One in 30 adults in Washington DC is infected with HIV, and that’s just the people we know about. That puts the capital of the United States on a par with Congo, Ethiopia and Angola.
Why these scandalously high rates, over 9 times the national average? The report (pdf file, 139 pages) from the Washington DC Department of Health doesn’t say. But here’s one guess: Federal funds can’t be used to pay for programmes that help drug injectors to shoot up more safely (even though all the major federally funded scientific institutions say these programmes save money as well as lives). For over 200 cities in the country, the restriction has been annoying, but not fatal. They’ve spent state or city funds on making sure injectors have easy access to sterile needles and syringes, in programmes that also refer drug users to detox services. Poor old DC is hamstrung by the need to get Congress to approve its spending, and Congress has forbidden DC to provide safe injecting programmes for nearly a decade. So injectors share needles, their sex partners get infected, and Washington glories in HIV infection rates that are higher than those of Angola, Ethiopia, Congo or Rwanda.