BIG BREAK IS POSSIBLE FOR SMALL CRUSADE

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.