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The release last week of a new report claiming 3% of all residents in the District of Columbia are HIV positive has sparked a rash of articles attempting to make sense of the news (including this particularly well written commentary). Some have focused on the fact that 3% probably underreports the crisis, while others have minimized the findings by suggesting the statistics are inflated by the increased longevity of HIV positive residents. However, whether or not the numbers are perfect, which they clearly are not, they represent a crisis for our nation’s leadership which must now face, head-on, issues of domestic HIV/AIDS.

To paraphrase Dick Cheney, the Bush Administration dropped the ball “big time” over the last eight years by flat funding efforts to prevent the domestic spread of HIV and providing only anemic funding increases to treatment programs, like Ryan White, which target Americans living with HIV. The result has been an increase in the spread of HIV across the country and in places like DC. Specifically, the Bush Administration’s unwillingness to focus federal dollars towards at-risk populations, such as intravenous drug users, sex workers and men who have sex with men, has allowed the virus to incubate within our communities and spread beyond at-risk communities into the general population. Today, HIV is the number one killer of African-American women between the ages of 25-34.

Some have suggested Bush’s blindness on the issue of domestic HIV was based, at least in part, on partisan politics. Two communities which have felt the brunt of the domestic epidemic, gay men and African-Americans, are traditionally Democratic constituencies who would be unlikely to switch parties regardless of Bush’s efforts to confront the domestic spread of HIV. Republican constituencies on the other hand, including Christian conservatives, have consistently balked at funding programs which address at-risk communities, claiming that such efforts tacitly endorse, and in the process normalize, behavior amongst at risk groups (read: gays). The lack of political benefits and presence of political risks have been identified, by some, as reasons Bush focused his Administration’s attention on the epidemic in Africa and Asia rather than America.

Fortunately Bush is no longer president and his party’s squeamishness with the realities of the epidemic are no longer driving policy. The Obama administration has already committed itself to prioritizing domestic HIV/AIDS efforts, and in a summary of its 2010 budget promised to increase “resources to detect, prevent, and treat HIV/AIDS domestically, especially in underserved populations.”
Furthermore, Obama has named Jeff Crowley as the next director of the White House Office of National AIDS Policy. Crowley, one of the nation’s leading public health policy experts, will be responsible for coordinating the government’s continuing efforts to reduce the number of HIV infections across the United States and develop a national AIDS strategy to help guide the federal government in efforts to contain the domestic spread of HIV/AIDS.

Obama’s promise of leadership on issues of HIV/AIDS still needs to be fulfilled and, while we must be vigilant about holding the new administration’s feet to the fire, we must continue to be personally vigilant. Each of us must show the courage of our convictions on this issue and lead by example if we ever hope to one day contain the threat of HIV/AIDS.

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Victor Maldonado

Victor Maldonado


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