While the issue may not garner much attention from candidates and the media on the campaign trial, the epidemic of HIV in the District of Columbia is a crisis that will need to be addressed by whomever is elected the city’s next mayor come November.

According to Michael Kharfen, Senior Deputy Director of the D.C. Department of Health HIV/AIDS, Hepatitis, Sexually Transmitted Diseases and Tuberculosis Administration, about 2.4 percent of the District’s population, or over 15,000 individuals, is currently living with HIV. This is four times the national prevalence rate of 0.6 percent for the disease, according to 2011 data from the Centers for Disease Control.

“We have a significant epidemic in the District of Columbia, which is what the World Health Organization defines as any disease that affects more than one percent of a city’s population,” Kharfen said.

D.C. Mayor Vincent Gray, who is facing a crowded field in the April 1 Democratic mayoral primary, appointed Kharfen to head HAHSTA in July 2013. During Kharfen’s tenure, D.C. government has focused on expanding access to treatment for HIV, as well continuing to develop and market the city’s condom distribution program, which, according to Kharfen, is one of the most aggressive in the nation.

“Condoms are the only devices that we know of that do effectively prevent HIV. We distributed nearly seven million condoms in 2013. That’s more per capita than any city in the United States,” Kharfen said.

But Gray’s challengers, like Councilmember Jack Evans (D-Ward 2), were quick to tout their own roles in the implementation of recent HIV prevention programs in the District.

“Many successful tools now used to fight this epidemic — from condom availability to needle exchange programs, medical marijuana, patient safeguards — exist because Jack worked for years with community leaders on these efforts to make them a reality,” Evans’ Communications Director Jermaine House said.

Councilmember Muriel Bowser (D-Ward 4) called for a continuation of these programs, but also a more targeted focus on certain communities affected by HIV in the District, in a 2012 questionnaire issued by the Gay and Lesbian Activists Alliance of Washington, D.C.

“HAHSTA has implemented an award-winning social marketing and community based prevention campaign that focuses on HIV testing, condom education and distribution and accelerated treatment. Clearly there needs to be more intensive focus on transgender, Latino, youth and MSM (men who have sex with men) populations,” Bowser said.

Kharfen reiterated the importance of greater outreach to the younger generation — especially the 20 to 29 year old demographic among whom the HIV transmission rate in 2010 was one percent — but said the city’s more generalized approach is better suited to address the epidemic District-wide.

“HIV is a condition that doesn’t make choices regarding who, what that person’s race or ethnicity is, what their age is, their gender or where they live. HIV affects everyone in the District,” Kharfen said. “However, reaching that 20-29 year old age group is a difficult task. That’s why we’re looking at different social media strategies and new ways to engage young people in this effort.”

Jack Pfeiffer, Communications Director for mayoral candidate Councilmember Tommy Wells (D-Ward 6), pointed to various initiatives Wells has worked on as evidence of his commitment to achieving the city’s goal of reducing new HIV cases as much as possible.

“Councilmember Wells has supported and worked on several bills to address HIV and AIDS in the District since he was elected to the Council, including the Effi Barry HIV/AIDS Program and various other bills during his time on the Council,” Pfeiffer said, referencing a program that aims to harness various community organizations such as churches and other groups in a more effective response to the epidemic.

John Kraemer (LAW ’08), assistant professor in the School of Nursing & Health Studies’ department of health systems administration, praised the city’s heightened approach to combatting HIV, though he acknowledged that the preexisting high prevalence rates from before the city increased its efforts to combat the disease have made prevention more difficult.

“D.C. is obviously way behind the 8-ball because prevalence rates are so high here. For so long the response was challenged, so that now it’s trying to dig itself out of a pretty big hole, but I think the city is doing things in a sensible way,” Kraemer said.

While lauding D.C.’s condom distribution program, which has over 140 sites in the District, Kraemer emphasized that the initiative must be coupled with an aggressive behavioral campaign if the city wants to maximize its effectiveness.

“If you want people not to get HIV, you have to make it easy for them to get condoms. Period. Having condoms is necessary, but not sufficient. You have to have good behavioral campaigns, you have to empower people to be in the position to bargain for condoms in sexual relationships,” Kramer said.

While candidates agreed that progress has been made, the consensus was that much more work has to be done to curb the HIV epidemic that has plagued the District for decades.

“We still have around 700 new cases of HIV in the District each year, and that is still 700 more cases than we would like to see,” Kharfen said.

The Democratic primary for D.C. mayor will be held on April 1, giving candidates less than a month to make their final pushes to earn a spot on the November general election ballot.

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