3%? really? well, color me unsurprised

On Monday, the DC Department of Health released its 2008 HIV/AIDS epidemiology report and the results created quite an uproar in the District. The report shows that DC has an HIV/AIDS prevalence rate of 3%, which is higher than the HIV/AIDS prevalence in West Africa.

While the rest of the city was up in arms and asking the DC HIV/AIDS Administration (HAA) how could they have let this happen, I shrugged my shoulders and went about my work. To me, the news wasn't particularly shocking. I've read the whole report (managed to read all 80 pages while commuting on the Metro this week) and nothing in it was news to me.

The fact is that those of us on the front lines already know that this city has a major HIV/AIDS problem. Maybe those of us in the field have become very jaded with whatever HAA puts out there. HAA has certainly let us down in the past.

HAA could've done something to prevent this awhile ago and they definitely should've seen this coming. But HAA has a reputation of...well...not doing enough (to put it mildly). HAA cannot even collect the right data, enough data, relevant data, and has even UNDERREPORTED the number of AIDS deaths for about 10 years. The lack of accurate data has led to the loss of millions of dollars in funding--funding that could be used to develop and execute effective prevention strategies.

From an epidemiological perspective, accurate data is of utmost importance in accessing an epidemic. How else would we know what populations are most effected, what risk behaviors are HIV+ people engaging in, what neighborhoods are hit hardest, etc.? HAA has seen many incompetent directors come and go over the years and the current director, Dr. Shannon Hader, has her work cut out for her. Not only does she have to deal with the crap left behind by previous directors who had no idea what they were doing, but she also has to deal with the crisis we are experiencing now (she's like Obama but on a smaller scale).

I have a bit of a soft spot for Dr. Hader. She's a public health nerd (or so I've read) so she has to know how important accurate record keeping is. Dr. Hader's got a long way to go, but I believe that she is capable of turning things around at HAA.

But she's got to act quickly. Thanks to this epidemic, time is a luxury we don't have.