D.C. Officials Pledge Increased HIV/AIDS Testing

By Darryl Fears and Jose Antonio Vargas
Washington Post Staff Writers
Tuesday, March 17, 2009; B01

A report showing that 3 percent of D.C. residents are infected with HIV or AIDS is probably an undercount, and the prevalence of the disease is probably worse than is known, according to Shannon L. Hader, director of the city's HIV/AIDS Administration.

Hader said the city will work harder to administer testing, which is key to knowing the true number of residents with HIV and to diagnosing the illness before it develops into AIDS.

"These are people who are diagnosed and alive in our city," Hader said. "If you're not getting tested . . . we don't have a way of making you part of the response."

Mayor Adrian M. Fenty officially released the report at a news conference yesterday in Ward 7, one of several wards where the prevalence of HIV and AIDS is high. He called it a wake-up call for the District and one of the "most serious problems" facing the city. The report confirmed for the first time that at least 15,120 residents -- about 3,000 per every 100,000 over the age of 12 -- have HIV or AIDS.

The mayor also released a study on heterosexual behavior by George Washington University's School of Public Health and Health Services saying that residents in parts of the city with the highest AIDS prevalence and poverty rates engaged in sexually risky behavior that fuels the spread of the disease.

"We know we have a lot of work to do as a government to educate and to get the information out, and as a community to step up and realize how dangerous we are with our sexual behavior," Fenty (D) said.

There was good news, Fenty said. Only one baby was born with HIV in 2007, compared with 10 in 2005. Also, 70,000 residents were tested for HIV as part of an aggressive campaign, compared with 40,000 four years ago.

The Centers for Disease Control and Prevention reported that the District is one of the top three jurisdictions in the country in conducting the most HIV tests and identifying the greatest number of HIV-infected residents.

The city plans to increase testing and introduce a marketing campaign emphasizing the use of condoms and clean needles and other forms of prevention, Hader said.

"Our goal is to diagnose more people as early as possible," Hader said. "This report is a very good snapshot of where we're at."

But, Hader said, "it's not the whole story." The report counted residents who were tested and had HIV and AIDS diagnosed, but not residents who had HIV but don't know it.

"The fact that 3 percent have already been counted, already been diagnosed, that's a dramatic, dramatic health statistic," Hader said. "It points out that HIV is a common disease here. If you really think that you don't know anyone affected with HIV, maybe it's time to think again."

Health Department Director Pierre Vigilance joined Fenty in emphasizing that residents should exercise personal accountability. D.C. Council member David A. Catania (I-At Large) said the AIDS administration under previous mayors shared blame for failing to pay nonprofit organizations on time, funding groups that did not exist and failing to provide accurate surveillance data to health-care providers.

"We allowed this government to collapse," Catania said of the AIDS office. "We do have our work cut out for us. Just because the government is functioning now, it's no excuse that it wasn't functioning well in the past."

But no matter what government does, "we have to, as individuals . . . love ourselves more and ask important questions about our own relationships," Catania said. "We can not protect you if you're not willing to protect yourself."

Donald Blanchon, who runs Whitman-Walker Clinic, one of the largest AIDS care providers in the city, attended yesterday's news conference. Blanchon said he was especially troubled by the heterosexual study, which tracked 750 D.C. residents.

"The fact that 70 percent of them said they did not use condoms -- that's unbelievable. This is 2009," Blanchon said. "We need each District resident to know his and her status and talk about their sexual behaviors and practices with their physicians and their partners. That goes a long way into how we attack this problem."

Last year Whitman-Walker, which operates two clinics in the District and one in Northern Virginia, reported 541 new HIV cases, a majority of them from clients living in the District, Blanchon said. There's a year's lag in updating HIV and AIDS cases in the city, he explained, so those numbers have not been added to the latest tally of 15,120.

After the report published Sunday in The Washington Post, Blanchon said, more people came for tests at Whitman-Walker's two clinics in the city. From 9 a.m. to 5 p.m. Monday, 44 clients got an HIV test, he said, about 50 percent more than usual.

Three people tested positive.

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