By Petula Dvorak
Washington Post Staff Writer
Wednesday, September 24, 2008 4:32 PM
The District will embark on a large-scale "social marketing" campaign to publicize the facts of its staggering HIV-AIDS epidemic and the plans to help curb it, D.C. Mayor Adrian M. Fenty (D) said today.
"There have been some setbacks, some things we could've done better in the past 20 months or so," Fenty said in response to a local advocacy group's report issued today that highlighted the mayor's failure to wage a more public battle against the virus.
But he said there are plans for a "social marketing campaign to make people more aware" of the epidemic, which is believed to infect one in 20 people in the District.
The District government has improved its performance this year in battling the HIV/AIDS epidemic, but the mayor needs to strengthen the city's public awareness campaign to combat one of the nation's highest infection rates, said the report released today by the DC Appleseed Center for Law and Justice.
"The District must take aggressive action to address the remaining obstacles to rolling back the epidemic," the report said . "We of course welcome Mayor Fenty's call for HIV/AIDS to be his top health priority, but sustained, highly visible government efforts to broadly raise awareness of the severity of the epidemic have been absent and reflect a lack of urgency."
That was something that Shannon L. Hader, head of the District's HIV/AIDS Administration, was working on.
"We do know that we have a modern epidemic in the District and we need a modern response," Hader said.
The city just signed a five-year contract with a marketing firm to help spread the word because to make progress, "we must reduce the ridiculous stigma" attached to the virus, she said.
In its report, the fourth since the advocacy group began tracking the District's HIV/AIDS rate in 2005, it portrays a government that is just beginning to grapple with the scope of the crisis.
It credits the city for making progress in basics such as needle exchange programs, expanded testing and education efforts in the schools.
The District is believed to have the highest rate of new reports of AIDS in the United States and it has one of the highest rates of people living with AIDS among major cities across the country, according to the D.C. Department of Health.
Almost 12,500 people in the District were known to have HIV or AIDS in 2006, the most recent year of statistics available. HIV was spread through heterosexual contact in 37 percent of the cases, compared with 25 percent of the cases attributed to men having sex with men -- the most common mode of transmission nationally.
New reports of AIDS in the District were coming in at the rate of 128 per 100,000, in contrast to 14 cases per 100,000 nationally. One in 50 residents is thought to have the disease.
According to the Kaiser Family Foundation, the District has the highest rate of AIDS among African Americans in the country: 277.5 for every 100,000 people. It also has the highest rate of new cases reported among Hispanics: 109.2 for every 100,000 people.
In the last three years, the Appleseed report said, the government has created a "top-flight" leadership team at the city's HIV/AIDS Administration and it has expanded testing programs in city jails. But it urged Mayor Adrian M. Fenty (D) to embark on a public awareness campaign, particularly in churches, to reduce the stigma associated with the disease.
"One of the things that I'd like to see is Fenty frankly speaking out more on this issue," said Walter Smith, Appleseed's executive director. "A very active mayor could influence the faith-based community, the African American communities, the Latino communities there. It's an issue that a lot people, even now, are afraid to talk about."
One reason HIV has remained pernicious in the District is that most new AIDS cases here are found in older people who may have been spreading the disease for years, according to the Appleseed report.
Although Appleseed praised some of the city's efforts to combat the disease, it is waiting for new statistics to determine whether the efforts have had any impact.
Improvements since the third report card, which was issued in December 2007, include several grade changes: routine HIV testing went from a B-plus to an A-minus, syringe exchange services also went from B-plus to A-minus, substance abuse treatment went from C-plus to B and AIDS education in D.C. public schools went from D to C.
A tangible change in one area was in the needle exchange program, which received $650,000 after Congress earlier this year ended a ban on the city using public money for such efforts. Needle exchanges often face opposition because of the connection to drug abuse.
PreventionWorks!, a group that targets people at risk of being infected, reported that they distributed nearly 180,000 new needles and administered 97 HIV tests last year.
Three counselors in the PreventionWorks! van made their regular 9:30 a.m. stop yesterday at Georgia Avenue and Morton Street NW. A couple of addicts were already in line, waiting for clean needles. About a dozen showed up during the two-hour stop.
Each person received about two dozen needles, alcohol swabs and latex strips. Each also received a meal, a piece of cake and some gentle questioning.
"When did you last get tested? You want to get a test?" asked Reggie Jackson, the team leader and a former addict.
Several spurned the offer, but one accepted and took the 20-minute mouth swab test.
Counselor Teefari Mallory went to work. She and the man waiting for his results talked about the things he could have done differently, what life might be like with the virus and how to turn things around. Mallory is HIV-positive, and she lost a daughter to AIDS two years ago. She told that story.
"This program gets them in to do tests, to get help, to get referrals," Jackson said.