City Desk

Remember the Mustard-Yellow Condoms? A Look at the District’s Tortured Response to the AIDS Crisis

A little more than a week ago, news broke that at least three percent of District residents have AIDS or HIV. This provoked Shannon L. Hader, director of the city's HIV/AIDS Administration to now-famously compare D.C. to West Africa. When pressed by Loose Lips at a press conference, Hader stated that our rates of infection were twice as high as New York City and five times that of Detroit.

As LL pointed out, the bigwigs at the press conference—Mayor Adrian Fenty, Councilmember David Catania, et al.—defensively argued that the part of the reason for the high infection rates is that the city is just testing more people. Case in point: testing is now routine at the D.C. Jail.

But this epidemic is not a new epidemic. In fact, it's been called an epidemic too many times to count. Perhaps the reason this story didn't provoke serious outrage and more press conferences and men in white coats discussing infection trend patterns is that this is an old story.

"This is the number one [public health] priority of this government," Fenty told the Washington Post. That quote was from an April 5, 2007, story headlined: "Fenty Renews Fight Against HIV-AIDS; Mayor Promises Strong Effort, Plans To Pick New Agency Chief." In the story's first graph, the mayor "pledged" to "put an end to this crisis."

While Fenty has recently received high marks from local watchdogs DC Appleseed, you don't get to a more than three percent infection rate by accident. Along the way, there have been screw-ups, questions about funding, and more than enough declarations to do better. A quick Nexis search reveals just a little bit in how we got to this point:

  • A Jan. 4, 2007, Post story reports that the city's AIDS/HIV Administration chief was stepping down after 16 months. The city would be forced to find a new chief—its third in two years—to head up the agency. The Post wrote: "The HIV-AIDS administration has had almost a dozen directors in its 21-year history. [Marsha Martin]'s predecessor, who held the job just 11 months, was fired after D.C. Appleseed issued a report critical of the city's response to the epidemic."
  • In the same April 5, 2007, story quoted above, the Post notes: "The mayor's promise of momentum follows a year of ups and downs for the agency, which leads the city's response. It launched a testing campaign last summer, drawing national attention with its goal to encourage all District residents between 14 and 84 to find out their HIV status." The campaign netted a huge increase in people getting tested but it also fell well short of testing several hundred thousand residents (total tested: about 48,000). And "the data collected at the test sites were not complete enough to provide the demographic breakdowns needed for the best prevention and treatment planning."
  • In a March 10, 2007, story, the Post wrote about funding to nonprofit groups who deal with AIDS/HIV prevention. It reported that in 2005, D.C. Council Chairman Vincent C. Gray had noticed a "disparity" in funding—of the 121 nonprofit groups and agencies who received city dollars, not one cent had gone to a nonprofit based in Ward 7. Two years later, Gray was able to funnel hundreds of thousands of dollars to nonprofits who would target Ward 7 and Ward 8. But why did it take Gray two years after he realized this disparity to get funding? Where were other councilmembers on this issue? The Post story noted that these wards had the highest rates of infection in the city. And then there's this little nugget: The District would shell out an additional $300,000 to help these organizations "to implement training and help with writing grants." That's a lot of money to teach a nonprofit Grant Writing 101. That's a lot of money for "training." Effi Barry—who's expertise on the issue was what?—had been assigned to coordinate the Ward 7 part of the initiative.
  • In late June 2007, the District government announces that it will launch a massive outreach effort aimed at teenagers and young adults. "We want to push the envelope....We have to be aggressive," Fenty says in a June 28 Post story.
  • In late September 2007, the District pulled out of the condom producing business. The Post reported in a Sept. 29 piece that "as many as 70,000" government condoms were returned due to complaints related to the "mustard-yellow packets' durability and appearance." The District's outsourced condom producer agreed to replace the mustard-yellow packets with name-brand Trojans. The Post noted that "in addition to the inventories sent back in the past several days, the department's HIV/AIDS Administration still had 350,000 condoms that were never distributed....The Health Department has promised to retool the entire condom distribution program."
  • A Nov. 26, 2007, Post article cites a District report calling the city's infection rates "a modern epidemic." The report was the first of its kind since 2000. "District health officials have long been faulted for the lack of HIV information and lagging AIDS data," the Post wrote. "Not until forced by federal funding requirements did the health department start tracking HIV." The city report found that more than 80 percent of the HIV cases were among black men, women and adolescents. Among women, nine in 10 were African American. The article quotes a letter Fenty had written that accompanied the report's release. He wrote: "We must take advantage of this information with the sense of urgency that this epidemic deserves."

The new report released last week revealed a 22 percent increase in the number of infected individuals from this 2006 study.

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Comments

  1. #1

    Governments can spend all they want, but they cannot persuade people to change. This is proven time and again, all over the world, not just in D.C. (though D.C. is a superior case study, especially when looking at public school spending.) Can you blame D.C.'s poor for a complete distrust of their government? You can elect all the black politicians you want, but are they on the side of D.C.'s black community? I say, hell no. D.C.'s political class is color-blind, and only cares about one class: Its own.

    The unfortunate thing about AIDS/HIV is that those social institutions that have demonstrated the ability to persuade people - churches - adopt a wholly unrealistic policy towards sex, namely abstinence. Until church leaders find a way to encourage safe sex rather than no sex at all, this problem will continue to worsen. And as more of D.C.'s poor black community forsake all social institutions, there will be no tools left for persuasion.

  2. #2

    David, you couldn't be more wrong. Governments and other policy level interventions can do all manner of things to elicit behavior change from citizens/residents. Raising taxes on tobacco products or gasoline. Providing anonymous (vs confidential) HIV testing or clean needles to IDUs. Requiring 100% condom use in foreign brothels. The list goes on and on. They may certainly entertain crazy notions about sex and they may embark on programs that are not derived from what communities themselves would want, but it is completely wrong to say that their policies can't influence human behavior for the better (or worse).

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