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City on a Hill: D.C.’s perception problem
World AIDS Day, which took place on Monday, annually brings the District of Columbia’s HIV/AIDS epidemic into citywide focus, if only for a few days. HIV/AIDS clinics and patient advocacy groups have dotted the Mall for the better part of this week, holding vigils and staffing information booths. If you’re downtown, you can probably score a free condom or two, and you can count on hearing one word in particular: stigma.
Many involved in the treatment of HIV/AIDS patients or disease prevention will tell you that among high-risk populations, pervasive prejudice against HIV/AIDS patients stymies-to a massive degree-efforts to reduce transmission rates and diagnose HIV-positive patients. Facing an HIV/AIDS rate that soars above the national average (there are about 128 in 100,000 cases among adults in the District compared to 14 in 100,000 among adults nationally, according D.C.’s 2007 Annual Epidemiology Report), these prejudices are exactly what the District needs to combat.
Chip Louis, the communications director of the Whitman Walker Clinic, a non-profit health organization with locations around the city that focuses on HIV/AIDS, explained that stigma carries enormous gravity for HIV/AIDS-positive District residents.
“We used to have a program for young mothers to receive treatment for HIV/AIDS,” he said. “One woman we treated had a family member who asked her, ‘Why have you lost so much weight?’” Rather than reveal to her family that she was HIV-positive, Louis said, the woman replied, “Oh, it’s the heroin.”
The woman, Louis explained, assumed that her family would prefer to learn that she was a heroin user than HIV-positive, a diagnosis that many associate with sexual promiscuity and immorality. This fear of judgment and condemnation dissuades a frightening number of District adults from getting tested for HIV/AIDS.
To address this problem, the Whitman Walker Clinic launched Project Red over the summer to encourage testing among high-risk populations, which Louis identified as heterosexual black males, heterosexual black women, and young homosexual men. Appearing at bars, clubs, and community centers with pamphlets and free condoms, Walker volunteers have been waging a smart, aggressive campaign.
But the city has not followed suit-clinics and District advocacy groups will host the bulk of this week’s AIDS awareness vigils and rallies. The city has barely acknowledged World AIDS Day. In September, a Washington Post article quoted Mayor Adrian Fenty as saying his administration would begin “social marketing” to bring a higher profile to the epidemic, but he failed to specify what these efforts will be beyond “better education,” and other typical platitudes.
It is crucial, however, that the city join the efforts of Whitman Walker and other clinics in a campaign that is, above all, highly visible. Even though the characterization of HIV/AIDS as an immoral disease has begun to subside, discussions of HIV/AIDS still seem to engender an idea of ‘otherness’ in certain communities. By allowing the perception that only clinics are responsible for the fight against HIV/AIDS to persist, the city reinforces the notion that D.C.’s HIV/AIDS epidemic is a problem whose solution is relegated to a small medical community, and not the dire citywide challenge that it is.
Score a free condom or two from Molly at firstname.lastname@example.org