Mayor Promises Continued Momentum as City Improves HIV/AIDS Report Card Grade

On Thursday, Mayor Adrian M. Fenty and DC Appleseed Executive Director Walter Jones released a third “report card” that assesses the government’s performance in 11 areas around HIV/AIDS in the District. As a follow-up to DC Appleseed’s August 2005 report, HIV/AIDS in the Nation’s Capital: Improving the District of Columbia’s Response to a Public Health Crisis, DC Appleseed has periodically issued report cards to monitor the District’s progress. The District’s release of the 2007 HIV/AIDS Epidemiology Annual Report included the first-ever data on HIV in the District and updated AIDS statistics, earned the District an “A”. The report is also being praised as providing the city a critical tool that will be used for targeting a response. “This is not a time to rest on our laurels and congratulate ourselves for our success,” said Mayor Adrian M. Fenty. “All progress is good progress, but we have much farther to go.” The District’s Department of Health HIV/AIDS Administration (HAA) is developing and implementing strategies to meet the large scale of the HIV/AIDS epidemic. Some of the District’s promising approaches include: Working to ensure that all medical providers are offering routine HIV testing and all hospitals have rapid testing available in their emergency rooms by 2009. Making local dollars immediately available for new comprehensive interventions as soon as Congress lifts the ban on syringe exchange services in the District. Increasing availability and education about condoms and planning to distribute three million by 2009. Reassuring District taxpayers that HAA has full accountability among its community providers with their services. Collecting accurate data on services and bringing in the technical expertise available from federal and other partners to work with providers. Working on interagency coordination with stronger agreements with sister District government agencies to mainstream HIV prevention, testing and linkages to care and treatment. Other areas that were highlighted include the commitment by top city leaders to reforms and the administrations continued HIV testing program and other HIV prevention services at the DC Jail. Summary: DC Appleseed’s Third HIV/AIDS Report Card Grades From First Report Card Grades From Second Report Card Grades From Third Report Card Leadership B- B- B+ Interagency Coordination N/A C- B- HIV Surveillance & Data Incomplete B A Grants Management B B- B Quality Assurance N/A B- B- Rapid Testing B B B+ Routine HIV Testing C Condom Distribution D D+ B D.C. Public Schools B- C- D Syringe Exchange Services B- B- B+ Substance Abuse Treatment D+ D+ C+ HIV/AIDS among the Incarcerated C+ B+ A Website B+ N/A N/A View the entire report card here.

Study Calls HIV in DC a Modern Epidemic

From the Washington Post: The first statistics ever amassed on HIV in the District, released today in a sweeping report, reveal "a modern epidemic" remarkable for its size, complexity and reach into all parts of the city. The numbers most starkly illustrate HIV's impact on the African American community. More than 80 percent of the 3,269 HIV cases identified between 2001 and 2006 were among black men, women and adolescents. Among women who tested positive, a rising percentage of local cases, nine of 10 were African American. The 120-page report, which includes the city's first AIDS update since 2000, shows how a condition once considered a gay disease has moved into the general population. HIV was spread through heterosexual contact in more than 37 percent of the District's cases detected in that time period, in contrast to the 25 percent of cases attributable to men having sex with men. "It blows the stereotype out of the water," said Shannon Hader, who became head of the District's HIV/AIDS Administration in October. Increases by sex, age and ward over the past six years underscore her blunt conclusion that "HIV is everybody's disease here." The new numbers are a statistical snapshot, not an estimate of the prevalence of infection in the District, which is nearly 60 percent black. Hader, an epidemiologist and public health physician who has worked on the disease in this country and internationally, said previous projections remain valid: One in 20 city residents is thought to have HIV and 1 in 50 residents to have AIDS, the advanced manifestation of the virus. Almost 12,500 people in the District were known to have HIV or AIDS in 2006, according to the report. Figures suggest that the number of new HIV cases began declining in 2003, but the administration said the drop more likely reflects underreporting or delayed reporting. A quarter-century into the epidemic, the city's cumulative number of AIDS cases exceeds 17,400. "HIV/AIDS in the District has become a modern epidemic with complexities and challenges that continue to threaten the lives and well-being of far too many residents," the report states. District health officials have long been faulted for the lack of HIV information and lagging AIDS data. Not until forced by federal funding requirements did the health department start tracking HIV. Until that began in 2000, critics said, neither the government nor organizations responding to the disease knew whether their dollars and efforts were effectively addressing the problem. The report notes that its comprehensive picture "offers the District a new tool to help improve the scope, quality and distribution of care and treatment and prevention services." HIV information is particularly valuable because it represents the most recent infections and can indicate changes in transmission patterns. It is mainly collected through the investigation of cases forwarded by laboratories and health-care providers. The compilation signifies a major step forward for the HIV/AIDS agency, which has gone through repeated program and leadership upheavals in recent years. "For us, this is a milestone," said Hader, its third administrator since 2004. A letter from Mayor Adrian M. Fenty (D) accompanies the release: "We must take advantage of this information with the sense of urgency that this epidemic deserves." The District's AIDS rate is the worst of any city in the country, nearly twice the rate in New York and more than four times the incidence in Detroit, and it has been climbing faster than that of many jurisdictions. One explanation might be the high percentage of infected residents labeled "late testers," people who learn they have AIDS within a year of the HIV diagnosis. Although the proportion of adults and adolescents screened for HIV is greater in the city than nationally, the finding raises questions about the strategy of the District's "know your status" campaign. People who learn of their infection late face serious consequences. By the time symptoms arise or infections occur, their immune systems have suffered considerable damage. They face increased medical costs and death rates. More than two-thirds of local AIDS cases fell into this category during the past decade, according to the report, compared with 39 percent of cases in the United States. "I think that's dramatic information for our care and treatment providers," Hader said. No longer is HIV a crisis primarily among younger adults. Starting in 2004, the number of new HIV cases among men and women ages 40 to 49 outpaced every other age group in the city. But the data made public today expose an alarming dimension of pediatric HIV. Each of the three dozen District children to test positive in the past five years was infected during birth. "This is a line that should be zero," said Hader, who is pushing for routine HIV testing during pregnancy, quick-results oral swabs during labor and "fast tracking" of the antiretroviral drugs that can prevent transmission during delivery. The administration said it wants to use the report to begin asking and answering, "What next?" Given the scope of HIV and AIDS in the District, health leaders say they can't focus on just one aspect of the disease or one at-risk group. "We don't have the luxury of only picking one," Hader said. "We have the imperative to do it all."

