As Crystal wrote toward the beginning of the quarter, the AIDS rate in Washington, DC is the worst in the country. A staggering report released in mid-March (http://www.washingtonpost.com/wp-dyn/content/article/2009/03/14/AR2009031402176.html) revealed that 3% of residents in the District have HIV or AIDS, a rate that far surpasses the 1% rate that characterizes an epidemic. This prevalence rate is consistently compared to that of West Africa, particularly Uganda and parts of Kenya. The epidemic may even be worse than reported, as infected individuals who had not been tested were not counted; the director of the HIV/AIDS Administration in DC estimates the rate of infection to be closer to 5%. Almost 1 in 10 residents between the ages of 40 and 49 has the disease, and people of all sexes and races are affected. Black men, however, bear the weight of the disease with a 7% prevalence rate. Men having sex with men, injection drug users, and heterosexual transmission are all involved in the spread of the virus.
As a resident of DC, I was astounded by this news and have been watching this spring to see whether and how the city responds to the news. There have been surprisingly few articles since The Washington Post's front-page announcement of the prevalence rate and severity of the epidemic - just one article about increased funding for HIV prevention in the US (no mention of DC), and one about internal feuding in one of DC's AIDS clinics. Finally, this past Tuesday, the Post announced that DC will begin a media campaign to raise awareness about the epidemic in the city (http://www.washingtonpost.com/wp-dyn/content/article/2009/06/01/AR2009060103479.html?sid=ST2009060103553). Mayor Fenty, the article reported, has committed $500,000 annually for five years toward a marketing campaign. Advertising has been shown to raise awareness of HIV, and awareness of transmission and prevention are desperately needed in DC. However, many are critical of the seemingly tame governmental response. Advertising experts, for example, say that Fenty will either need to commit millions more or base the campaign primarily on free public service announcements from television and radio stations, billboards, and the Metro; the costs of advertising are simply far beyond the proposed budget. In my opinion, $500,000 represents far too little commitment for an disease that is the number-one public health challenge in the nation's capital. This being said, DC also faces issues of poverty and a failing school system, and balancing all of these issues is a virtually impossible task.
Regardless of the sum, it is heartening that DC is beginning to respond to the epidemic. In my opinion, now is the time for nation-wide agencies to step in and bolster the city's governmental response. Just 3 days ago, the AIDS Healthcare Foundation, which is the nation's largest AIDS organization, released an ad in DC called "AIDS is DC's Katrina" (see picture). The ad will appear on 60 bus shelters on street corners throughout the District. It shows a picture of a seemingly indifferent and complacent George Bush looking out the window of Air Force One at the devastation of Katrina below, and compares this image to HIV in DC with the phrase "AIDS is DC's Katrina" written on a piece of cardboard and held by two hands. The ad is intentionally provocative and seeks to pressure Obama to take a stronger stand on HIV, especially in DC; it includes the website "changeaidsobama.org". It also criticizes the CDC's leadership in combating HIV in the US. The organization also released an ad with Katrina imagery that will run on YouTube before being broadcast on television; the script of the ad is as follows:
"The aftermath of Hurricane Katrina symbolized George Bush’s neglect and indifference of some of America’s most vulnerable citizens. Today in Washington, the rate of HIV has surged past 3% of the population, higher than in Lagos, Nigeria...yet President Obama has remained silent. 56,000 new U.S. HIV infections each year symbolize neglect and indifference. President Obama, please be the change we can believe in on AIDS."
I certainly believe that Obama needs to take a stand on HIV in DC and in the US, but I also believe that DC must be held accountable for the health of its own citizens. While the new media campaign represents at least a start (I have never, in 4 years of living in DC, seen a single AIDS-related advertisement), more commitment, from the local government and citizens, is needed to draw attention to the epidemic and prevent its further spread.