States who were willing to implement partner notification programs would be eligible to receive higher amounts of federal aid to use in the fight against HIV/AIDS (Collins, 1). In 1992, the Washington D. C. area was able to provide more AIDS related services to its citizens when the Centers for Disease Control updated the AIDS case definition used in the United States (Collins, 1). The original diagnosis relied on the ability to detect one or more defining illnesses associated with AIDS.
The new diagnosis criteria took into account the fact that many other diseases could model similar characteristics and this often prevented people from receiving the AIDS services they needed. Further, the new AIDS case definition required the use of CD4 T-cell counts, which are the specific blood cells affected by the HIV virus. The new formal AIDS diagnosis now includes all those with CD4 T-cell counts lower than 200 who have been diagnosed with “pulmonary tuberculosis, invasive cervical cancer, recurrent pneumonia, HIV encephalopathy, chronic isosporiasis, disseminated histoplasmosis, wasting syndrome, or other conditions” (Collins, 1).
Finally, in 1999, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists encouraged universal testing of all pregnant women for the HIV virus. This included the Washington D. C. area. Under this new plan, pregnant women would be notified that they were being tested for HIV but it would not be required to receive written consent to conduct the test. In October of 2000, it became commonplace for pregnant women in all states and Washington D. C. to be screened for HIV.
1). Historical Analysis of HIV/AIDS Initiatives in Washington D. C. The AIDS crisis in the United States was only just beginning in 1981 when the first known cases were diagnosed. However, by the end of 1986, nearly 25,000 people in the United States had died from AIDS (The Ryan White HIV/AIDS Program, 1). During the time between 1981 and 1990, the number of AIDS related funding services grew from four to twenty-four. However, overall funding to fight the spread of AIDS did not grow significantly (The Ryan White HIV/AIDS.
1). Therefore, it was difficult for Washington D. C. and other areas hard hit by the AIDS crisis to conduct research regarding the prevention of AIDS across the country. Despite this lack of funding, the rates of new AIDS cases as well as the rates of AIDS deaths in Washington D. C. continued to increase in staggering numbers. There were 22 new AIDS cases reported in Washington D. C. in 1983. By 1990 that number had risen to 740; by 1995 it had increased to 1029 (The Rainbow History Project, 3). In response to the initial discovery of AIDS, the widespread effort to stop the spread of the HIV virus was immediate.
Washington D. C. quickly began to work diligently towards preventing HIV/AIDS while also providing funding and services to those already infected. Washington Blade and Washington Post both included reports about the initial discovery of the rare type of “cancer” found in gay men. In response to these news stories, the Capital Area Physician Association was formed in November of 1981 in order to educate gay men about the dangers of this new disease (The Rainbow History Project, 5). This was quickly followed with the organization of the AIDS Education Task Force at the Whitman-Walker Clinic in Washington D. C in 1983. It was also in 1983 when Washington D. C. formed the DC AIDS Task Force The Rainbow History Project.
6). In 1984, the Whitman-Walker Clinic hired its first AIDS program director and issued its first AIDS education pamphlet. Also in 1984, the Washington Blade ran its first obituary where death was contributed to AIDS (The Rainbow History Project, 7). The Whitman-Walker Clinic remained an important advocate for education and medical services for the Washington D. C. area. In 1985, this clinic treated 55 patients and fifty percent of these 55 patients had transitioned to full blown AIDS.
At the same time, Johns Hopkins was organizing clinical trials and invited Washington D. C. citizens living with AIDS to participate in the earliest trials associated with new treatments for AIDS (The Rainbow History Project, 8). In 1986, the Whitman-Walker Clinic opened the Schwartz House for people living with AIDS. The clinic also began anonymous testing for AIDS and quickly became the largest testing center in the area. Over the next several years, the Whitman-Walker clinic expanded to include more testing centers as well as more houses for those living with AIDS (The Rainbow History Project, 9).
This clinic was an integral force in the early AIDS initiatives enacted in Washington D. C. and offered the earliest support to citizens living with AIDS or the HIV virus. There were many other collective ways that the citizens of Washington D. C. worked together to help combat HIV/AIDS. In 1992, the city raised one million dollars through the first AIDS Walk (The Rainbow History Project, 16). These AIDS Walks were held annually and were able to raise millions of dollars towards research in the Washington D. C. area.
In 1994, Washington D. C. held its first Metro Teen AIDS Conference in order to provide the teenage population with information and education regarding the prevention of the HIV virus and AIDS (The Rainbow History Project, 18). In 1995, the Youth Positive Support Group formed in order to provide medical and mental intervention to teenagers living with HIV/AIDS (The Rainbow History Project, 19). Many other groups also formed during the 1990s in order to provide support and education to Washington D. C. residents.
Also in 1995, the Inner City Community AIDS was formed as was the Friends for Friends group which was formed to provide AIDS education to lesbians. The Mothers March Against AIDS group was also started in 1995 (The Rainbow History Project, 19). In 1996, Washington D. C. began its first needle exchange program and in 1997, the Whitman- Walker Clinic begins a similar program (The Rainbow History Project, 21). The needle exchange programs implemented in Washington D. C. as well as in other parts of the country were created to reduce the transmission of blood borne pathogens, specifically HIV/AIDS (Safaeian, 169).
The primary purpose of such programs was to allow injection drug users to exchange their used needles for sterile ones in an effort to reduce the spread of infectious disease (Safaeian, 169). There is a large body of research that suggests that needle exchange programs can be effective at reducing the incidences of HIV/AIDS contractions among injection drug users (Safaeian, 169). However, it is unclear whether these original programs were truly effective at significantly reducing the spread of HIV/AIDS in any given population in the United States (Safaeian, 169).
One potential downfall to needle exchange programs is that they rely on the self reporting behavior of drug users which may not be the most effective approach to reducing the incidences of needle sharing (Safaeian, 169). However, Washington D. C. initiated this program in an effort to encourage needle users to take the necessary precautions to protect themselves from contracting the HIV virus.
This was in light of the rapid spread of HIV/AIDS in the Washington D. C. area during the 1980s and 1990s. During the late 1990s, the Washington D. C. area began to incorporate a variety of education programs aimed at specific populations where HIV/AIDS was more prevalent. In 1997, a new HIV prevention program was started and was designed to educate men of color about the dangers of unprotected sex (The Rainbow History Project, 21). In 1998, a similar program was created to educate the Latino population in Washington D. C. about the dangers of HIV/AIDS transmission and another program was aimed at people of color (The Rainbow History Project, 22). In 1999, several of the most prominent HIV/AIDS education programs received federal money in order to expand and continue their programs.