HIV/AIDS Administration Seeks Input on New Directory

MetroWeekly reports that the Department of Health's HIV/AIDS Administration (HAA) is currently preparing an updated version of its free ''Directory of HIV/AIDS Services in the District of Columbia,'' first released in May of this year, to include more agencies that provide HIV/AIDS-related services. read more here

HIV/AIDS Administration Surveillance Report Delayed

The HIV/AIDS Administration 2001-2006 Surveillance Report that was scheduled to be released this month has been delayed once again. This can only be described as yet another setback for the HIV/AIDS Administration, whose performance has been questioned on a variety of fronts including condom distribution, HIV testing, and program oversight. The Surveillance report provides an overview of the HIV epidemic in the city and helps us better understand where new HIV cases are occurring in the city, which populations are most affected, and what modes of transmission are most prevalent. I was looking forward to having the report this month, before AIDS Walk Washington, one of the most visible HIV/AIDS events in the city, so that we could accurately give information about HIV rates in DC. That's not going to happen. The HIV/AIDS Administration now says we can look for the report before the end of October. This will give Dr. Shannon Hader, the new Director of the HIV/AIDS Administration, and opportunity to review the report before it is released (Hader does not actually start work until mid-October). In light of this development, The October ACTION Lunch with Tiffany West-Ojo from the HIV/AIDS Administration to present the Surveillance Data has been rescheduled for November 15th. click here for more information about this event.

Welcome Dr. Shannon Hader

Send your welcome message to Dr. Shannon Hader, the new Director of the HIV/AIDS Administration, at www.fighthivindc.org/welcome. The Washington Blade reports that Dr. Shannon Hader has been selected to be the new Director of the DC HIV/AIDS Administration. The position has been vacant since January when Mayor Adrian Fenty took office and chose not to keep Dr. Marsha Martin in the position. Since January, Director of the Department of Health Gregg Pane has served as Interim Director, juggling this role with his other responsibilities. Here's what google tells us about Dr. Hader ...... Dr. Shannon Hader earned an M.D. at Columbia University and trained in internal medicine and pediatrics at Duke University Medical School and in infectious diseases at Emory University Hospitals. According to this biography of Dr. Hader, In 2001 she took a job as an epidemic intelligence service officer with the Centers for Disease Control and Prevention (CDC). Hader went on to serve as the Director of the U.S. Center for Disease Control (CDC) office in Zimbabwe. Dr. Hader has served as an adjunct clinical faculty member at Emory University School of Medicine. An accomplished researcher, she has worked on numerous HIV/AIDS research studies.(If you want to search for articles she's published search "Hader, SL"). She was licensed to practice medicine in Atlanta Georgia, but more recently was licensed in Dulles, Virginia. That's all I found for now, I'm sure we'll learn more about Dr. Hader in the weeks and months ahead. Check out the Washington Blade article for more. Fight HIV in DC has a new mini-site where you can send your own welcome message to Dr. Hader. Check out www.fighthivindc.org/welcome. You can post your own welcome message to Dr. Hader on the site by sending an e-mail to welcome@fighthivindc.org. All welcome messages will be posted live to the site and will be delivered to Dr. Hader. Send your welcome message to Dr. Shannon Hader, the new Director of the HIV/AIDS Administration, at www.fighthivindc.org/welcome.

