Why D.C.’s AIDS Walk Is Becoming the Walk to End HIV
When D.C. native Waldon Adams was diagnosed with HIV in 2004, he kept using drugs, and he skipped his medication, assuming he would just die like the other people he knew and had heard about with the disease. In 2008, he was on that very path; his illness progressed to full-blown AIDS, or what’s commonly known as the final stage of HIV, when the patient’s number of cells that fight infections dips to fatal levels.
But then Waldon started attending Whitman-Walker Health’s now-closed Austin Center for Healthy Living program for HIV patients, and the 53-year-old has since celebrated almost six years of sobriety, run 10 full marathons, and became the father of a healthy HIV-negative baby boy with an HIV-positive partner. He is the embodiment of what it can mean in 2014 to be HIV-positive—a disease that is no longer deemed a death sentence, but rather, in medical circles, considered to be a very livable chronic illness.
Still, Walden isn’t comfortable being a walking billboard for all the progress doctors and researchers have made with the disease. He’s run in about a half-dozen of Whitman-Walker’s annual charity AIDS Walks, but he’s never worn any of the event’s T-shirts in his Northwest neighborhood near Manor Park because of what he says is the stigma associated with the term “AIDS”—wasting sickness, contagiousness, and death.
But the shirts for this year’s October run won’t have “AIDS” written on them, and Waldens say he’ll consider wearing one outside the house.
Whitman-Walker Health—the District’s largest community-based provider of HIV services—announced this week that it will change the name of its 28th annual fundraising event from the “AIDS Walk Washington” to the “Walk to End HIV,” a symbolic switch reflecting the current reality that treatment exists to keep people with HIV from ever having AIDS. The next step is to end HIV altogether, and Whitman-Walker believes that’s possible.
“When I heard ‘AIDS Walk,’ I always thought it was a memorial,” Waldon says. “‘The Walk to End HIV’—it just sounds different, it makes me think that maybe somebody is still working on this. It says that you think we can get rid of this.”
That’s the idea. D.C. has historically been considered one of the nation’s epicenters of the HIV/AIDS epidemic; the tone and substance of the conversation the city is having about the disease matter beyond the District line. While most major cities around the country have similar AIDS charity walks, Whitman-Walker’s appears to be the first prominent one to make such a name change.
“For the first time in our lives, it’s all lining up and we can do this, there’s a finish line,” says David Chalfant, Whitman-Walker’s director of development. “Whereas before AIDS Walk may have been more about honoring someone you lost or making a commitment to the future, now this is about hope, about getting the answers and using the answers to end this in the city.”
Is the name change actually representative of what’s occurring on the ground, though? When looking at D.C.’s HIV statistics, there’s reason to be skeptical. In 2011, there were 15,056 people in D.C. with HIV, or about 2.4 percent of the entire population. For black residents, that percentage jumps to 3.7 percent, and for black men, it’s up to 5.4 percent, according to the D.C. Department of Health. Black heterosexual women accounted for 18 percent of all new D.C. cases between 2007 and 2011, and 75 percent of all these new cases occurred in the black population.
The World Health Organization defines an epidemic as a disease that infects at least 1 percent of the population, which means that in D.C., HIV is still very much an epidemic—and, for some demographic groups, a severe one. The Washington metro area, according to the CDC, has the fifth highest rate of HIV diagnosis in the country.
But the promising news for D.C. is that the number of new HIV diagnosis has dropped dramatically in recent years, far outpacing more static national rates. In 2007, there were 1,333 new HIV cases in the District. In 2011, that number declined by 46 percent to 718 new cases. Similarly, the number of newly reported AIDS cases decreased by 47 percent between 2007 and 2011, from 682 to 363 cases. The drop in AIDS diagnoses means people are detecting their HIV infections early, and the subsequent treatment is working.
The stats coming out of Whitman-Walker are even brighter. The center treats about 20 percent of the District’s HIV-positive residents, and its chief medical officer, Raymond Martins, says 90 percent of its HIV patients have an undetectable viral load, which means these patients have just a 5 or 6 percent chance of transmitting the disease to someone else. Nationally, only 25 percent of all people with HIV have undetectable viral loads, according to Martins.
The progress in preventative treatment for the disease is also reason for some optimism. In 2012, the FDA approved a prophylactic drug, Truvada, that, when taken properly, can reduce the risk of HIV infection among those who are at high risk by 92 percent. But Whitman-Walker—like medical centers across the country—is having some trouble getting people to take it: The center currently only administers it to about 165 people.
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Now that HIV is on the verge of becoming just another chronic disease with a walk, at least for patients who can access the necessary drugs, the challenge for doctors is how to reach a new generation of people who weren’t old enough to remember the staggering number of deaths—and the accompanying panic—of the AIDS crisis in the 1980s and early ’90s. Without that collective memory, Martins says it’s a struggle to get young people to take the necessary precautions to prevent getting infected.
“The one time behavior changed in the gay male community is when people were dying,” says Martins. “Since then, it’s been really hard to change behavior.”
The name change for the walk is Whitman-Walker’s attempt to remind people that the risk of HIV is still alive and that preventative measures are still necessary.
Nationally, the number of new infections among gay men aged 13 to 24 increased 22 percent, from 7,200 in 2008 to 8,800 in 2010. Young black gay men accounted for 55 percent of new infections in this group. In D.C., the number of young people who became infected between 2007 and 2011 didn’t increase, but it also didn’t decrease nearly as much as other demographics.
“I’m not as optimistic,“ George Washington University professor Lisa Bowleg, a social psychologist and HIV prevention researcher, says about the end of HIV. “Young black MSMs [men who have sex with men] whose incidence rates are on the rise, no they are not ready to end HIV.”
But still, she says the name change “makes sense” and reflects what’s happening in contemporary research of the disease.
“I can’t tell you the last time I used the term ‘AIDS prevention’ in my work,” Bowleg says.
In the ’80s and ’90s, people talked about “AIDS” and “AIDS prevention,” then gradually switched to referring to “HIV/AIDs prevention.” Now it’s mostly just “HIV prevention,” Bowleg says.
Michael Kaplan, the president of AIDS United, an organization with the mission to end the AIDS epidemic in the country, supports Whitman-Walker’s decision to change its walk.
“I think it’s brilliant, I think it’s on target, I think it’s leading the conversation where it needs to go,” says Kaplan, who has had HIV for 23 years. “We’re at the point where the end of AIDS is really possible, so let’s focus on the bigger picture: The end of HIV is quite feasible.”
The team at Whitman-Walker is, in part, banking on the mere change in the name to spur this new conversation. As it advertises the Oct. 25 5K run, it will explain why it dropped AIDS from the name and hope people take notice.
Whitman-Walker relies on the walk to raise money for services it provides—last year it raised $800,000 from the walk, and officials partially blame the government shutdown for missing the $1 million target—and although Chalfant acknowledges there is a chance the name change could result in lighter coffers for the health center, he doesn’t think that matters in the long run.
“The benefit outweighs that we make less money,” he says. “It gives us a chance to re-engage.”
Adams, the HIV patient, says he will be at the walk in October, despite plans to run the Marine Corps marathon the next day. He may still be relatively healthy, but he wants to make sure that isn’t stopping researchers from finding an end to HIV.
“I’d hate to hear you all not having a job,” he says, referring to members of the Whitman-Walker staff. “But I’d like it cured, I really would.”
Photo by Darrow Montgomery