iStock

By Michel Martin

New guidelines from the U.S. Preventive Services Screening Task Force suggest that women don't need routine screening for breast cancer until age 50, not 40 (as has been recommended for years) and that self-exams are of virtually no value. But the American Cancer Society says no way, keep screening.

So, what's a woman to do?

Well, that depends in part on who are you.

I am going to make a statement that might upset some people. Health is the one area where some profiling is actually helpful. It is just a fact that some ethnic groups are more susceptible to some conditions than others. For example, African-Americans are statistically more likely to experience Sickle Cell disease, Ashkenazi Jews to experience Tay Sachs disease.

Who knows why? In some cases we know, in others we don't. But in any case, ethnic backgroundplays a role just like individual family history, just like social context. So that's one reason we spend a lot of time talking about how health issues play out differently in different communities. You need to know if you are more at risk.

As for me, I hit the 50 mark recently so I'll be trudging off to get my cousins squeezed up in short order in any case. Sigh. I'll be happy when they come up with a more pleasant method for detecting breast cancer but until then I am glad there is ANY method for detecting breast cancer. But until then, we hope you weigh ALL the arguments carefully and consult your medical professional.

Don't hide from the facts, check it out and decide what's in YOUR best interest. And then treat yourself to a Starbucks when it's over. And when they ask if you want the whipped cream, say yes this time.

J.J. Sutherland, here, visiting senior producer with Tell Me More ...

As the parent of a newborn, I've been somewhat frantically searching for a place I can get the H1N1 vaccine. As someone who has spent a lot of time in, well, less upstanding countries, my first instinct was to figure out who to bribe.

My wife and colleagues convinced me this was a bad idea.

The lines were hours long at the local schools where they were giving it out, and until Thursday my doctor's practice had run out. When I finally made it down to the office with my wife and 8-week-old in tow, I heard the receptionist say repeatedly to people on the phone, "I'm sorry you don't meet the criteria, and if we give you the shot, we won't get any more from the government."

This pandemic was panicking people. We went in to get our shot and the nurse didn't even look at our paperwork, just looked at my daughter, saw that she is under six months old, and gave us our shot. And then it came to me. I'd been willing to pay money to get a shot. I'm sure others would be. And you can't get a shot unless you have a baby under 6 months old or are pregnant. I couldn't help the second situation without getting a divorce, but, maybe, just maybe, I could rent out the baby. Think about it, charge a thousand bucks for twenty minutes. When they come out, change her outfit and send her back in.

I looked thoughtfully at my little money maker.

My entrepreneurial dreams crumbled, though, when I glanced at my wife.

But still ...

We are still trying to get our hands around the Pakistan story. We all remember how traumatized WE were after Sept. 11, so naturally we wonder about the Pakistanis trying to go to school and work everyday during this terror campaign.

What about the parents of those girls in that university cafeteria in Islamabad, where a suicide bomber attacked earlier this week? All universities are closed, for now. So what do all those students do now?

What does this mean? We're working on it, and we hope to bring you some distinctive conversations as soon as we can.

And health care reform/overhaul/fix it up, whatever you want to call it. Yes, we are spending a lot of time on this story but we think it's important. The decisions made today may affect the way health care is delivered and paid for in this generation and the next. We just think we owe it to you and ourselves to feel we have done what we can to let you know the principles and ideas shaping the debate.

Is it too much? Too little? Let us know. There is no rule here. (We could, literally, do a story every single day but ... then we think, okay, too much.) This is not a science, trust me.

And the cancer screening thing ...

I read the New York Times story on Wednesday and I thought, huh? I thought the word of wisdom was pretty simple -- GET SCREENED. But now maybe not? Or, now maybe there's a concern about OVER treatment or mis-diagnosis? Wha?

Continue reading "More On Health Care ... And What About Megan Williams?" >

Lee Hill, here ...

Here's a video from a town hall meeting on health care, hosted yesterday by Rep. Barney Frank, a Democrat from Massachusetts:

Today, we talked more about the vitriol that seems to be flowing freely from many of these meetings -- against the public option component of proposed health care legislation, against Democrats, against Republicans ... against President Obama.

Shouting matches (stoked by both attendees and Congressional hosts), caricatured illustrations of the president, hateful rhetoric ...

Whatever happened to civil -- albeit spirited -- discourse?

