Many Questions Follow Report on HIV/AIDS in D.C.

Recent statistics reveal that Washington, D.C., has the highest rate of HIV/AIDS infection in the country. Washington Post political writer Jose Antonio Vargas reacts to the HIV/AIDS crisis in the nation's capital and attempts to make sense of how a city that was once at the forefront of AIDS prevention has failed to stem the epidemic.

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MICHEL MARTIN, host:

And now we want to continue a conversation that we began last week about some news that may have come as a shock to many people. We're talking about HIV/AIDS in the nation's capital.

A study out last week by Washington, D.C.'s HIV/AIDS Administration showed that the city has the highest rate of HIV/AIDS infection in the country. The report described the situation as a modern epidemic. What's even more surprising that Washington was once considered ahead of the curve in its approach to the disease.

One person who was not shocked by those findings was Jose Antonio Vargas. He's a reporter with The Washington Post. He's been writing about the effects of the disease in Washington, D.C., and around the country for several years.

Welcome. Thanks for speaking with us.

Mr. JOSE ANTONIO VARGAS (Staff Writer, The Washington Post): Thanks for having me. I really appreciate it.

MARTIN: You wrote an article for this past Sunday's paper where you described AIDS in Washington as a tale of two cities. What did you mean by that?

Mr. VARGAS: You know, to put that into context, I mean, I think you can talk about many issues in this city - look at education, look at crime, and you look at AIDS - and I think you see two very different realities.

Actually, what was interesting to me about the essay that I wrote for Sunday's paper is the day before that, Laura Bush in our editorial pages had an op-ed about international AIDS. Basically talking about global AIDS epidemic and how things are improving. And, you know, the White House is only a few blocks, a couple of miles, maybe, from some of the places that I've visited, and you kind of wonder, you know, if people's eyes are really open enough to be looking at things in the way that they should be looking at them.

MARTIN: You know, the numbers in the report are disturbing enough. And one of the reasons this report got a lot of attention is this was considered to be the first time that this district actually had some accurate numbers…

Mr. VARGAS: Yes, yes.

MARTIN: …from the extent of the disease within this city. And those numbers are disturbing enough. Some 12,000 D.C. residents have HIV or AIDS or some 3,300 new cases reported between 2001 and 2006. But you still doubt the accuracy of the numbers. You know, what would be the reason that we wouldn't have accurate numbers at this point?

Mr. VARGAS: Because I think we're talking about a disease that still has a lot of stigma. Frankly, a lot of people still aren't getting tested - that's a really, really, really big one. And we're not just talking about young people who have grown up with AIDS in terms of hearing about, you know, the HIV get-tested campaigns - but also among adults who don't want to be attached to this disease.

I remember when I was writing this piece, I was re-reading a James Baldwin essay when he was talking about, you know, numbers always hide as much as they reveal. And that was in my head the whole time as I was thinking about this piece because really for many years, some of these AIDS organizations have operated kind of in their own silos as if they existed in their own cities -all working from different sets of numbers.

And, you know, D.C., eight wards, the way that it is - east of the River, Anacostia - kind of the segregation and the classicism that happens in this city, the city has done a very poor job tracking this epidemic in terms of numbers. And here they are again - a new AIDS director, a new report - they're saying again, quote, unquote, "a modern epidemic." You know, I was kind of skeptical looking at the numbers.

MARTIN: And one of the things that also interested me about the piece is you pointed out that you were born in 1981, which is the year that…

Mr. VARGAS: Yeah.

MARTIN: …HIV was identified as a distinct virus or syndrome. And so you grew up with AIDS as a part of your consciousness…

Mr. VARGAS: Yes, yes.

MARTIN: …as a part of a political and cultural reality that you grew up with. And you've also reported on AIDS in other parts of the country, in San Francisco, which is, of course, a place that has a lot of consciousness around…

Mr. VARGAS: Yes, yes.

MARTIN: …the disease. What I was curious about is if — what you've learned about the way HIV/AIDS works in the district and the way it - our efforts to address it are not working? Does that have broader - is there something that the rest of the country needs to be concerned about or is it just part of the, you know, problem of living in a city with kind of a mixed-up governance and, you know, new home rule and, you know, city systems don't always work as well as they should?

Mr. VARGAS: Well, one of the things that I found staggering was this idea - you know, I had profiled a guy named Ron Daniels who runs the - who runs Prevention Works!. This is the needle exchange program in the district that basically he drives around on RV that goes through the eight wards of the city, especially in the poorer areas of the city, and hands out clean needles in exchange for dirty ones, right.

I ended up reporting this story and I didn't know that, guess what, D.C. is the only city in the country that can't use its own tax dollars to fund a needle exchange program, which by the way exists in some 206 municipalities in 30 states in the country. And we can't do that because, guess what? The city's budget has to be approved by Congress. And some Congress members - some of them Republicans - didn't like the fact that the city of - you know, that the District of Columbia would be handing out needles to anybody, much less drug addicts.

I thought that was really interesting because, again, again - I mean, you have here the mixing of Capitol Hill and you mix it up with basically the demographics of this city, which in many areas of the city is still poor. There's that to think about. And frankly, especially as it relates to the African-American community, I think this is something in the next 20 years or so, if this is not targeted now — because guess what, what's happening in D.C. it's what's happening in Detroit, it's what's happening in Chicago, it's what's happening in Philadelphia.

You didn't see it - we don't see it a lot in San Francisco because the demographics of San Francisco is people who are getting HIV or AIDS are predominantly gay men - white gay men. There's not a lot of black people in San Francisco. And so I think if this is not something that specifically the African-American community addresses, this is something that can take - that can just keep on evolving and keep on growing. And we have to get people tested.

MARTIN: Finally, I wanted to ask you about the Latino population, which is growing in the district as it is in many cities both large and small.

Mr. VARGAS: Yeah.

MARTIN: I noticed that about 5 percent of the folks living with HIV/AIDS in the district are Latino. Is that an — also a community that needs to pay more attention…

Mr. VARGAS: Yes.

MARTIN: …into what's going on?

Mr. VARGAS: Yes, definitely. And I think a part of that, too, is, you know, machismo, and again, homophobia. You know, this is not something that people like to talk about, and this is something that they're struggling with through to get people to come in and get tested, and to have people openly talk about educating each other, you know, on this epidemic.

And also, by the way, both in the Latino community and the black community is transgender; not a lot, but there's a sizeable amount of transgender prostitutes, right, out there that are also getting infected. And this is not something, you know, that a lot of people really talk about.

MARTIN: Jose Antonio Vargas is reporter with The Washington Post. You can find a link to his article about HIV/AIDS in the district on our Web site, npr.org/tellmemore. He was kind enough to join me here in our Washington studio.

Thank you so much for speaking with us.

Mr. VARGAS: Thank you for having me. I really appreciate it.

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