High Number of HIV Cases Found Among Female Inmates in Washington, D.C.

A high number of HIV cases has been detected among female inmates in the Washington, D.C., jail, according to data released recently by the district Department of Health as part of a summary of its six-month campaign encouraging district residents to be tested for HIV, the Washington Post reports (Levine, Washington Post, 8/2). District health officials and HIV/AIDS advocates in June 2006 launched the campaign -- titled "Come Together D.C., Get Screened for HIV" -- which emphasized the importance of HIV testing. The campaign aimed to reach 400,000 men, women and children ages 14 to 84 in the district. According to statistics presented at the Mayor's Task Force on HIV/AIDS, which convened for the first time in June 2006, up to 25,000 people, or more than 4% of all residents, in the district might be HIV-positive. District health officials ordered 80,000 rapid HIV tests for the campaign, which organizers planned to distribute at no cost to hospital emergency departments, private physician offices, community health programs, detoxification and substance use centers, and sexually transmitted infection treatment clinics (Kaiser Daily HIV/AIDS Report, 4/5). According to the Post, the jail was "ahead of city health officials' push to make HIV testing a routine part of most medical screenings." According to the data, 3,216 inmates were tested over a six-month period, 607 of whom were women. The report found that 7.3% of the women tested positive for HIV, compared with 2.7% of the men. Devon Brown, director of the district's Department of Corrections, said he believes the figures are representative of the nearly 2,000 women who are processed annually at the jail. Brown added that commercial sex work and injection drug use -- which often place people at an increased risk of HIV -- are the most common charges among female inmates. The report also found that inmates ages 45 and older had the highest rate of HIV by age, with 4.8% of all inmates in that age range testing positive for HIV. According to officials, fighting the spread of HIV in the district's jail is essential to citywide efforts because nine out of 10 inmates are released within 30 days. The district's jail is one of a few facilities nationwide that automatically tests for HIV upon entry and release unless an inmate refuses to receive a test. According to district officials, fewer than 10% of inmates refuse a test. The not-for-profit group Unity Health Care provides treatment for inmates who test positive for the virus, the Post reports. A December 2006 report by the DC Appleseed Center for Law and Justice praised the Department of Corrections' approach to testing inmates but said the department should provide counseling and HIV/AIDS education for all inmates, regardless of their HIV status, the Post reports. According to Brown, such efforts have been implemented, beginning with HIV-themed programs played on the jail's television system. "You literally have a captive audience," he said, adding that women pay closer attention to the programs than men (Washington Post, 8/2). reprinted from Kaiser Daily

Vincent Gray Calls for Recommitment to HIV/AIDS in DC

At the dedication of a new tribute to local HIV caregivers, City Council Chairman Vincent Gray called on the DC community to recommit itself in the fight against HIV in DC. Vincent Gray told WTOP: "We know on the eastern end of this city we are seeing a spread of the virus in ways we haven't seen before. I.V. drug use is now one of the most prevalent forms of transmission." While Vincent Gray's comments are welcome, active leadership in fighthing the HIV/AIDS epidemic is what is needed most. Specifically: 1. Mayor Fenty is the only Mayor since the beginning of the epidemic who has never had a full time director of the HIV/AIDS Administration. We've been waiting six months for a new director. A new Director is desperately needed. 2. While we are still waiting for a final report from the Health Department on their 'Come Together DC Testing Initiative', we know that the HIV/AIDS Administration failed to meet their goals around HIV Testing in the District. 3. Similarly, the HIV/AIDS Administration has failed to meet their goals around condom distribution. 4. The HIV/AIDS Adminstration is not even keeping an accurate count of services provided to people living with HIV due to ongoing problems with their database. I hope that Chairman Vincent Gray will be a leader in addressing these issues.

