Mayor Anthony A. Williams promised his personal involvement in the fight against HIV/AIDS yesterday, after saying he agreed with a report that found the city's response to the epidemic that infects one in 20 residents has been disorganized and ineffective.

"We spend a lot of money on AIDS and are not getting the mileage we should," Williams (D) said, leading a chorus of government officials reacting to a study by the D.C. Appleseed Center for Law and Justice. The study, released yesterday, found the city's efforts badly understaffed, poorly coordinated and lacking especially for youths and other at-risk groups.

"This challenge is of life-and-death importance," the report says. "Simply put, business cannot go on 'as usual.' The District's efforts to address HIV/AIDS have fallen far short and addressing the epidemic must move front and center as a priority of District government."

Adam Tenner, executive director of Metro TeenAIDS, said: "This is unacceptable. Business as usual means people dying." He said HIV-infected residents have little hope of receiving proper care when the system that serves them is failing. The nonprofit group coordinates HIV prevention workshops with 10 public middle and high schools in the city.

Williams said that he planned not only to comply with a recommendation in the report to form a task force to spearhead improvements but that he would also chair it. He said the task force would be based on a similar effort with city libraries. But he dismissed a suggestion that the city create an outside commission, such as what the financial control board did in the 1990s, to talk over AIDS efforts.

"People elected me as mayor to fix the problems I identify," said Williams, who has been mayor for nearly seven years.

Speaking at the mayor's weekly news briefing, D.C. Health Director Gregg A. Pane also said that he agreed with most of the findings in the report and that his department is already working on many of them.

Pane said the department will focus on filling jobs, addressing spending problems, developing a state health plan and getting out into the community more to discuss these issues.

A recent report from the Centers for Disease Control and Prevention criticized the number of vacancies in the city's HIV/AIDS Administration, which has led to overworked staff.

D.C. Council member Vincent C. Gray (D-Ward 7) said, "There's not the sense of urgency about this epidemic that needs to be demonstrated, and the report sees that."

Pane, who was named to his position in the fall, said he has finished listening and is prepared to follow through on reforms.

"We know what needs to be done," he said. "What I need to do are the right things -- right now. We also need a closer bond with community leaders."

The Washington AIDS Partnership, which financially supports nonprofits working on AIDS issues, requested the study. Executive Director J. Channing Wickham said yesterday that he was pleased with the outcome, especially because the District government participated in the study.

"Now is really where the hard work starts," Wickham said. He said the partnership plans to give D.C. Appleseed money to continue monitoring the progress of the report's recommendations.

"We can only make the kind of change we want to make with the full cooperation of the . . . government, and that's what we're looking to as the next step," he said.

Pane also promised an end to chronic delays in payments to such AIDS/HIV providers as the Whitman-Walker Clinic.

Although the Health Department has made progress with releasing funds, Philippe Chiliade, medical director of the clinic, said AIDS prevention and treatment efforts are still hampered by limited statistics on who is getting infected and how.

"We shouldn't make decisions based on feelings or impressions; it should be based on reality. Dollars are limited," Chiliade said.

Williams says he agrees with criticisms of AIDS services.