Rep. Frank did go toe-to-toe in loaded jabs at some who spoke out at his forum (whether his reflexive blows was warranted is up for debate), but he did reference something to someone that raises yet another interesting point in this whole health care debate-turned-debacle fiasco ...

What's The Point?

A quote from Frank (after engaging with a dissatisfied audience member):

You came here believing what you wanted to believe. Nothing I say is going to have any influence, so what's the point?

So, really, what is the point?

This morning, in our daily editorial meeting, I was disturbed when a colleague mentioned that she would never take her children along to attend a town hall meeting. Why? Probably because the room temperature at some of these gatherings is just plain cold and, arguably, is a sorry crash course in civil communication for a youngster to witness. (Although it has to be said, not at all of them -- Maryland Rep. Donna Edwards was reportedly engaged in an emotional but relatively calm discussion with attendees at her town hall forum.)

Question: So are these town halls actually accomplishing anything? Perhaps time will tell...

Speaking of which, tell us about your experience if you've attended -- or stood on-line waiting to get into -- one of these gatherings. And help us by answering the bigger questions: did you go with an open mind, and what did you walk away with?

And, remind me, what ever happened to civil discourse?

... Meet you back here tomorrow ...

Teshima Walker, here ... Michel is preparing for an interview - so I "volunteered" to write today's blog.

Prostesters demonstrate against Democratic-sponsored healthcare reform at a rally ahead of President Obama's visit on August 15, 2009 in Grand Junction, Colorado. (John Moore / Getty Images)

According to the U.S. Census Bureau, nearly 46 millions Americans, (under the age of 65) were without health insurance in 2007. So, what have we learned about President Barack Obama's health care plan? Much of the fuss is over the public option -- where public and private insurance plans compete for your dollars.

But is it or isn't it an option?

Health care cooperatives, a board of directors and "the people" get to vote. Who are "the people" again? Then there's single-payer health care, which is legislated insurance with centralized payment of doctors, hospitals, etc. Or -- bottom line -- you'll have to go through the government as the health care administrator; or maybe a publicly owned agency.

That's a lot to think about, right? Is your head spinning yet? No?

Good, because after one week of some very intense and emotional town-hall meetings across the country this battle for universal health care isn't over yet. Let us know whether you've attended a town-hall meeting in your state.

And what's really going on with the Caribbean islands of Turks and Caicos? Britain has imposed direct rule after an investigation discovered evidence of corruption among the territory's officials (mainly the government of former premier Michael Misick, who is alleged to have acquired a multi-million-dollar fortune since he was elected in 2003). I visited the official tourism Web site of the Turks and Caicos Islands.

It looks cute.

There are 40 islands and cays but only eight are inhabited. And just in case you're a contestant on a game show like Jeopardy: Christopher Columbus walked around the islands in 1492, and salt was a commodity back in the day; the island has been inhabited by the Taino and Lucayan Indians; Bermudians came for the salt; the French and the Spanish took control from the Bermudians; and then the British came swooping back in to deliver a smack down that handed the island back to the Bermudians. The people of the islands are called "Belongers." It sounds a little cultish, but I'll go with it. But I digress (got a little caught up, sorry). I searched for a site that would tell me about the population and the people. The Turks and Caicos Islands have about 33,000 people and they consist of descendants from African slaves, Bahamians, and a large expatriate community of British, American, French, Canadian, Haitians, Dominicans and Scandinavians. It's a shame to know the suspension of the government could last up to two years but, maybe you can benefit from some great travel deal to the island. Take some pictures of your toes wiggling in the sand and post the link for our digital media guy Lee Hill in the space below.

And, just in case you're wondering what we have in store for you next week, let me take you deep inside the Tell Me More editorial meeting. The staff thinks the following stories are HOTTTTTT. (Let me know if you think differently. I only ask that you be gentle when you're smacking down our ideas.):

Continue reading "Health Care: Whose Option?" >

We took up a number of important issues today: the debate about whether the credit card industry needs reform, how we use credit cards and what's going on with parents in school districts that have been closed down because of fears about swine flu. But the issue that I bet will get people going is the last one we talked about in our Moms conversation: breastfeeding.

Save the eye roll, please. I am sure there are people for whom this conversation means nothing or is distasteful but, you know what? If you were born (and if you're reading this, I know you have been), then your mother had to make a decision about whether to breastfeed you or not, and that decision might have been harder than you ever imagined. And it might be getting harder as more women enter the workforce.

