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In AIDS Crisis, Serious Times Call for Serious Measures

By Courtland Milloy
Wednesday, March 18, 2009; B01

In response to a report released Monday on the HIV/AIDS crisis in the District, city officials say they plan to develop a new and improved public awareness campaign. Such efforts will no doubt take time and involve focus groups and require lots of data and even more money.

A person could contract AIDS and be dead by then.

Perhaps I can help get the campaign going based on what we already know, starting with black women, who represent more than one-quarter of HIV cases in the District. Most of them -- about 58 percent -- have been infected through heterosexual sex.

I propose a TV public service announcement that goes something like this: You see a man holding a gun to a woman's head and pulling the trigger while professing his love for her.

Voiceover: "Is that any different from what a 'down-low brother' does when he has unprotected sex with other men, then comes home and has sex with his unwitting wife?"

As a rule of thumb, marketing strategists told me, it is best to emphasize the positive -- say, remind the man of how good it feels to provide for and protect his family -- instead of denigrating him for immoral behavior.

So I tweaked my ending.

Voiceover: "Women, protect yourself. Men, it's bad enough being a liar and cheat, but don't go so low as to become a murderer, too."

(If you have a better message, please let me know.)

Asked in a telephone interview what she thought of my PSA, former surgeon general Joycelyn Elders said, "That would get my attention."

And isn't that what public awareness is all about?

In releasing the first report on the AIDS epidemic in 2007, city officials laid out an action agenda calling for a "modern response" to a "modern epidemic." Two years later, little has changed except the name of the problem -- which city officials now refer to as a "generalized and severe epidemic," and just in case you don't know the difference between the two, the latter involves infection rates "higher than West Africa."

In other words, be afraid, D.C. Be very afraid.

"You and I could go today from one end of the city to other and back again by different routes and not see a single HIV prevention message," D.C. Council member Jim Graham told me. "Why? Because there aren't the resources for those types of things."

Not even a billboard. Gone are the "silence equals death" signs put up by ACT UP, the AIDS activist group that kept the issue in your face back in the '80s and '90s. You haven't seen that AIDS memorial quilt spread out on the Mall in quite a while, either. Red AIDS ribbons seemed to have faded to pink as breast cancer became the illness du jour.

"If AIDS was an insect, it would be a cicada," Philip Pannell, a longtime Washington AIDS activist, told me. "AIDS is a cyclical issue, comes around every few years or so, makes some noise, then disappears until the next go-round. Every time an AIDS report comes out, Mayor Fenty talks about a wakeup call. But all we do is hit the snooze button."

Meanwhile, the disease itself continues to incubate and spread in manners we have not yet even acknowledged. Look at the sexually transmitted disease chlamydia. As of 2007, there were 1,037 cases per 100,000 residents reported in the District, compared with a national rate of 370. We're talking about mostly black teenage girls and young women. With STDs such as chlamydia known to weaken the immune system and make HIV infection more likely, this epidemic is but an indicator of how vulnerable the population really is.

I'd put Elders to work on PSAs for hip-hop radio stations immediately. Let her teach junior high school students about the ABCD's of STD prevention -- the same ones that got her drummed out of the Clinton administration: A) Abstinence is unrealistic; B) Be faithful to your partner; C) Condoms do work; D) Do other things.

Student: "What other things, Dr. Elders?"

Elders: ["The M-word."]

Voiceover: "Nobody ever caught AIDS from themselves."

Hey, don't go squeamish on me now -- not with 3 percent of the District population walking around radioactive. Culturally inappropriate, you say? Not in a culture where sex has become a weapon of mass destruction.

E-mail: milloyc@washpost.com

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