- The Washington Times - Tuesday, February 4, 2003

President Bush is hardly heralded as a hero east of the Anacostia River, but those working to combat HIV/AIDS infections are applauding his commitment to increase funding to fight the disease in Africa.
Still, they wonder what effect the president's promises will have in the national capital's back yard.
"I applauded the president's message in the State of the Union [address], but we've got to find a way to fund more resources right here in the U.S., especially in the [Washington] metropolitan area," said Barbara Chinn, director of the Max Robinson Center of the Whitman-Walker Clinic on Martin Luther King Jr. Avenue SE.
During his speech last week, Mr. Bush pledged to nearly triple the funding during the next five years to African nations to help eradicate the HIV/AIDS pandemic there. Currently, the United States spends $1 billion annually for foreign and domestic HIV/AIDS programs, but Mr. Bush's proposal, which must be approved by Congress, earmarks $15 billion for Africa alone.
Some worry that the money, which will be used to purchase cheaper generic drugs, will not arrive soon enough for the 40 million people worldwide who are infected now. Others worry that the rhetoric will become reality. "You can't save the lives of 40 million people on promises," Ms. Chinn said.
While Ms. Chinn hopes that the president's pledge will also heighten awareness of the HIV/AIDS pandemic, her fear is that folks will focus on the problem in Africa and not "people who we know and have contact with every day." The pandemic is not "out there," it's right here. It's not just happening to "them," it's happening to us.
Ms. Chinn's Southeast clients are predominantly black and female.
Women worldwide are the fastest-growing sector of the newly infected. Most often surprised are women who contract the disease because they are unaware that their partner is engaged in intravenous drug use or bisexual relations.
Few realize that the District has an HIV/AIDS infection per capita rate that is 12 times higher than any other place in the country, according to Whitman-Walker Clinic officials. The rate of AIDS deaths is seven times higher than the national average. "What is not clear from the president's budget is what are we going to do about increasing prevention programs, or testing people who don't know, or trying to get treatment and provide social support services?" asks Ms. Chinn.
"All these things have got to be dealt with, with insufficient funding to deal with the problems at home," she said.
Mr. Bush said that a South African doctor told him some patients do not get treatment because there is insufficient medicine, "They are told to go home and die." Ms. Chinn said, "That's not supposed to happen here … but people are falling through a crack here and a crack there." The Max Robinson Center receives approximately $1.2 million a year to service about 700 patients with a variety of medical and social services, she said.
Combating and eradicating the deadly disease that knows no geographic, sex, ethnic or economic borders begins by arming ourselves with better information.
Ms. Chinn said the biggest battle those working in the trenches here must face is education and prevention. Everyone who is sexually active should start with getting a test to find out their status.
"Making people understand that they are at risk, that's the key," she said. While treating children is a priority, Ms. Chinn said of equal importance is educating them about "risk-reduction behaviors." To that end, this straight-shooter said, "We can no longer refuse to talk to them about sexual behaviors that increase their risks." And, "The first thing we have to teach them is how to say 'no.'"
She used the analogy of teaching our children not to touch the hot stove. Invariably, there are going to be those who will try it anyway. But given today's deadly consequences from risky behaviors, the remedy won't be "as easy as running [their hand] under cold water."
Ms. Chinn said helping women is harder because, first, they are so busy taking care of everybody else that they don't take care of themselves. Even trickier, "for women, it's extremely difficult for them to negotiate safer sex practices like using condoms."
After working in the clinic for a dozen years, Ms. Chinn is convinced that promoting condom use and increasing needle-exchange programs helps to save lives. "It's not about who you are or what you do, it's about what you can do in terms of risk reduction," she said. "It's not about pointing fingers but asking yourself have you placed yourself in harm's way, because you don't have to do that." During a fall testing drive, Shelli Dinerstein, a regional AIDS educator working in the Maryland suburbs, said she talks to adults and teens about abstinence and prevention.
But, "Some people are in denial. They think what they're doing is not at risk and they don't believe it can happen to them." Borrowing a well-worn phrase, Ms. Chinn said, "It will take a village to eradicate this disease." After all, the disease is preventable.
"We can do it because we know how to do it," she said.
So it gives the longtime AIDS activists working east of the Anacostia River "hope that [Mr. Bush] stepped forward and made a commitment on a global level; now, I'd like to see the same commitment on a national and local level."

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