Between Promise and Performance: Leadership

Promise & Performance: Leadership | Condom Distribution | HIV Testing | X-Pres Leadership The District of Columbia still does not have a Director for the HIV/AIDS Administration. For six months now, the HIV/AIDS Administration has been a ship without a captain. Mayor Adrian Fenty announced at the beginning of his term, that he would not reappoint Marsha Martin to the position. At that time, Gregg Pane, head of the Department of Health, appointed himself as interim leader. Gregg Pane continues to split his time between his responsibilities as the head of the Department of Health and as the interim leader of the HIV/AIDS Administration. Both Pane and Fenty have referred to HIV/AIDS as the top health priority in the District, yet for six months now, we have settled for part-time leadership. The Promise: On February 9th, the Washington Blade reported that: "he (Gregg Pane) said he and Fenty would name a new director of the administration in 30 to 60 days after Pane 'gets to the bottom' of what AIDS activists and health advocacy groups have said has been a problem-plagued agency for years." The Performance: Gregg Pane failed to make good on this statement. Now, five months later, we are still waiting for a new Director. Adrian Fenty now bears the awkward distinction of being the only Mayor of DC without a full time Director of the HIV/AIDS Administration since the beginning of the epidemic.

Washington Post Article on 'New' Testing Initiative

On National HIV Testing Day Mayor Adrian Fenty and DOH head Greg Pane announced a new HIV testing plan without offering any additional information about the outcome of the last HIV testing plan. The Washington Post reports: Mayor Adrian M. Fenty (D) and city health director Gregg A. Pane used National HIV Testing Day to announce the effort, which aims to boost by 25 percent the number of young people who know their HIV status. It will be one of several new undertakings, all of which target some of the city's most at-risk populations, and could force the often-criticized school system to implement a comprehensive, up-to-date HIV/AIDS curriculum. While the focus on young people is encouraging, and the reference to comprehensive sexuality education is much needed, I still find myself wondering if we accomplished any of the goals we set with the last HIV testing plan. Where is the accountability? Even after the Washington Post filed a Freedom of Information Act Request to get this information, we are still in the dark. The biggest challenge the HIV/AIDS Administration faces is not setting goals, it is meeting them. As I have been blogging this week, the challenge is getting from promises to performance. If there is no accountability for accomplishing the last plan, it's hard to imagine anyone will be held accountable for accomplishing this one. While I would like to be optimistic, I can't help but wonder how this plan is any different from all the other plans that have fallen by the wayside.

Between Promise & Performance: Testing

Promise & Performance: Leadership | Condom Distribution | HIV Testing | X-Pres HIV Testing & Counseling HIV testing is crucial in the District of Columbia. You can't treat HIV if you don't know you have it. One of the reasons DC has the highest HIV death rate, is that many folks don't get tested for HIV until years after they have become positive. They show up at a clinic or an emergency room and their HIV has progressed beyond the point at which current medications can be most effective. The Promise: Former Department of Health HIV/AIDS Administration (HAA) Director Marsha Martin set the ambitious goal of having all DC residents tested for HIV between June 27th, 2006 and December 31st, 2006. This was based in part on the CDC's Revised Recommendations for HIV testing. Since that time HAA has failed to set any specific, measurable goals on HIV testing in the District. The Performance: While HIV testing in the District did increase between June 27th, 2006 and December 31st, 2006, HAA did not come anywhere close to the ambitious goal of having everyone in DC know their HIV status. To make matters worse, many of the expensive HIV testing kits that were ordered had to be given away before their expiration or were simply thrown out. Further, a number of experts are now challenging the revised CDC recommendations, the basis upon which this campaign is built, arguing that targetted HIV testing is much more effective than the CDC's 'mass testing' initiative. I believe that in DC we need both a general testing campaign and smart, targetted HIV testing initiatives like the one conducted at DC Black Pride. HAA's testing campaign failed to meet it's goal. Which means, quite frankly, that there are people out there in DC who won't find out their HIV status until it's too late. We will continue to have the highest HIV death rate until we can get our residents tested and into treatment sooner. We desperately need leadership on this issue. HAA needs to set specific and measurable HIV testing goals and meet them.

