Hundreds of my friends and fellow AA members are HIV positive or dead from not having access to needle-exchange programs." Howard Moses wrote these words last year, not in the pages of POZ, an ACT UP leaflet or a New York Times op-ed. He went right to the source: Donna Shalala, U.S. secretary of health and human services. "I hoped that simply by telling my story, she'd rethink her position on needle exchange," he says.

Before you dismiss him as naïve, consider this: Moses, 47, is a Washington insider. At the time he wrote Shalala, the Clinton appointee was deputy assistant secretary for the office of special education and rehabilitation services in the department of education. His qualifications? Cerebral palsy. Not that his family in Kansas made much of it -- Moses had to do the same farm work as his brother, helping to grow the feed and tend to the hogs. "I didn't even realize I had a disability until I was fourteen, when I read about it in health class," he says.

His father told him he'd "just have to try harder," and Moses does -- despite hepatitis C, colitis, rheumatoid arthritis and more than a decade of HIV infection. "If HIV was all I had to worry about, I'd be fine right now," says Moses, referring to the various treatments he juggles.

Moses got a response to his Shalala missive three months after he sent it, not from La Secretary, but from David Satcher, then director of the Centers for Disease Control and Prevention. "I had hoped that the response would have come from Shalala herself," Moses says, whose job inside the Beltway didn't win him any special attention: A form letter with the date crookedly rubber-stamped at the top.