Houston and HIV.

The theme for World AIDS Day 2005 is Stop AIDS: Keep the Promise. This theme emphasizes the critical role of advocacy and the importance of keeping our foot on the neck of this epidemic. Our collective attention on this 25th year is turned to those in leadership, calling for increased financial commitments and policies that reflect and answer the needs of the community.

What does this mean for the city of Houston and HIV/AIDS services? How does the theme apply to us? Houston has remained one of the top 6 cities in the nation with severely disproportionate HIV statistics. We have participated in local, state, and federal efforts, but it was not until the last 10 years that HIV appeared on the radar of many who were simply unfamiliar with it. Since then, Houston has been a strong leader in the fight against HIV/AIDS, and the relationship between community and the political leadership has had a critical impact on increasing those efforts. This has not been an easy accomplishment, but looking back, we can definitely see where change took place because of such efforts.

It was not until the late 1990s that HIV's impact on communities of color in particular, garnered steady city- and state-wide recognition. In 1999, Mayor Lee P. Brown, along with Harris County Judge Robert Eckels, announced a State of Emergency against HIV in the African-American community and issued a Call to Action. Soon afterward, several resources were re-allocated to support that call. What had traditionally been lacking in terms of advocacy efforts with policymakers was a clear dialogue within the community on the true impact of this disease.

Prior to this emergency call, the epidemic in Houston among communities of color was increasing at alarming rates. In addition, the epidemic was largely being ignored by those communities it was impacting most. This made advocacy difficult because the information was not being shared or analyzed collectively to achieve better outcomes. HIV educators had been forced to use scarce resources to blanket communities with prevention materials and health services that had limited success. A large portion of the prevention and care dollars available were going to few agencies and oftentimes the services provided did not meet the needs of nontraditional communities, particularly communities of color. As advocates, many of us found ourselves in adversarial relationships with federal funders and policymakers.

For underserved communities in the Houston area, the climate towards HIV started to shift after the mayor's Call to Action and institution of an HIV State of Emergency Task Force. The community had collectively developed a strategy to educate local city officials as well as county and federal leaders. There was a persistence of door knocking, event planning, and political protesting that generated visibility for the HIV-positive community and stressed the importance of funding for prevention efforts. Through these ongoing advocacy efforts, Houston's HIV community continued to increase its political base. City Councilmember Annise Parker, one of the first political advocates for HIV/AIDS on Houston's City Council, lent her support to calls for increased resources early on in the epidemic for the gay/lesbian community. Her support continued with the call for action in the African-American community. The State of Emergency further expanded the opportunity for collaboration and education with nontraditional providers and allies from other service communities, including those involved in substance abuse and mental health issues. For many of us in the struggle for resources, this was a milestone.

In 2001, Ada Edwards was elected City Councilmember in District D. Soon afterward, HIV advocates saw a surge in attention to the epidemic and its relationship to the Black community and youth. Advocates found themselves talking about HIV disease with anyone that the Councilmember Edwards could bring to the table ... including in 2004, then-incoming Mayor Bill White, who has continued the task force under his administration. Through Councilmember Edward's leadership on the State of Emergency Task Force, HIV educators and testers were able to reach nontraditional communities that had never been served.

Today, the relationship between community advocates for HIV prevention, treatment, and housing work closely with elected officials to ensure that attention remains on this disease. Houston is fortunate to have had the ability to combine advocacy efforts from different communities with political access to increase services available to the entire city ... not just one population. As a result of these same advocacy efforts, decision-makers have included community advocates at the table. Many of our local advocates have made a national name for themselves through their efforts and have taken the call to the nation's capital. Houston is represented on several national efforts, and funding is coming into the city from sources once unavailable to us.

Everyone has a role to play in stopping this epidemic. The World AIDS Day call to Keep the Promise is directed toward our City Council members, as well as state and federal legislators and senators, and is critical. But we cannot expect our elected officials and decision-makers to do this work on their own. We have to continue to make our presence known through dialogue and planning. For the past few years, The Center for AIDS has conducted Project LEAP (Learning, Empowerment, Advocacy, and Participation), which is a program designed to educate HIV-positive persons and encourages advocacy. We need programs such as this to continue so that HIV advocacy efforts can continue.

HIV is still ravaging our communities. The number of persons requiring care continues to outpace the dollars put into the system. We have to step-up our efforts and not become complacent with the accomplishments that have been achieved. We are asking our government officials and representatives to listen, to learn, and to act on HIV/AIDS. Therefore, as community, we must continue to inform, to fight, and to serve. This is the only way that we collectively can attempt to keep the epidemic in check. Without an ongoing and open dialogue, HIV can slip into obscurity. Our work is not done. We have to keep alive the promise and goal of an eventual elimination of HIV/AIDS.

Dena Gray is the Administration Manager, HOPWA (Housing Opportunities for People with AIDS) Program, City of Houston Department of Housing and Community Development.