At New All Saints Roman Catholic Church in Forest Park, Md., on Sunday, before a group of religious leaders gathered to discuss AIDS in Baltimore's black community, Melanie Reese, 50, rose to reveal she is HIV-positive. She had known she was infected since earlier this year but kept the news secret from everyone but her daughter. Now, she said, she had decided God wanted more from her than silence. "We need to break the silence," she said.

"What she said in a few minutes had more impact than any speech I could give," said Joseph F. O'Neill, the Bush administration's AIDS policy director and a speaker at the meeting. O'Neill, a faculty member at the Johns Hopkins School of Medicine who has treated the city's AIDS patients for years, told of one patient who died six years ago. The man kept his illness secret, telling his family and fellow church members only months before his death. The church community embraced the man, a beloved member of the choir. Asked to speak at the funeral, O'Neill said he admired the congregation's outpouring of love, but he also offered sobering words. "I was the only person he told for five years -- not his family, not his church -- that he was gay and that he was dying," O'Neill said. "That's a shame. We can't let that happen." The crowd at Sunday's meeting murmured and nodded in affirmation.

O'Neill followed his story with a promise that the Bush administration would continue spending billions of dollars to fight AIDS worldwide. He said the president believes faith-based efforts are key to the battle. O'Neill splits his week between the White House and the Hopkins AIDS clinic. By bridging the gap between policy makers and doctors, he said, he hopes to show people that the administration shares their pain and worry. "None of this is theoretical to me," he said.

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