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At Least 3 Percent of D.C. Residents Have HIV or AIDS, City Study Finds; Rate Up 22% From 2006

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Reporter Darryl Fears speaks with D.C. Mayor Adrian Fenty about the HIV/AIDS statistics in the 2008 Epidemiology Annual Report scheduled to be released Monday. Video by Hamil Harris/washingtonpost.com

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Ron Simmons, who is black, gay and HIV positive, said he's not shocked by the study's findings. "You have a high incidence of HIV among African Americans, and a lot of African Americans live in the city," said Simmons, who is a member of a black gay support group. "D.C. also has a high number of gay men, and HIV is high among gay black men."

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Charlene Cotton, a D.C. resident who got an HIV positive diagnosis five years ago, said breaking the taboo on discussing HIV is the key to moving forward. "You need to start at home and talk about it," Cotton said. "It's so hush-hush."

Mayor Adrian M. Fenty (D) said he is aware that some advocates have called on elected officials and others to more aggressively and publicly address the crisis. He praised the city's recent efforts, however, and expressed his frustration about the struggle ahead.

"In order to solve an issue as complex as HIV and AIDS, you have to step up," he said. "It's the mayor and certainly other elected officials. But it's also the community. You have this problem affecting us, and you tell people how serious it is and it literally goes in one ear and out the other."

David Catania (I-At Large), chairman of the D.C. Council's health committee, said that although the District's testing and monitoring have improved in the past two years, the AIDS office is still playing catch-up. The city was in the forefront of the crisis when it created the office in 1986, but it fell far behind. Hader took control in 2007. She is its 12th director and the third in five years.

"Frankly, there can be no excuse for the state of the HIV/AIDS Administration that I found in 2005," Catania said. "I cannot speak to why it was not a priority previously. For years prior to 2005, mayors and previous individuals allowed things to exist in an unacceptable way. And I do blame this government for part of the epidemic we're confronting."

Until recently, the District's AIDS office lacked a fully staffed surveillance unit to collect, analyze and distribute data. Inevitably, the office lost credibility, and although it has received millions in federal and local funds -- $95 million this year -- some care providers questioned whether resources were being properly allocated.

Critics also say congressional control over the District had restricted the AIDS office's ability to combat the virus among drug injection users by banning the use of local tax dollars for a needle exchange program. After almost a decade, the ban was lifted last year.

The study is the most precise count to date, according to the authors. The document is an update of a breakthrough 2007 report, which brought into clearer focus a picture of a city in the grip of a complex and "modern epidemic" that had traveled from a mostly gay population to the general one and disproportionately hit blacks.

For years, District HIV/AIDS workers depended on estimates that put the rate at 1 of 20 living with HIV and 1 of 50 living with AIDS.

The current study notes that its tracking occurred as the city made a switch from a code-based counting system to a name-based one. The surveillance unit interviewed medical providers to find unreported cases, pressed providers who did not consistently report to the administration and searched databases for unreported cases.

More than 4 percent of blacks in the city are known to have HIV, along with almost 2 percent of Latinos and 1.4 percent of whites. More than three-quarters -- 76 percent -- of the HIV infected are black, 70 percent are men and 70 percent are age 40 and older.


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