In fact, a majority of women of young children are in the workforce, so it's an urgent conversation. It's an issue that's written about in Unbuttoned: Women Open Up About the Pleasures, Pains, and Politics of Breastfeeding. Is this book the book that tells it all? Nope.

There are a lot of voices I would like to have seen in it that aren't there. But it's a start.

And now I'm turning the mic over to our editor Alicia Montgomery. She has something to say: Alicia?

Alicia Montgomery poses with infant son William. Courtesy of Alicia Montgomery

Michel, I wish that I had heard today's breastfeeding conversation long ago -- two years ago, to be exact -- when I was pregnant with my son. At that time, I entirely bought into the breast feeding ideal. I did my research, and looked forward to the blissful moments of bonding pictured in all my mothering books.

But my son's birth brought a reality check. For the first few days, he alternated between gnawing and screeching at me, and after nursing, flecks of my broken skin were scattered across my bed. During one particularly frustrating feeding, my son sat back, whimpered, and gave me three sharp kicks to the stomach, the way you would with a broken vending machine.

I was totally unprepared for the pain, and my breast feeding books and pamphlets insisted that it shouldn't hurt, as long as I did it right. They also warned that giving my son just one bottle could turn him off nursing permanently. He'd be deprived of IQ points and a healthy immune system, and I'd lose my best chance to bond with him. There were moments in my sleep-deprived hysteria when I thought I would never figure it out.

Well, eventually I did. Between the nursing and, I confess, some formula, he gained weight, and I started to enjoy that blissed out bonding feeling. Breastfeeding still hurt; I just got used to it.

But so many of the mothers I confided in -- smart women with lots of love for their babies -- had the same trouble I did. And many came to believe that those troubles meant they were doing something wrong. And the crushing feeling of failure pushed many of those mothers to quit.

So I hope that our Moms discussion today tells new breastfeeding mothers what I wish someone had told me -- that breastfeeding, like motherhood itself, is hard, hurts more than you expect, and will sometimes make you feel like a failure. But, just like motherhood, if you stick it out, you'll find that it's completely worth it.

Thanks, Alicia.

A man wearing a face mask walks along Reforma Avenue in Mexico City. Mexico was preparing Monday to reopen many businesses and tourist sites closed by the so-called swine flu, which recently claimed 26 lives in the country. EITAN ABRAMOVICH/AFP/Getty Images

 

It's a gray, dreary day in Washington but our spirits were high because we are starting Year Three on the air, and that's exciting because there's alot to think about, and talk about.

For tomorrow's program, we were debating whether we would be adding to perhaps unnecessary swine flu hysteria if we keep focusing on what seems to be turning into a rather mild, albeit fast moving, bug. But we're not into telling people whether they should be hysterical (we opt for not), but we are following the impact.

We think that the decisions governments and school officials, and parents, and workers and employers have to make in the face of imperfect information makes its own interesting story.

Also tomorrow, along the lines of "the unexamined life is not worth living," there's a new book out about ... breast feeding. We think you'll find it interesting.

On we go.

A pedestrian reads a newspaper, which headline states that up to 103 deaths due to the swine flu, in Mexico City on April 27. OMAR TORRES/AFP/Getty Images

Scrambling a bit this morning. We were committed to talking about the big moves in the auto industry when we started seeing how the swine flu story was percolating over the weekend. What made the decision of switching things around even easier for us is that our Planning Editor Luis Clemens just back from Mexico City, having moved his family here to Washington, D.C., just a couple of weeks ago.

This is where it's helpful to be part of a big news organization, or at least one with an interest in accuracy. I was trying to follow the story over the weekend, but none too successfully (in trying to do that and keep my twins from disappearing into separate wings of the museum, where I took them to escape the heat). So I was appreciative to walk into work this morning and find a memo of guidance about how to describe the swine flu "outbreak" (not epidemic, but with pandemic potential) to listeners. Thanks Joe Neel, et al....

We'll have more on this story as it unfolds. In the meantime, listen to today's conversation ... and remember to sneeze into your elbow.

