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.

Those comparisons came from Dr. Shannon Hader, head of the city's HIV/AIDS Administration and a former public health officer who did extensive work in Africa. But LL and LL's boss had the thought: Is this just another example of the District suffering in an apples-to-oranges comparison---you know, where the District is compared to a state or country encompassing both urban, rural, and suburban areas rather than to its peer cities?

So after today's press conference on the numbers, LL asked Hader to put the numbers in context of American cities: "Our rates are twice as high as New York City and five times as high as Detroit," she said, adding she wasn't aware of a city with a higher infection rate.

Hader added this thought: "What I'm most concerned with is...southern cities are starting to have the same complexity of epidemic that we have, where you have every risk factor contributing. I hope that in a sense we can be a cautionary tale to some of our other southern urban centers who if they don't take the opportunity to know they're data and intervene now, they could evolve to matching us, and we don't want anyone to evolve further."

Hader and her boss, health director Dr. Pierre Vigilance, both made the point that D.C. in recent years has developed one of the most comprehensive testing regimes in the country. Vigilance, in his slight British accent, pointed to a "surveillance bias," where "doing a better job of testing people means more people actually get tested and more people get results. And you may find that there are more people with disease than you knew beforehand."

The unspoken subtext, of course, is that if New York or Detroit or Uganda or Kenya tested as thoroughly and reported their data as thoroughly as the District does, the District might not look so bad.

In any case, the four folks behind the mic at this morning's presser---Hader, Vigilance, Mayor Adrian M. Fenty, and Councilmember David A. Catania---urged District residents to get tested regularly for HIV.

So LL asked each of them when their last test was. Said Hader, "I've been tested as recently as I access heath care, so i guess I'm a few months behind in my annual checkup." Vigilance said, "I was tested last year and need to get tested again this year." Fenty said he'd been tested "within the last year," and Catania said, "It has been some time," citing his now seven-year-long committed relationship as reason for his delinquency. (For the record, LL was tested when he had a checkup in fall 2007.)

"The Celebrity Solution," as the New York Times recently called it, has become an industry in itself in the decades since Geldof first lambasted television viewers to "just give us the fucking money." There are more than twice as many charities today, all competing for shrinking pots of money, and desperate for ways to put their cause ahead of the rest. There are online databases of celebrities and the charities they represent, and at least one nonprofit dedicated to helping celebrities hook up with the right charity. Some groups, including YouthAIDS, have had to turn away stars calling to offer their services.

YouthAIDS's founder Kate Roberts, a British-born marketer who got her start selling cigarettes in Eastern Europe in the 1990s, has fully realized the potential of using other peoples' fame to promote a good cause. Her organization, which serves as the promotional arm of the charity Population Services International, has raised millions of dollars, generated billions of media impressions (they counted) and made Roberts into something of a celebrity herself. But her biggest accomplishment is her relationship with Ashley Judd, YouthAIDS's Global Ambassador and all around oddball.

Judd's has a reputation for her vocabulary--she reportedly learns a  new word a day--and space-cadet tangents. Her keynote address at Friday's gala did not disappoint. Judd explained how traveling with YouthAIDS changed her life (and rocked her soul). She'd made a "sacred commitment" to "speak truth to power...It is my pact with the god of my understanding." Sweet and self-deprecating, the star admitted she had worked late into the night  trying to compose her speech. Sitting in her farmhouse, "with the first autumnal fire crackling," she agonized over how to talk about her most recent travels as YouthAIDS global ambassador. Then inspiration hit. "I couldn't tell you about Rwanda or the DRC," she said. The experience was too awful. She realized she had to begin at the end, with "The Calamity of Coming Home," as she titled the entry in her diary.

It all began at JFK airport, where an attendant took issue with the way Judd handed over her baggage slip, or some such piece of paper. "Are you the Ashley Judd?" the woman sneered. Judd says she was only able to contain her fury by looking for somewhere to go lay her head and sob. The suffering in Africa was still to fresh for her to care about a rude American. Later, walking along the path to her home, Judd says the dogs greeted her one by one  because, "They knew my tender heart couldn't stand to see them all at once."

She stumbled into her house and was overwhelmed with the terrible contrast between life in America, a life "untouched by civil strife," and the misery she had witnessed in Rwanda and the Democratic Republic of Congo. She counted her faucets, all six with hot and cold running water, and obsessed guiltily over a plastic cereal dispenser her housekeeper had purchased to hide the cornflakes from those "pesky pantry pets." The contrast was too much.

""I thought about Astrid, a tiny starving toddler whose dress hung slack from her frame." she said. Astird was "grasping" a feeding bottle from UNICEF "with the fury and rage that only the starving can understand."

Judd's fugue persisted for days. Finally, she sought the advice her family doctor, who diagnosed a case of "reverse culture shock." But Judd still suffered. "I knew I did have some trauma," she says. So she went to a psychiatrist who specialized in something called EMDR. They decided her trauma came from seeing genocide memorials. A few tears and rounds of treatment later, Judd said it will still take time for her to heal.

Meanwhile, MSNBC's Chris Matthews had his closed his eyes, either concentrating or napping, I wouldn't want to say. Around him, other guests were finishing a meal that included a beet and goat cheese napoleon, fillet Mignon and something called "Chocolate Graffiti." There was a silent auction, and a loud live auction, and a performance by John Mellencamp.

After collecting rather light swag bags (mini Luna energy bars, Kiehl's products, airplane bottles of Jim Beam), guests trudged downstairs for an after party in "The Band's Suit," a smallish hall made up like a trashed hotel room, with a few too many electric guitars, empty pizza boxes and, hanging from the chandeliers, fancy lingerie. A tiny young model in a French maid costume pushed an ancient vacuum cleaner while the band, several skinny models in chains and tight black denim, wandered around looking cool. I met one of them earlier in the hallway—he's an undergrad studying engineering at Virginia Tech—and he told me they were trying to figure out what to do with the guitars, since none of them knew how to play.

I approached a paunchy man holding two white paper shopping bags. I asked him what he won at the auction, and he opened a bag to reveal what looked like a vinyl record melted into the shape of a giant taco salad bowl. "Some vase my wife bought," he said. She paid several hundred dollars. Just then, his wife wandered over, grinning over a plate of tiny hot dogs scored from the steam trays by the door. She never eats during the day before  a gala-- they attend two or three a month from fall through spring--so she can fill up on all the fancy food.

I asked if they attended the parties to stay in the in-crowd and they agreed the galas are a social obligation, but one they enjoy. They also make good financial sense. Like many wealthy couples, the husband and wife, who did not want their names used, put their "excess income" in a trust. They have to spend 5 percent of the total each year "or the IRS will snatch it," the wife said. "You can either give it away, or give it away and go to parties."

This year's gala raised $1.2 million, down a bit from the $1.5 million raised last year.  Kate Roberts told the audience the money would save 120,000 young lives. "Everyone can get involved to save lives," she said, transforming the room full of diners into a room full of healers. When I asked a communications staffer what metric they used to convert dollars into lives, she explained that $10 could educate and protect a child for a whole year.

I took many terrible photos. This is a very meta shot of Anna Kournikova taking a photo of celebrities on the stage.