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Mayor Thomas M. Menino, municipal leader


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Led the way on intravenous needle exchange and citywide AIDS education

When Tom Menino was still a district city councilor from Hyde Park, he asked “two kids from Harvard Business School” to study the rates of HIV infection among Boston residents with those of New Orleans and municipalities in New Jersey. The results were startling: Boston had a much higher rate of infection.

The issue of needle exchange was a hot topic in the city. Then-Mayor Ray Flynn had proposed a needle exchange pilot program that was being opposed by then-Governor Michael Dukakis and state lawmakers. Menino admits he knew little about the issue. “I was so nave that I didn’t even know what a syringe was,” he says. “But there was something about the issue that intrigued me and I told my staff we were going to do something about it.”

‘We have to educate people about this on an almost daily basis.’

Menino’s ambitious proposal called for 24 full-time outreach workers to educate intravenous drug users about the risk of AIDS; two community health vans to be deployed to at-risk neighborhoods to provide general health education as well as AIDS prevention information; increasing the availability of drug treatment programs; designating June as “AIDS prevention month,” and implementing Flynn’s needle exchange program. Acknowledging the powerful political resistance to needle exchange, Menino told the Boston Globe at the time: “It will take a long time to get that program in place. In the meantime, we need to be doing something.”

Five years later, Menino became Mayor when he won a special election after Flynn was appointed ambassador to the Vatican by President Clinton. Just a few short months later, Menino implemented a citywide clean needle exchange program. Called AHOPE (Addicts Health Opportunity Program Exchange), it was the state’s first needle exchange program and included many of the elements of Menino’s first proposal as a city councilor: outreach workers, a mobile health van, and harm reduction educational materials. It also included the creation of Safe Place, a drop-in site that provided substance abuse referrals and case management assistance, as well as food for drug users.

Menino says he took the opportunity when he was running for mayor to educate himself further about AIDS and the gay community — which were one and the same at the time. He called Harry Collings, whom he first met at the Boston Redevelopment Authority in the 1970s, and asked him to put a group together of gay and lesbian leaders for him to meet. Collings gathered about 20 power brokers and activists to meet with Menino. “We sat down together and talked about the issues,” Menino says.

The group made a lasting impact — as has Collings himself, which Menino is quick to add. Partly as a result, Menino has been, unquestioningly, one of the country’s municipal leaders on the issues of HIV prevention. In 1993 he assembled an advisory board of leading public health officials to help him implement policies around AIDS treatment and HIV infection prevention. He hired John Auerbach, who is now the Commissioner of the Massachusetts Department of Public Health, to run the Boston Public Health Commission.

In 2001, he raised money to help pay for a liver transplant for Belynda Dunn, a longtime employee of AIDS Action Committee who was a leading HIV educator in the city’s African American community. Dunn, who was HIV positive, had been denied payment for a transplant by her health insurer because of her HIV status. Menino announced the funding at a moving press conference at the Boston Living Center. The move was classic Menino: acting on the emotion generated by a heartbreaking story of injustice and using his position and pulpit to move quickly to solve the problem. “I thought it was important to act,” he says. “I saw a problem and I tried to solve it.”

Today, Menino describes the state of HIV and AIDS in the city as something that has stabilized somewhat thanks to the work of organizations like AIDS Action, the Living Center, Community Servings, and the Victory Program. But he warns, “We have to educate people about this on an almost daily basis. We cannot let our guard down and that’s why I’m involved.”

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