Also, today we talked about the growing number of families who find themselves homeless. We brought you a conversation with the Greenes, a homeless family in Virginia. Barbara Anderson, the founding director of Haven House Services in Indiana, also joined us to explain just how serious this issue has become for many who are struggling to fight their way through financial troubles. After we finished taping, Anderson shared some additional thoughts about homeless children. Here's a note she sent to Tell Me More producer Jasmine Garsd:

No school age homeless child in this country has to worry about transferring out of their school. Under former Department of Education Secretary Stewart B. McKinney, it became law that homeless children must be transported to their school of origin and the school system must provide the transportation. It is not the burden of the parent. Barbara Duffield is an expert on this issue and in D.C., you can get her number from Michael Stoops at 202-462-4822. Policies on poverty have to be developed in this country that are effective for everyone and the root cause of homelessness is poverty, whether it be long term or episodic. The National Coalition for the Homeless advocates strongly through the Bring America Home Act and the comprehensive approach it will take to end homelessness. It is a bill that is probably as close to Roosevelt's policies than even the War on Poverty and with passage and implementation, would have a greater and more profound impact in this country. Some of the best minds in the country helped mold the act, please take a look at it on the NCH Web site. Homelessness is America's shame. To allow our own citizens to sleep under bridges, in chicken coops -- with a wage half of what they should earn -- and children frightened, cold, and hungry is a national disgrace. We need to organize. --Barb

(The above was published with Anderson's permission. However, the views contained do not necessarily represent the opinion of "Tell Me More", or its staff.)

Thanks, Barb.

Well, I am back. Thanks to NPR's Cheryl Corley and Korva Coleman for holding down the fort.

I'm not going to lie to you, I still feel kind of sick-ish (and I know that's not a word). But after a certain point, when you've swallowed all the pills they've given you, and after the cough syrup starts to make you feel worse than coughing, it's time to head back in. Whatever.

I was excited about today's program, in part because, to be honest, it addressed questions I have been thinking about. (That's not why we did the show. I was out last week, so the staff carried the bookings without me.)

I have often wondered, why do so many research studies go forward without ethnically diverse subjects? Is it because ethnic variations are not deemed relevant, or that different groups are less likely to volunteer? Is it that they are unconnected to research outreach?

We tell you about a pioneering breast cancer study that aims to answer important questions for the whole population, and about how they went about finding diverse subjects.

And we talk about the challenge of taking care of your senior-aged loved ones when the economy is in turmoil. It's something my siblings and I have also been worrying about, to tell you the truth.

And, yes, I had to throw in my two cents on the Michael Steele-Rush Limbaugh dust up. Let me know if you think I am on to something.

Now, I think I'll go find some more chicken soup. Oh, and I tried that home remedy somebody sent me for my cough -- lemon juice, honey and a dash of cayenne pepper. That was too hardcore for me, so I had to throw in some hot water ... but, it was awesome.

I don't know if it helped, but it sure felt good going down. Thanks!

We're trying something here and we'd be interested in your response.

Not that we're asking you to program the show for us because that would be wrong. We know that's our job, but remember. We started this program essentially as an "open source" project. We always invited listeners to comment on specific aspects of the show.

Anyway, we're trying something:

One of the executives here stopped by recently and said something like, "I have a friend that I like a lot, but if his number comes up, sometimes I don't take the call, because I know it's going to be intense and sometimes I'm just not up for it."

(Hmmm, you wouldn't be talking about anybody over here would you?)

Point taken.

We don't want to be that phone call. Sometimes it's just necessary to but sometimes it's not, so we are making a concerted effort to be a bit more varied over the course of a program. That might feel a big like a crazy salad to some people, where the ingredients don't always go together, or are not satisfying, we're not quite sure but that's why we're going to try it and see how it works.

Finally, some of you may be wondering why, on such a controversial issue as abortion, we had only one guest -- Cecile Richards, president of Planned Parenthood Federation of America -- to talk about how one chapter of organization is offering gift certificates for health services at their clinics, services which may include abortion. We decided that the issue of the gift certificates itself was really a proxy fight for abortion over all (which was not going to be settled in a conversation, no matter how long it took) and that I could just as easily raise the tough questions, likely to be posed by someone with different values. Also, Cecile Richards was on the program previously upon her appointment as President of Planned Parenthood and we thought today's conversation could be a continuation of that newsmaker conversation.

As always, we're interested in your reaction -- both to the underlying issue and to the coverage.

On we go.

