. I should have shut up and listened."

At his parents' house, Mr. Roach stepped outside the house for a cigarette. He had been pronounced addiction-free at a Dallas treatment facility he was sent to after his arrest, he said, but still needed his nicotine. Smoking is banned in prison, he reflected bleakly. He should give it up, he said, but added that now "is not a good time to give up anything."

If he is sentenced to prison, he said, he does not know where he will end up, but that no place will be much good.

"Prosecutors don't do well in the pen," he said.

 

 
David Bowser
Richard J. Roach pleaded guilty in Pampa, Tex., to possessing a firearm while using illegal drugs.

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