In several days, the XIX International AIDS Conference will be held in Washington, D.C. and about 30,000 scientists, HIV/AIDS activists, physicians, and advocates will descend on our nation’s capital. Recently there has been much reflection on the impact that HIV/AIDS has had on Washingtonians since the last international AIDS conference was held in the United States in 1990.
I arrived in Washington, D.C., from New York City in the mid-1990s to run a small faith-based HIV/AIDS organization called Damien Ministries. I remember being shocked by the impact HIV/AIDS was having on our nation’s capital, which was a relatively small city compared to the larger cities that were overwhelmed by the disease at that time. The disease was having a devastating impact on Men who have Sex with Men (MSM) — both black and white — as well as on black women of childbearing age, and heterosexual men who were mostly IV drug users. The system of care for those living with HIV/AIDS in D.C. was fragmented, and the health department was in disarray and could provide very little effective leadership. The rates of infection were going through the roof and HIV/AIDS prevention efforts for communities of color seem to rely solely on condom use and abstinence only. There were many HIV/AIDS organizations, both small and large as well as individuals, who are performing herculean tasks in providing care with few resources.
Fast forward to 2012 and one can see that things have drastically improved, particularly in the area of HIV/AIDS prevention and the delivery of care in Washington, D.C. About 122,000 District residents received an HIV/AIDS test in 2011. There have been no children born with HIV in the District since 2009. Five million male and female condoms were distributed in 2011, which is incredible when you consider the population of the District is only 660,000. The HIV/AIDS continuum of care is much improved with newly diagnosed HIV/AIDS men and women moving quickly into treatment and care after being diagnosed with HIV.
The District has no waiting list for our AIDS Drugs Assistance Program (ADAP). The D.C. Department of Health, HIV-AIDS, Hepatitis, STD and TB Administration and HIV/AIDS, service providers and the community can take some degree of satisfaction in knowing that the rates of infection leveled off in the District for first time since the pandemic started. The HIV/AIDS prevention campaigns — Ask For the Test and the Rubber Revolution also have appeared to contribute to increased HIV awareness and prevention in the District. However, the most important change has been the vast improvement of coordination between HAHSTA and community-based organizations that provide the bulk of HIV services in D.C. Consistent leadership from the Department of Health has been a factor in this improvement of coordination of HIV services and District.
While these are bright signs that we are finally getting a handle on HIV/AIDS in the District, there is still much to be done. HIV/AIDS and sexual education must be taught in our schools, community centers and places of worship. The HIV/AIDS rates for our youth and seniors are still too high. We must also remember the important role that our smaller HIV/AIDS providers play as gatekeepers to various communities throughout the city especially as funding streams become smaller. These smaller HIV/AIDS providers must also take stock of the realization that this may be the time to look at consolidation and stronger linkages with medical providers to make the HIV/AIDS continual care system even stronger.
We must continue to understand how racism, sexism and poverty impacts decision- making when it comes to HIV/AIDS messaging and prevention, especially for communities of color. Finally, we must acknowledge that the leveling of the rates of HIV/AIDS in our city is not the end of the beginning but the beginning of the end in the fight to eradicate this disease from all parts of our community.
Earl Fowlkes, Jr. is chair of D.C. Mayor Vincent Gray’s GLBT Advisory Committee.