Between Promise & Performance: X-Pres

Promise & Performance: Leadership | Condom Distribution | HIV Testing | X-Pres X-Pres One of the most important things the DC Department of Health HIV/AIDS Administration (HAA) does is to make sure that the people living with HIV in DC get the services they need. In order to do that, HAA needs to make sure that the agencies and organizations they give money to actually provide the services they say they are providing. HAA is supposed to accomplish this through site visits, monthly reports, and by tracking the data entered into X-Pres. X-Pres is a computer program that (if it is working) allows organizations that receive HAA funds to enter information about their clients and the services they are providing. The Promise: Over the years HAA has spent millions on a computer system that is supposed to accurately track the services being provided to people living with HIV/AIDS in the District. The Performance: X-Pres is currently in a state of failure. Last month I asked you to send me stories about your experience with X-pres and boy, did you. Here is what I learned. Agencies are not entering data into X-Pres because they have folks who have been waiting months to get trained. Those who have received training in the past year were very critical of the training they received. Agencies are not entering data into X-Pres because they have been waiting (in some cases six months or longer) for usable user-id's and passwords Most agencies that can enter data are not entering accurate information because they have one or more grant numbers that haven't been updated in the X-Pres system. So there is NO way that you can tell whether or not an agency is providing services under current HAA grants The state of this system is shameful. What is more shameful, however, is that these problems have been brought to the attention of HAA time and time again; month after month; to no avail. I personally sent an e-mail back in May, hoping that the situation could be fixed and it wouldn't be necessary to blog about this. I'm still waiting to here back. With so many problems with X-pres it is impossible to produce any useable data. What are the demographics of people living with HIV who access services in the District? Which local AIDS Service Organizations did not meet their goals in providing service last month? Are women less likely than men to access health services in DC? How many people living with HIV accessed any services at all in the past three months? If X-pres was working properly, getting this kind of data pulled would be a simple task, and it would be incredibly useful information for HAA and for our Ryan White Planning Council. Once again, however, this is not the case.

November ACTION Lunch: DC 2001-2006 HIV Surveillance Report

This event was originally scheduled for October 11th. Due to a delay in the release of the surveillance data by the HIV/AIDS Administration, this lunch has been rescheduled for November 15th Please join us for the NOVEMBER ACTION Lunch. Tiffany West-Ojo, MPH, MSPH, will be presenting the DC 2001-2006 HIV Surveillance Report. Tiffany serves as the Interim Bureau Chief, Bureau of Surveillance and Epidemiology at the HIV/AIDS Administration. Tiffany will provide us with detailed look at this important new information about HIV and AIDS cases in the District of Columbia, and you'll have the opportunity to ask questions. This lunch takes place Thursday November 15th at 1:00 PM at the DC CARE Consortium, 1156 15th St, NW Suite 500. To RSVP for this presenation click here. To download the flyer for this event, click here.

Outcome Document from Mayor's Summit on HIV/AIDS

Those of us who attended the Mayor's Summit on HIV/AIDS received the outcome documents in the mail last week. If you didn't have a chance to participate, click here to download the outcome documents and see what we talked about.

Washington Post Article on HIV Testing in DC

From Kaiser Daily: Conducting routine HIV tests in hospital emergency departments was shown to be cost effective and "welcomed" by many patients, according to a study conducted by researchers at the George Washington University School of Medicine and Health Sciences, HealthDay News/Washington Post reports. For the study, Jeremy Brown, research director at GWU's emergency medicine department, and colleagues offered rapid HIV tests to 4,000 ED patients, 2,500 of whom agreed to be tested. The study found that 1% of the patients who agreed to be tested, or 26 people, had preliminary positive results for HIV. According to HealthDay News/Post, the Washington, D.C., Department of Health provided the rapid screening kits at no cost, and the researchers administered the tests and analyzed the data. Brown said that the approach would not be feasible in the long term but added that the study's findings suggest some models for ongoing HIV testing programs in EDs. The cost per preliminary positive result was about $1,700, and the cost per confirmed HIV case was about $4,900 -- lower than other early detection methods -- such as the nucleic acid amplification testing method, which costs $17,000 per case -- Brown said. "Washington, D.C., has one of the highest AIDS case prevalence rates in the United States, and our results suggest that ED HIV screening in this high prevalence area is well accepted by patients," Brown added. The study was scheduled to be released Thursday in Chicago at the annual meeting of the Society for Academic Emergency Medicine, HealthDay News/Post reports (HealthDay News/Washington Post, 5/16).

Tell me your X-pres X-periences.

Oh X-pres, the bane of my existence. This post is going out to the folks who work at local AIDS service organizations. If that's not you, please feel free to ignore. If you are having problems working with X-pres, I want to hear from you! This includes: not having received training on X-pres for an extended period of time, not having a current X-pres password, not having accurate and current grant numbers listed when you enter X-pres data, and of course not having your requests for X-pres technical assistance answered. Send your experiences with X-press to xpresyourself@fighthivindc.org. We won't be able to fix the problems until they are properly documented.