It's Lynn Neary filling in for Michel Martin while she takes some much-needed time off. I'll be blogging here throughout the week, so feel free to chime in with your thoughts.

Looking dapper and trim, and very much not his age, 89-year-old John Tatum walked down the hall to the TMM studio and I knew who he was without being introduced. To look like that at his age, you have to take care of yourself. Good genes can only get you so far.

And that, of course, was the point of Lonnae O'Neal Parker's article in the Washington Post Magazine which features John Tatum, a member of the Washington Wizards swimming team for people fifty and older. As Lonnae explained on today's program, research has shown that exercise can offset the ravages of age. And I have to say, after meeting Mr. Tatum, I am a believer.

This weekend, I just happened to be staying in a building with a pool on the roof, so with all the enthusiasm of the newly converted I got up early Saturday morning and swam 30 laps.

Okay, so it wasn't an Olympic sized pool. It was a mere 15 yards. Still I did it. And I would like to tell you I did the same thing the next morning. But I didn't. I slept in.

Sleep is helpful in offsetting the ravages of age too, isn't it?

--Lynn Neary

Douglas Hopper, here ...

I'm back home today, and after two weeks in Mexico City learning about the global crisis of HIV/AIDS, I'm left with just as many questions as answers.

I learned about the latest research, the newest numbers, emerging trends in treatment, vaccines and prevention. I came across non-profits that are trying new prevention approaches and making impressive progress. I also met brilliant people -- both journalists and activists -- people who are driven by a collective sense of duty. The passion I witnessed was inspiring.

But I'm also heavy with cynicism.

Why -- in a country like the U.S. with so much wealth and technology -- is there a rise in HIV transmissions? Why have the numbers seemingly been ignored for so long? Why are black gay men at such high risk?

Who is accountable?

Why is the International AIDS Society just now calling attention to global infection rates among men who have sex with men? Which countries are failing, and what needs to be done to push them in the right direction? Why is the UN just now creating a special program to deal with this issue? The data has been there for years.

And what's up with the U.S. just now lifting its travel ban on people living with HIV? And why do countries still have such restrictions?

Why do so many countries refuse to create laws to protect sex workers, given that they face an obviously higher risk? Why are ground-breaking medications still unavailable to millions of HIV-positive people around the world? Can the global community negotiate a system that works and fits into the vision of the pharmaceutical companies?

It's a heavy, mind-boggling conversation. But as I unpack my bags full of pamphlets and business cards and reports, I suppose the only antidote to my cynicism is that I know so many others are engaged. At least 25,000 of them at the conference and I believe millions of others who couldn't get to Mexico City.

Now it's your turn. Have your say. Where you are on these issues?

Tell us what questions are on your mind and who you'd like to hear talk about some answers. We're listening.

See you next time from D.C.

One of many HIV/AIDS data charts being presented at the conference.

Douglas, NPR

 

Douglas Hopper, here. I'm blogging from the International AIDS Conference in Mexico City. I'll be bringing you more about what's taking place here - with 25,000 people from around the world, there's no shortage of things to mention.

Numbers.

Three days into the conference, I'm swimming in data. My bag is bursting with reports from the latest studies, the newest surveys. And I'm not so sure that's a good thing. Last night I dreamed of PowerPoint data. The story of HIV/AIDS is feeling like one big number crunch.

It's not the first time.

Back in the day, before I started a career in journalism, I had my eyes set on public health. One of my first jobs in the field was with Vanguard Youth Services in Portland, Ore. I was an outreach worker in rural Oregon charged with bringing HIV prevention information to queer-identified youth.

It was great work. Actually, I loved my job. But one of the most grueling regular duties was the dreaded CDC report.

Each month I'd have to file a report for the Centers for Disease Control (CDC), the main source of funding for our project. And each time I faced the massive form -- with all its columns of categories and sub categories -- I'd feel instantly inadequate. Not because sometimes the boxes would blur together, not because sometimes I'd have to call up my boss to decipher a question. The truth is I thought my numbers were just too small.

Some nights we'd only have three or four young people show up to the group meeting. And weeks would go by, during which time I'd gotten permission to put up just one poster in a high school. Even worse, one month I had only contacted one youth online ... and I didn't even know where he was from.

