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The Washington Post, July 1, 2007
by Keith L. Alexander, Washington Post Staff Writer
In Paola Barahona's tiny office at PreventionWorks!, a needle exchange program, a Wonder Woman Pez dispenser sits on the shelf above her desk. She sports a Wonder Woman bracelet and carries a Wonder Woman notebook.
On the city's back streets, where she encourages intravenous drug users to use clean needles and get tested for HIV, Barahona is a down-to-earth version of a superhero, trying to save lives. "I just wish I had a magic lasso in this town to make people tell the truth," she said recently, recalling her experience with bureaucracy.
Barahona, 39, oversees PreventionWorks!, a predominantly privately funded program. For the past nine years, while a federal ban on using local tax money for the needle-exchange program was in place, PreventionWorks! distributed needles to addicts as part of an effort to help stem the spread of HIV and AIDS.
Now that the House has lifted the ban, over White House objections, such organizations as PreventionWorks! could begin tapping into local tax money as early as October, said D.C. Health Director Gregg A. Pane. The bill must still go through the Senate, which is not expected to reverse the decision.
The Health Department would commit $1 million to support needle-exchange programs, HIV testing and intravenous-drug counseling services next year, Pane said. The city would allocate $250,000 to PreventionWorks!, he said, but would also encourage other programs in the city, including several run by the Health Department, to begin offering needle-exchange and drug counseling services.
"This isn't just giving away needles," Pane said. "It's a chance to interact with people. To do HIV and hepatitis testing and make the appropriate referrals to detox. It's a chance to interact with folks and do a number of good things."
Pane said he expects criticism from people who oppose using government money to give clean needles to drug users. But, Pane said, needle exchange has been proved effective in reducing the spread of HIV.
More than 210 similar programs are in place in 36 states. About half receive local or state funds, according to the North American Syringe Exchange Network.
The Whitman-Walker Clinic helped set up PreventionWorks! after the clinic's government funding was jeopardized by the ban. In 1998, as the newly named executive director of PreventionWorks!, Barahona delved into books at District libraries, teaching herself how to apply for private grants that would subsidize the program. With an operating budget of about $666,000 this year, almost all of the funding comes from private donations. It was only last year that PreventionWorks! got its first District contract. The $15,000 grant was not for a needle exchange but to provide HIV testing to Ward 7 residents as part of a three-month health initiative. By the end of the program, 433 people were tested; 5 percent tested positive.
PreventionWorks! has two full-time employees: Barahona and Ron Daniels, who oversees its street outreach program. There are also three part-time workers. PreventionWorks! relies heavily on the 137 volunteers who help pass out needles and offer counseling at its offices, on 14th Street behind the Whitman-Walker food bank, or twice a week from its Winnebago at sites across the city.
With the funds, she says, the program would expand such services as HIV testing and counseling and increase the number of support workers. From Oct. 1, 2005, to Sept. 30, PreventionWorks! counselors saw more than 10,000 addicts. During that time, they passed out more than 236,000 needles.
The District has one of the highest HIV infection rates in the nation, with as many as one of 50 D.C. residents testing positive for the virus, according to Health Department estimates. About one-third of new AIDS cases annually are caused by syringes passed among drug users.
At Barahona's office recently, a man wearing a red bandanna shuffled through the door carrying a bag under his arm. His face was gaunt, but his forearms were swollen. He appeared to be in his late 50s or early 60s. It turned out he was in his mid-40s.
He carried a bag of 35 used needles. He and Barahona disappeared into a side office. The exchange service is anonymous, but she asked for his first name, birth date and mother's first name for recordkeeping purposes.
She gave him a cup of water, an antibiotic ointment swab, bandages, a bottle top for cooking drugs and some condoms. He dumped his old needles into a red bio-hazardous container, and Barahona handed him 35 new needles. He thanked her, stuffed the items into a duffle bag and walked out.
"We could offer so many more services with those funds," Barahona said.
If PreventionWorks! successfully taps tax money, Barahona will not be around to manage it. She recently resigned. Her last day is Aug. 15.
Although accessing government funds is something that she fought for, Barahona said she would rather be out helping prevent the spread of the deadly disease.
"I made a commitment that I would fight for public funding, but I didn't want to manage the funds," she said. "It's a good time for a change in leadership, someone who can deal with the bureaucracy of government money."
Or maybe someone with a magic lasso.