Six Questions for Mayor Adrian Fenty

Mayor Adrian Fenty will be making an appearance at the Gertrude Stein Democrats meeting Monday May 14th. Mayor Fenty will be discussing several issues of relevance to the lesbian, gay, bisexual, and transgender (LGBT) community, which is likely to include HIV/AIDS. I will be looking specifically for an update on progress made on the HIV/AIDS front since the Mayor’s HIV/AIDS Summit last month. While many of the issues raised at the summit are long-standing problems that will require long-term solutions, there are also several short-term issues that require immediate action. The most pressing questions are: 1. When can we expect the appointment of a full-time director of the HIV/AIDS Administration? 2. What will the Mayor’s Task Force on HIV/AIDS look like under the Fenty administration and when can we expect this task force to be operational? 3. What is the status of the outcome document from the Mayor’s Summit on HIV/AIDS, and when will this document be made available? What are the next steps to ensure that the recommendations from the summit are implemented. 4. During the summit, Mayor Fenty made a pledge to Raymond Blanks to come up with a plan for better communication between the Mayor’s Task Force on HIV/AIDS, the HIV Community Planning Group, the Ryan White Planning Council, the HIV/AIDS Admministration, and the Mayor’s office. Mayor Fenty said we could expect to see a plan in the next 60-90 days. What progress has been made in this area? 5. Given the overwhelming evidence that federally funded abstinence-only-until-heterosexual-marriage programs have no benefit and are damaging to LGBT youth , is the Mayor committed to join with the states who have rejected this federal funding? Given the Mayor’s new authority in DC Public Schools, how can we work together to assure that every student in DC receives comprehensive sex education? 6. How is the Department of Health responding to the new data on circumcision as an HIV prevention measure? How can we guarantee that men who want this procedure receive it regardless of whether or not it is covered by their health insurance or they can afford it. I hope to be at the meeting on May 14th, but it depends on how much work remains planning for the Speakout on the 17th, and HIV Vaccine Awareness Day on the 18th. I encourage you to attend this meeting and to print out these questions and take them with you. Let's make sure they all get asked and answered.

Mayor's Summit on HIV/AIDS

I will post my thoughts on the summit tomorrow hopefully. In the meantime, here is a review of the Post Article from Kaiser Washington, D.C., Mayor Adrian Fenty on Wednesday pledged to "put an end to [the] crisis" of HIV/AIDS in the district, although he did not commit to declaring a state of emergency based on the number of cases in the city, the Washington Post reports. Fenty held Wednesday's summit -- which was attended by more than 150 health experts, service providers and advocates -- as part of his action plan for his first 100 days in office. Fenty said that within one week, district agencies involved with HIV/AIDS will be called on to work together and that he likely soon will select a new director for the city's Administration for HIV Policy and Programs. "This is the No. 1 (public health) priority of this government," Fenty said. Also at the summit, Department of Health Director Gregg Pane said that about 48,000 people in 2006 received HIV tests as part of the district's citywide testing campaign (Levine, Washington Post, 4/5). District health officials and HIV/AIDS advocates in June 2006 launched the campaign, titled "Come Together D.C., Get Screened for HIV," which emphasizes the importance of HIV testing. The campaign aimed to reach 400,000 men, women and children ages 14 to 84 in the district. According to statistics presented at the Mayor's Task Force on HIV/AIDS, which convened for the first time in June 2006, up to 25,000 people, or more than 4% of all residents, in the district might be HIV-positive. District health officials ordered 80,000 rapid HIV tests for the campaign, which organizers planned to distribute at no cost to hospital emergency departments, private physician offices, community health programs, detoxification and substance use centers, and sexually transmitted infection treatment clinics (Kaiser Daily HIV/AIDS Report, 12/18/06). According to Pane, the number of people screened in 2006 is the most recorded in a single year and a 75% increase compared with 2005. Half of people screened were tested at private medical facilities and more than one-third were tested in clinics or hospitals. Men and women in their mid-30s to mid-40s were the most likely to receive tests, while older teenagers and young adults were the least likely to receive tests, according to the Post. The campaign did not attain its goal of reaching the several hundred thousand residents in its targeted population, and Pane added that data collected at testing sites were not complete enough to provide the demographic information needed to develop the most effective prevention and treatment plans. According to the Post, officials are examining data to determine how many new HIV cases were identified among district residents who did not receive tests in more skewed settings, such as the city's prison facility. The district estimates that 17,000 to 23,000 people in the city are living with HIV, but "years of surveillance shortfalls mean that data-driven calculations are unavailable," the Post reports. According to Pane, 5,179 new AIDS cases were reported locally between 2001 and 2006 (Washington Post, 4/5).

HIV Testing & Vaccine Research: Letter to Dr. Gregg Pane

Earlier this week I posted on the issues around HIV vaccine study volunteers and HIV testing in the district. To update everyone, members of the Capital Area Vaccine Effort (CAVE) have submitted this letter to Dr. Gregg Pane at the Department of Health. I'm pretty confident that the necessary information can be easily integrated into current training for folks who so HIV testing in the district. I'll keep you posted. In the meantime, read more about this issue and other information about HIV Vaccine Research at the CAVE website: www.aidsvaccine.org.