How could I put these numbers down? I imagined some bureaucrat at the CDC laughing hysterically at my form, passing it down the line as an example why programs like ours shouldn't be funded. Or worse, I thought I'd be forced to pump up the numbers. I knew I couldn't do that ... honestly. I was working in conservative communities, places where tolerance of homosexuality was an exception to the rule.

I knew we were making a difference, even if what was inside the boxes didn't make it seem so. I braced for the worst.

The CDC bureaucrat never faxed my form to the president. And my boss never questioned my elementary-size numbers. And our funds stayed intact, at least for awhile.

But I still wonder about those numbers. I still ask myself whether that was the best measurement of our success. All the quirky details of our meetings, all the tense moments, the embarrassing questions ... those were never recorded.

Here at the International AIDS conference, I'm struggling with the same dilemma. Yesterday, I went to a presentation about the increased risk of HIV among migrants along the US-Mexico border. Each person on the panel gave a very earnest speech, accompanied by PowerPoint slides detailing a myriad statistics about the immigrant population. All of the facts were important. One study showed that men who migrated across the border were more likely to engage in sex with a sex worker. Another set of data showed a similar increase among men who have sex with men.

Continue reading "Dispatch from Mexico: The Numbers Crunch" >

Douglas Hopper, here. I'm blogging from the International AIDS Conference in Mexico City. I'll be bringing you more about what's taking place here - with 25,000 people from around the world, there's no shortage of things to mention.

"Men who have sex with men have an average 19 times greater chance of being infected with HIV than the general adult male population in low-and middle income countries."

... a fact just presented at a press conference organized by the International AIDS Society and the Global Forum on MSM and HIV.

Criminalization, prejudice, social hostility and human rights abuses are boosting the spread of HIV, according to the presenters.

Dr. Jorge Saavedra, director of Mexico City's National Center for Prevention and Control of HIV/AIDS, said the stigma of HIV and homophobia keep many men from seeking tests or treatment. In fact, MSM in Mexico City are 109 times more likely to contract HIV.

Dr. Saavedra is openly gay and has launched an anti-homophobia campaign in the city.

He and several other openly gay public health officials from around the world spoke at the press conference.

In light of my rant about the obscurity of statistics, I'm hoping some of you may have stories to share about how this issue manifests.

... Have you seen this kind of social exclusion in your culture? Are men who have sex with men marginalized in your home country?

A collection of German public health posters sprayed along walls is an example of the strong public relations efforts underway at the conference.

Douglas Hopper, NPR

 

Douglas Hopper, here. I'm blogging from the International AIDS Conference in Mexico City. I'll be bringing you more about what's taking place here - with 25,000 people from around the world, there's no shortage of things to mention.

Thanks, Michel.

Finally, I scored a computer with Internet access! I think the hundreds of journalists in this room are jamming up the connection. ... I suppose that's a good thing.

I just returned from the what's being branded as a Global Village. It's a huge space full of non-profits and advocacy groups attending the conference from around the world.

I'll admit I was first skeptical about whether there would actually be a diverse representation of organizations here. (And I sometimes cringe whenever the word "village" is used to describe an event, but I'd say it might be the right description in this case.)

Hundreds of cultures are represented at this gathering. The diversity in the crowd is overwhelming. There are organizations here that most of us know, like Act Up, formed in the early days of the HIV/AIDS epidemic. But I'm finding that most of the groups here are new to me.

An LGBT-rights organization in Kyrgyzstan?

Though they don't know it, but their group has become the symbol of everything I don't know about the world.

Nearly every group has its best posters and PR campaigns on display ... an explosion of public health messages. One of the most popular messages I've seen yet is on a bumper sticker made by a women's rights organization:

More Boobs in Public Spaces, Less Boobs in Public Office.

I'll have more later from the Global Village and from other sessions.

Next up: a session about HIV transmission along the U.S.-Mexico border.

Clinica Condesa is the only medical facility of its kind in Mexico City.

Douglas Hopper, NPR

 

Douglas Hopper, here. I'm blogging from the International AIDS Conference in Mexico City. I'll be bringing you more about what's taking place here - with 25,000 people from around the world, there's no shortage of things to mention.

Let me take a step back ...

Before the conference started, I went with a group of journalists to tour a Mexico City clinic that specializes in care for people living with HIV/AIDS. Unexpectedly, stepping into Clinica Condesa took me back to a place I'd nearly forgotten.

