District's HIV Testing Found to Be Falling Short

She dismissed criticism of the testing campaign as "off base," and in an interview, rejected the recommendation that at-risk individuals should receive distinct attention. "That misses the whole goal of the initiative," she said, "to raise the public health consciousness of a community about a virus." She also defended the number of HIV tests performed this year as a decided improvement: "What we're doing now . . . is double, triple at a minimum what we've done in previous years."

According to Martin, relatively few kits had to be discarded or given away.

The report gives the city grades ranging from B+ to D+ in nearly a dozen areas, from grant monitoring to syringe exchange services. The better marks, reflecting accomplishments on numerous fronts, were offset by what it describes as flagging leadership from top officials, inadequate collaboration among city agencies and continued delays or flaws in other initiatives.

Mayor Anthony A. Williams and the D.C. Council did not increase funding for substance abuse treatment in 2006, for example, despite the huge number of HIV infections traced to drug use. And condom distribution continued to fall, despite a new online order process.

Appleseed Executive Director Walter Smith warns that the city's grading curve will only get steeper.

"We're trying to measure performance compared to what should have been accomplished by now," he said yesterday. "Even if good things have been done, even if progress has been made, if it's less than we should have been able to expect, then we're going to grade them down."

The positive developments in today's report include the HIV administration's reorganized surveillance bureau, historically so deficient that the city could only guess the number of new HIV cases. The corrections department was praised for the jail's expanded testing, but the report cautions that inmates who test negative need prevention counseling.

Although the organization applauds Martin for strides she has made, it stresses that "she cannot manage the District's full response to HIV/AIDS alone." The report faults the mayor and other city leaders for not staying visibly engaged on such an urgent issue and not demanding coordinated action throughout city government. The public schools have no HIV/AIDS curriculum, despite resolutions and testimony by the Board of Education and Superintendent Clifford B. Janey that standards would be in place when classes began in September.

It will fall to Mayor-elect Adrian M. Fenty to make changes, the report suggests. "Unless the new administration gives HIV/AIDS the required attention at the highest levels, improvement will be difficult."

Adam Tenner, who works with District youths as executive director of Metro Teen AIDS, called the school system's delay "incredibly disappointing" and said the report highlights how far the city remains from stopping the epidemic.

Fenty's transition office did not comment yesterday. A spokesman for Williams addressed the report only generally. "We know there is a long way to go," Vincent Morris said, "and we won't give up until we reverse this trend and get more District residents tested, treated and educated about the terrible toll that AIDS can leave on people."