By Ryan McNeely

At the D.C. gay pride festival this past weekend, I heard a lot of anti-Fenty rhetoric regarding the mayor’s supposed lack of attention to the HIV/AIDS crisis. Having been a D.C. resident for only a week or so, I’ll defer to others on Fenty’s performance, though there is some evidence that he has on at least one occasion inappropriately used the issue as a bargaining chip in his battles with the City Council. But Fenty has dealt with some of the most severe failings of the District’s AIDS Office since his term began and called HIV/AIDS one of “most serious problems” facing the city. And he’s right.

At least 3% of D.C. residents have HIV or AIDS, and officials believe that figure significantly underestimates the true number of those affected, as the estimate is based only on those who have been tested. For purposes of comparison, the CDC characterizes a population with a 1% incidence of HIV as experiencing a “generalized and severe” epidemic, and Shannon L. Hader, director of the District’s HIV/AIDS Administration, notes that the District’s HIV rate is “on par with Uganda.” The most recent data shows HIV/AIDS is on the rise throughout the U.S., but the District has the highest AIDS case rate in the country and new AIDS diagnoses are twice as high in D.C. than in New York and five times higher than Detroit.

There are many sobering figures contained in the report, but perhaps the most striking is that 7% of black male residents have HIV or AIDS, and, somewhat surprisingly, heterosexual sex is the primary mode of transmission for blacks — not gay sex or drug use as is the case for whites.

I wonder if Americans realize that one out of every thirteen black men in the U.S. capital has HIV/AIDS. Given the decline in the amount people are hearing about the subject, the answer is probably no:


Aside from the obvious suffering involved, the saddest aspect of this tragedy is that it’s preventable. We know how HIV is transmitted and we know how to prevent its spread. 14,110 Americans died of AIDS in 2007, which is far more than the zero who died due to terrorism and about half of those dying in car wrecks. And yet nationally we spend less than $600 million annually on domestic HIV prevention services, a figure that has remained flat even as the CDC announced in 2008 that new cases of HIV are actually 40% higher than previously believed. HIV prevention programs work and are extremely cost-effective. When less than 5% of AIDS-related spending goes to prevention even though HIV/AIDS costs us about $40 billion every year in total, we need to take a fresh look at our priorities.


Apparently Shannon Hader, Director of the District’s HIV/AIDS Administration (quoted above), resigned just last week under somewhat strange circumstances. Hopefully her successor will be up to the enormous challenge.

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