One of my mentors in life was a man named Chris Gonzales. He was an activist, a teacher, an agitator and also an exceptionally gifted fund raiser who used his passion to build one of the country's most successful LGBT youth groups, the Indianapolis Youth Group (IYG). I started attending meetings 1992. By that time, Chris had already raised enough money to buy a house for the group and at least five people were on the payroll -- a case worker, a nurse, a counselor and even a political organizer. It was an incredible space.

Every Thursday, roughly 50 of us young people would show up for the weekly meeting. The lucky ones were dropped off by our parents. But most of everyone else showed up with more than a little fear -- and exhaustion -- in their eyes. They'd come from every corner of Indiana, often having sneaked away from their homes, riding buses for hours to get there.

Looking back, I understand why. It wasn't the seemingly endless supply of free food, nor the huge selection of bubble gum and R&B music, which was typically blasting from the stereo hours before the meeting. We weren't coming to IYG to get something. We showed up to get away.

This is what Chris had in mind -- a space to escape the stigma, the harassment, the sharp judgment and hate most of us knew. It was also a place where AIDS wasn't a 'plague' that would -- at least in my mind -- lead me to my grave. (Though I never completely believed I would be spared, I at least was convinced that I should try). Chris created an oasis. It was a hideaway where we could breathe.

Visiting Clinica Condesa here in Mexico city, reminded me of what that was like.

After an impressive tour of the newly remodeled facility, we were led into a room where a group of patients joined us to share their stories. A gay man, who said we could refer to him as "Charlie," told us how homophobia keeps many men from getting tested for HIV. Then, an elderly man spoke about contracting HIV when we was a heavy drug user. He stood up to thank God -- more than a few times -- for the treatment he's receiving.

And then, a story I'll never forget.

A mother of four told us only her daughters and a neighbor know she's living with HIV. But she said the stigma of the disease has driven them apart. When she cooks for her daughters, they won't eat her food. When she does laundry, they ask her to wash their clothes separately. No one knows where she's going when she visits the clinic to get medication.

The stories went on ... for a long time. To those who frequent the clinic, we were a group of curious international journalists paying witness to their experience. They didn't let us go easily.

But aside from the all the gut-wrenching details, and the sometimes excessive platitudes they paid to the clinic, what I really heard was a collective sigh. Much like the one I heard when I walked into IYG more than fifteen years ago.

Chris died -- just a year after I met him.

None of us knew he was living with HIV. I heard he kept it a secret because he wanted to be perceived as living, not dying, which he thought would have stopped some of the support dollars from flowing in. If that's true, I appreciate the sacrifice. But I still wonder whether he feared losing the trust of the benefactors, or the youth.

... And if he were alive now, would he have spoken the truth?

IYG, Clinica Condesa are both testaments to the importance of creating safe spaces. But, groups form, spaces get built, shelters emerge ... So, the other question on my mind is what's changing outside?

Who would you tell if you were HIV-positive?

Who have you told?

iStock

By now, you've heard the news that the number of new HIV infections in the U.S. is higher than previously known.

Just to be clear, the news is not that the epidemic seems to be worsening, but, rather, that the detection methods are better, which means that we can now know approximately when people became infected and how many actually are.

All fine and good, but why, in the richest country in the world, do African Americans, as a group, have an HIV/AIDS infection rate that rivals that of the developing world?

I participated in a town hall forum with Phill Wilson of the Black AIDS Institute last fall, in conjunction with the Congressional Black Caucus annual legislative weekend. What impressed me about that conference was -- in contrast to the new data we're just learning about -- how much we do know about what works and what does not in fighting HIV/AIDS. There were so many great initiatives already up and running. I was amazed. (I recognize that that was a reflection of my own ignorance, but I was under the impression that this was all new news.)

Wilson says the big issue is coordination: one hand does not know what the other is doing, so the best practices and innovative ideas that are working well in some communities are not replicated. Of course, there are also the systemic problems with health care in this country, but still.

We'd like to hear from you. What innovative, effective programs to fight HIV/AIDS are working where you live? If we hear from enough of you, we will find a way to showcase these ideas in an upcoming program.

I'll figure something out. We cannot let this epidemic go on.