Articles on DOH/HAA Restructuring

There have been several recent articles about the restructuring of the HIV/AIDS Administration at the Department of Health. As most of you know, Gregg Pane, who is the head of the Department of Health, has also appointed himself as the interim Director of HAA. In this Washington Blade Article, Pane clarifies that they do plan to hire a director in the next 30-60 days. Articles have also appeared in The Examiner, the NBC 4 Website, and of course I'm quoted in this article that appears in Metro Weekly, where they referenced previous blog posts about Gregg Pane. I've received a lot of positive feedback from the Metro Weekly article, and a little negative feedback. Let me just say this about the article. When it comes to HIV/AIDS, DC ranks as one of the worst cities in the country, if not the world. Things are not going well, and to say otherwise at this point, is unconscionable. As long as I know in my heart that we can do better, I will be the guy in the back of the room standing up and saying those very words as loud as I can. Why? Because we can do better. I hope those of you who believe that will join the Metro DC Campaign to End AIDS. Together, we can make a difference.

Thirty Three Days and Counting. Where's our AIDS Czar?

A while back in a previous post, I asked the question, Does that leave us with Gregg Pane (pictured left) as our new AIDS Czar/DOH head?. To clarify, that was a rhetorical question and the answer is NO! Because obviously nobody can be the head of the Department of Health and a full time AIDS Czar simultaneously. I regret the wording, however, because I see the Examiner has set the dangerous precedent of referring to Gregg Pane as the AIDS Czar in a recent article. Nothing could be further from the truth. Let me make a couple points about this article that need to be said. First, as head of the Department of Health, Gregg Pane has been the man ultimately responsible for the operations of the HIV/AIDS Administration ever since he was first appointed as Acting Director in August of 2004. Nothing has changed in this regard. Second, nobody can simultaneously hold two full-time jobs. Gregg Pane simply can't be both a full time head of the DOH and a full time AIDS Czar. He needs to hire a full time, competent and qualified individual to assume leadership of the HIV/AIDS Administration. He simply is not going to be able to accomplish part-time what others have failed to accomplish full-time. Third, the goals Pane has set for the HIV/AIDS Administration are nothing new. In fact, they are terribly similar to many of the goals laid out by Marsha Martin. We had a previous goal of distributing a million condoms, which we did not meet (Pane's new goal is lowered to 250,000). We had a previous goal for HIV testing which we did not meet. The challenge is not setting goals, the challenge is in actually accomplishing them; a view that was eloquently stated by Raymond Blanks in his op-ed Between Promises and Performance. I seriously doubt we can do this without a full time, dedicated Director for the HIV/AIDS Administration. Thirty three days and counting. Where's our AIDS Czar?

NAPWA Hiring Local Advocates for People Living with HIV

The National Association of People with AIDS has received funding from the DC HIV/AIDS Administration (previously known as AHPP, they've changed their name again!) to create a Consumer Advocacy Project for people living with HIV/AIDS in our Title 1 area. Interested? Here's the job description: "Consumer Advocates work as an extension of NAPWA professional staff to provide outreach to the Washington DC Eligible Metropolitan Area (EMA) PLWH/A community to help consumers access and maintain Title I services. Consumer Advocates participate in workshops, meetings, events and education for HIV/AIDS services. Duties associated with the position include presenting Title I program related information to HIV + persons across the metropolitan area, including the consumer grievance process, assisting at health fairs/events, assisting with office work, along with other duties as they arise during the Consumer Advocacy Project. Comprehensive training will be provided to familiarize consumer advocates with the Ryan White services available to PLWH/A in the DC EMA, outreach materials, and the consumer grievance resolution process Consumer Advocates are paid, hourly stipend positions, trained and supervised by NAPWA professional staff. Consumer advocates will report to the Director of Community Affairs, the Community Affairs Associate, or designated NAPWA Staff." To read the entire job description click here To download the application click here

Twenty Days and Counting

It has been 20 days since Mayor Fenty declined to reappoint Marsha Martin as Director of AHPP and still no word on a replacement. Nada. Zip. It makes me wonder whether or not the plan to restructure the Department of Health (as mentioned in Fenty's 100 Day Plan) includes eliminating the position all-together. Does that leave us with Gregg Pane (pictured left) as our new AIDS Czar/DOH head? I'm not convinced that Gregg Pane is focusing on HIV/AIDS. And I'm definitely not convinced that we are better off now (without a director) than we were when Marsha Martin was in office. Mayor Fenty, I thought HIV/AIDS was a top priority for your administration. What's going on? Twenty Days and counting. I suggested at the last Campaign to End AIDS Metro DC meeting that if the silence continues for 99 more days, we should plan a protest on day 100. I hope something happens soon, but if not, you know where I'll be on April 13th.

