Dispatch from Mexico: The Numbers Crunch

Douglas Hopper, here. I'm blogging from the International AIDS Conference in Mexico City. I'll be bringing you more about what's taking place here - with 25,000 people from around the world, there's no shortage of things to mention.

Numbers.

Three days into the conference, I'm swimming in data. My bag is bursting with reports from the latest studies, the newest surveys. And I'm not so sure that's a good thing. Last night I dreamed of PowerPoint data. The story of HIV/AIDS is feeling like one big number crunch.

It's not the first time.

Back in the day, before I started a career in journalism, I had my eyes set on public health. One of my first jobs in the field was with Vanguard Youth Services in Portland, Ore. I was an outreach worker in rural Oregon charged with bringing HIV prevention information to queer-identified youth.

It was great work. Actually, I loved my job. But one of the most grueling regular duties was the dreaded CDC report.

Each month I'd have to file a report for the Centers for Disease Control (CDC), the main source of funding for our project. And each time I faced the massive form -- with all its columns of categories and sub categories -- I'd feel instantly inadequate. Not because sometimes the boxes would blur together, not because sometimes I'd have to call up my boss to decipher a question. The truth is I thought my numbers were just too small.

Some nights we'd only have three or four young people show up to the group meeting. And weeks would go by, during which time I'd gotten permission to put up just one poster in a high school. Even worse, one month I had only contacted one youth online ... and I didn't even know where he was from.

How could I put these numbers down? I imagined some bureaucrat at the CDC laughing hysterically at my form, passing it down the line as an example why programs like ours shouldn't be funded. Or worse, I thought I'd be forced to pump up the numbers. I knew I couldn't do that ... honestly. I was working in conservative communities, places where tolerance of homosexuality was an exception to the rule.

I knew we were making a difference, even if what was inside the boxes didn't make it seem so. I braced for the worst.

The CDC bureaucrat never faxed my form to the president. And my boss never questioned my elementary-size numbers. And our funds stayed intact, at least for awhile.

But I still wonder about those numbers. I still ask myself whether that was the best measurement of our success. All the quirky details of our meetings, all the tense moments, the embarrassing questions ... those were never recorded.

Here at the International AIDS conference, I'm struggling with the same dilemma. Yesterday, I went to a presentation about the increased risk of HIV among migrants along the US-Mexico border. Each person on the panel gave a very earnest speech, accompanied by PowerPoint slides detailing a myriad statistics about the immigrant population. All of the facts were important. One study showed that men who migrated across the border were more likely to engage in sex with a sex worker. Another set of data showed a similar increase among men who have sex with men.

I also went to a presentation about outreach to men who have sex with men (MSM) in developing countries. Whoa... I was spinning in numbers. Some of them were no-brainers to me, others were very revealing. I had no idea, for example, that there was such a large population of men who have sex with men in Peru. And that so many of them don't perceive themselves at risk of HIV.

But here's my problem: I heard a lot of numbers. I saw a lot of graphs and pie charts and percentage points. Yet, I heard almost no stories. I realize this is a professional conference and much of the presentations are based on empirical evidence, as they should be. But what is this all really about? When we all leave Mexico City, the numbers will be recorded in journals, and websites and books on prevention. Some of them may end up on the desk of a CDC bureaucrat. Its likely they'll be used to justify important programs that save lives.

The question on my mind is not whether the data has a place. I'm wondering whether its place is too big.

Why does the PowerPoint chart gets so much play. Are the numbers an innocent way of avoiding awkward details? ... An inoffensive means of talking about a controversial public health crisis?

What about looking at the story of the young Ugandan man that quietly sneaks into the city for sex with men? Or the Peruvian man who hooks up online, but doesn't know how to put a condom on. The sex worker in Mexico City who joined a collective so she could have access to condoms and moral support? The migrant farm worker who discovers sex with men after he crosses the border? Or the young gay woman who came to our youth group in rural Oregon and met other women like her and realized there was a reason to take care of herself?

You can't count everything.

Douglas Hopper

11:03 AM ET | 08- 7-2008 | permalink