And, speaking of news, meet the new Washington bureau chief for NBC News, Mark Whitaker. A quiet trailblazer, he spent most of his career at NEWSWEEK magazine, winning four national magazine awards as editor. Now, he's heading the network's D.C. bureau. His new role has to be one of the most glamorous jobs in journalism, filled rather remarkably for the last decade by someone who was surely one of the city's best loved, as well as best respected, journalists, Tim Russert, who was not a glamour hound. Russert was a down-to-earth teddybear who brought the heat.

Big shoes, but Whitaker has his own big shoes, not least that he is the first African American to fill many of the key jobs in which he's served, including this one.

And because it's Monday, and I know some people are sad to be back at work, we decided to make it funky for you with Brian Culbertson.

Enjoy. You know you can't fake the funk.

Do you ever get sick of yourself? That's how I feel right now. This cold is making me nuts. The hacking is not only disgusting, it's painful. ... Enough already!

But thanks for the suggestion of Throat Coat -- one of our bloggers (P. Umunna) recommended it and one of our producers, Douglas Hopper, ran out to the grocery store near here to get me some (don't worry, he was also getting his own lunch ... I wouldn't do him like that!) and it seems to be helping. And it's yummy, too.

OK, back to work. Chad. We promised we'd try to shed some light on that situation, where rebel forces -- some of them actually relatives of incumbent President Deby -- attacked the capital city Ndjamena in an attempt to overthrow the government. We had great guests today, but we hope to do more and still hope to make contact with folks on the ground. If we do, we'll certainly bring you those voices right away. Listeners have been helping us, and we appreciate it.

And, on to books...

The American Library Association president Loriene Roy stopped in, as she does on her swings through Washington, and brought us some goodies -- the award-winning, or as she called them "honor" books, the association and other groups selected this year. I want all of them. Clip and save this list for your Christmas shopping!

We also brought you the second of our conversations about mental illness. Yesterday, we talked with author Terri Cheney about her book, Manic. Today, Terrie Williams talked about her book Black Pain. Having known Terrie for years, believe me when I say that she very convincingly wore the mask. I didn't see her a lot, by any means, but I saw her enough to know that she is a top player in New York public relations circles. So imagine my shock to discover that all that time, she was struggling with depression.

What a gift it is, in my view, for Terrie to be willing to share her story. Of the things Terrie has done, this may be her greatest achievement -- to let everyone know that one does not have to be perfect to be successful, and that success sometimes comes at a price ... but that one can decide that the price is too high.

Thank you, Terrie.

NO politics today, per NPR rule -- it's an election day. But we did want to remind everybody that the right to vote did not come for everyone in this country at the same time, and in the same way. The 15th Amendment was ratified this week, 138 years ago. Hear one of the country's most eminent civil rights leaders, Ted Shaw of the NAACP Legal Defense and Education Fund, explain how it happened. It's a more complicated story than I knew.

See you tomorrow. Keep those throat remedies coming!

AP Photo

Was there a theme to today's program? Not really. How about ... trying to make it through the best we can.

Our lead story: the numbers on HIV/AIDS in Washington, D.C. are eye-popping. Read (pdf) through the recent report it for yourself.

If you DON'T live in D.C., what does this mean to you? Well, I'm still trying to sort that out. I think it shows the way this disease is progressing through the general population, and, especially, coursing through the African American community. The numbers for Latinos in the District are also important to consider -- nearly 5 percent of those living with HIV/AIDS in the district are Latino.

HIV/AIDS can truly be considered an epidemic in the District -- D.C. had the highest AIDS case rate nationally -- a whopping 128.4 cases per 100,000 population, compared with 14.0 cases per 100,000 nationally ... but it's also true that the rate for newly reported cases is higher than rates in Baltimore, Philadelphia, New York City, Detroit, and Chicago. So, is there something about D.C.? Or, is there something broader at work? Our guests, Dr. Shannon Hader, MD, MPH, senior deputy director of Washington's HIV/AIDS Administration, and Rae Lewis Thornton, a longtime AIDS survivor and activist who lives in Chicago, helped us sort through it. If you are a regular reader of Essence magazine, you will have surely read Thornton's story at some point.

If you have insights on how the message about HIV/AIDS can be more effectively communicated, please don't keep it to yourself. We're going to go back to our panel of college students to get their take. We visited with them the week before last about a Pew poll on racial attitudes in the country, and we found their ideas so interesting we decided to have them back.

We also want to let you know about two upcoming Mocha Moms segments...

Continue reading "Washington's Health Scare" >