An Overwhelmed D.C. Agency Loses Count of AIDS Cases

Marie Sansone, who runs the surveillance branch of the District's AIDS office, says,
Marie Sansone, who runs the surveillance branch of the District's AIDS office, says, "Our department's mission statement reads, 'to provide a comprehensive picture of the HIV/AIDS epidemic.' We're not doing that. Not yet." (By Marvin Joseph -- The Washington Post)
By Jose Antonio Vargas
Washington Post Staff Writer
Saturday, December 30, 2006

In late August, barely a month into her new job, Marie Sansone of the District's AIDS agency was astounded by what she discovered: five boxes of unexamined HIV and AIDS cases that had not been touched in more than a year.

In the boxes were records of 2,000 to 3,000 cases that had yet to be entered in the city's database. The records are mostly from 2004 and 2005, some from 2003. Who's getting sicker, who needs treatment, who died. All boxed up.

"Oh, my goodness," Sansone, surveillance chief for the city's Administration for HIV Policy and Programs (AHPP), remembers saying.

"We were flabbergasted, just flabbergasted," adds Sansone's boss, AHPP Director Marsha Martin.

That information is critical to managing a spreading epidemic, now in its 25th year. Under guidelines from the federal Centers for Disease Control and Prevention, AHPP is required to collect, maintain and distribute statistics on the disease, which dozens of community-based organizations depend on for their prevention and treatment programs.

City officials acknowledge that the District is behind in tracking new cases of HIV, as well as in reporting the number of deaths from AIDS complications.

AHPP reports that about 10,000 District residents -- nearly 1 in 50 -- have AIDS. It estimates that between 17,000 and 25,000 have HIV, the virus that causes AIDS. Though AHPP started collecting HIV data in 2001, it has yet to release the statistics, and it hasn't released data on AIDS-related deaths since 2002. In contrast, Baltimore issues yearly and quarterly updates of HIV cases and AIDS-related deaths.

With the additional five boxes, the District's big problem just got bigger.

"This is very, very, very serious," Sansone says. "Getting through these boxes is of the highest priority."

And Sansone's historically disorganized, chronically understaffed surveillance department shoulders the weight of correcting the public record. Since early September, Sansone and her staff have been going through the five boxes, looking at each case, going back to local health care providers to complete reports, making sure that an HIV case is not counted as an AIDS case and vice versa. She's kept a weekly tally.

By the end of September, they'd added 15 AIDS cases and 236 HIV cases.

By the end of October, they'd added another 126 AIDS cases and 636 HIV cases.

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