Gregg Pane off to a Rocky Start

When Adrian Fenty announced that he would not reappoint Marsha Martin to head AHPP, I was left with the impression that DOH chief Greg Payne was going to be closely working with AHPP until a new Director is hired. In fact the Blade went so far as to run the headline Health chief assumes control of AIDS office. We got two indications last week however, that Greg Payne is not going to be quite as "hands on" as expected. First, he was a no-show at last week's HIV Community Planning Group Meeting. The previous month, Marsha Martin had come on board as the co-chair of this planning body. Personally, I think his presence at the meeting would have left a strong signal that we are not going to be left hanging in the wind while there is no director in at AHPP. And who did they choose to replace Marsha Martin? Marie Sansone. The woman who is already so swamped with work that she can't keep track of AIDS cases in the District. I don't mean to be unkind to Sansone. I just believe giving her additional responsibilities means it's going to take even longer to get those AIDS cases counted. Secondly, Greg Payne is holding up approval of the new HIV Community Planning Group Members. Without approval of the new member,s the CPG is barely able to function (they couldn't get a quorom until 20 minutes into the meeting). To fully understand the frustration, you have to understand these community volunteers first applied to serve on the CPG in August of 2006. They have been waiting more than six months now to be approved. This is completely unreasonable. Granted, not all the delay can be attributed to Payne. But the delays make waiting an extra month or two for his approval all the more frustrating. We either need Greg Payne to step up, or we need a new Director of AHPP as soon as possible. Since hiring a new Director of AHPP was not included in Fenty's 100 Day Plan, I can't help but be concerned.

Adrian Fenty's First 100 Days

Adrian Fenty has released his plan for his first 100 days in office. The plan, which includes 200 action items, can be downloaded from the DC Government Website. There are a few things I find interesting. First, among the action items are plans to hire several permanent staff members (Director of Dep of Human Services, Director of the Office on Aging, Director for the Department of Disability Services, Director of the Department of Disability Services). The plan does not state, however, whether or not Fenty will hire a new Director for the Administration for HIV Policy and Programs in his first 100 days. This is one action item which is urgently needed. Also, the plan includes a cryptic goal, "Reorganize DOH to consolidate administrations and improve public health functions" which Fenty plans to do in the next 30 days." I can't help but wonder, what administrations are going to be consolidated in the next 30 days, and why didn't he just come out and tell us? I would think it's unlikely he's referring to the Administration for HIV Policy and Programs, but you never know. Regarding the other goals on HIV/AIDS, most of the action items are items DC is either already working on, or the action item is worded so broadly (i.e. "exploring") that you don't know if there will be an actual outcome. Here are some snippets from the plan, but you really should read the whole thing for yourself. "Preventing of sexually transmitted diseases through exploring implementation of needle exchange programs and broader condom accesibility (100 days)" "support mental health and wellness as well as offer HIV/AIDS prevention services through DMH provider agencies (100 days)" "Coordinate with medical service providers, especially those part of the Medicaid/Alliance safety net, to implement routine HIV testing for patients ages 14+ and up (100 days)." (isn't that what AHPP's been doing for the past year?) "Develop an East-of-the-River HIV/AIDS response capacity-building initiative (1st year)" "Increase community messages on testing and prevention of HIV/AIDS and explore establishing a medical home for low income residents testing positive (1st year)"

Marsha Martin to leave DC Administration for HIV Policy & Programs

Marsha Martin, Director of the DC The Administration for HIV Policy and Programs, will be leaving that position. In a farewell e-mail, Martin wrote "As a Williams appointee, it is my time to leave the government and I do so with great respect and admiration for this agency. Together, you have changed and re-ignited the conversation about the HIV epidemic in Washington, DC." Is anyone else out there as suprised as I am at this news? During her tenure, AHPP launched an ambitious HIV screening program for the district. The program fell far short of it's goals, and of the 80,000 rapid HIV test kits that were purchased, the majority were either given away or expired without being used. Still, 20,000 were tested for HIV in a five month period which is a significant increase (twice that of an average year). AHPP appeared to be steadily improving under Martin, and new staff members brought on board by Martin (some very recently) offer a lot of hope for the future. Unfortunately, some problems that plagued the office did continue. HIV/AIDS Surveilance continues to be a major problem. And a recent audit criticized AHPP's monitoring of local HIV/AIDS service organizations. Yes, there are still many things that need to be fixed at AHPP. That said, I'm sad to see Marsha Martin leave. I felt like under her leadership we were moving in the right direction. Finding a new Director of AHPP could take several weeks, or it could take several months. Once we do find a new director, there is no guarantee that the staff members Marsha Martin brought on board will want to remain under new leadership. The thought of going several weeks or sev