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Dead Boys: Fast Sex and Slow Suicide on the West Side Docks

Dead Boys: Fast Sex and Slow Suicide on the West Side Docks
January 30, 1990

AT TWO A.M. THIS BILIOUS TUESDAY, Pookie hops off the low wall of the pier and fastens a moistened forefinger to his ass. “Fsssssssss,” he goes, flashing his frog-eyed crack grin, “I’m hot like a full-time motherfuck.” On the instant, all the pretty cars come courting, making the hairpin turn at the north end of the dock. A black Saab swings by, a silver Volvo hard behind him, slowing to get a load of the short, plump kid with the sort of epicene beauty peculiar to boys of a certain age. At the back of the pack, the guy in the blue Town Car leans on his horn.

The Town Car pulls up; its passenger window whirs down. A broad, pink man with a polished skull peers out, composed as a corpse in his Chesterfield topcoat. “Aren’t you freezing in that little thing?” he inquires. “Aren’t you hot in that big thing?” says Pookie, popping his head in. “I don’t recall seeing you out here before.”

“And might not see me out here again, so best pick up while the iron is hot. Is your iron hot, love?”

The Pink Man’s eyes play up and down the boy. “How old are you, 15?”

“At least!” Pookie trumpets. “Plus tax.”

The Pink Man frowns and looks away awhile, performing his moral arithmetic. “Get in.”

Pookie jumps in. In the eight or 10 seconds it takes the Town Car to hit the exit. Pookie is across the seat and in the Pink Man’s embrace. “That’s a fuckin’ yo-yo right there,” sneers Georgie, who at 18 looks spent, his face cinched up like an old canvas bag. It is impossible to tell whether his is the voice of experience or envy. “I told him, ‘Stay in the loop till you know the game.’ Instead, he’s gonna bust right outta here with a stone-cold freak. I laugh if he come back here with a knife in his chest.”

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IF YOU ARE SITTING on that wall at two in the morning, the cold and damp on you like a molestation, chances are you aren’t one of the sleek-skinned kids who turns up here on weekends for the party off of Christopher Street. Chances are even better that you aren’t one of the buttoned-down 20-year-olds hustling a place like Rounds on 53rd Street, pre­senting your business card — Professional Escort — to the Aquascutum crowd. No, the chances are you are what they call a “dead boy” down here — a throwaway be­tween the ages of 16 and 20, homeless and hungry and, like as not, in ill-health.

According to Covenant House, the ex­perts by default, there are between 10,000 and 20,000 adolescents on the streets of this city: the kids from the Koch pest­-houses like the Martinique, the Prince George; the kids off the Greyhounds, flee­ing predaceous families; and the kids shot out of the foster care system, New York’s sprawling pathology factory. The most desperate of them eventually land with a thud on the docks, where not even the salt in the air can preserve them.

For the past several months, these kids have talked to me about certain johns who heal them up as a sort of postsex purgative; about the perils of sleeping amongst the crazies at the shelters; about the crackheads and dealers who ride herd on the scene, picking kids off on the fly. But in a sense all of this is overkill, because if you stack it up together and pile on things like polyaddiction and double pneumonia, the sum total will not finish off as many of the kids I spoke to as their numb indifference to AIDS. According to the CDC, the number of kids nationally between 13 and 19 with full-blown AIDS cases has more than doubled in the last two years.

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Everyone on the docks has a pocketful of condoms. Project First Step, the outreach arm of the Hetrick-Martin Institute, dispenses them nightly with the strenuous injunction to please use them. But pull a kid aside, out of earshot of the pack, and he’ll tell you that (a) he doesn’t need them, (b) the johns won’t wear them, and (c) a rubber these days is just a bargaining chip — “they’ll give you five, maybe 10 more bucks to let ’em do it skin-on-skin.”

“In the first place, I fuck, I don’t get fucked,” harrumphs Arnie, the tall, haggard kid to whom Covenant House intro­duced me. “In the second place, I get sucked, I don’t suck. Does it sound to you like I need to put on a bag?” Actually, I tell him, it sounds like he needs to put on two.

“Nah,” he sneers, sliding down in his seat. “I’ve been out here running game going on like six years now. And every time they test me…” he clucks, giving me his stagey grin. “Clean as the Board of Health.”

“Twelve per cent of the older kids who come into our system test positive for HIV,” reports George Wirt, Covenant House’s tireless VP of Communications. That figure is staggering, matched up against the national infection rate of 4.3 per thousand, but, as Wirt says, “You really can’t even go by the 12 per cent. Most of the kids who’ve been out there hustling for any length of time don’t even come into our system. The real number has got to be significantly higher.”

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Covenant House is itself a telling gloss on the problem. For all its celebrated good works — and even its detractors agree that life in this city would be un­thinkable without CH’s interventions­ — the agency is notorious for giving gay kids a hard time. At the crisis center on 41st Street, effeminate boys are thrown in with the hardass straights, with the predictable result that some “get raped, or beat up, or harassed to no end,” says the director of another agency who de­clined to be named. And Joyce Hunter, the director of social services for the He­trick-Martin Institute, a small but ex­traordinarily effective agency whose charter is the protection of gay and lesbi­an youth, tells the story of a kid who once called her in desperate shape. “I referred him to Covenant House. Where else could I send him? He said, ‘If that’s the best you can do, I’ll take the streets,’ and hung up. That call still haunts me now. It’s why we decided to start this agency.”

And even as Covenant House beats the drum about teenage AIDS, it stands on its refusal to hand out condoms. Instead of safe sex, it preaches abstinence to these kids, proving that Catholic obscu­rantism isn’t dead, it’s just gone private sector. This isn’t to scapegoat Covenant House, which recently opened up a floor for homeless kids with AIDS, and is re­viewing its policy of lumping gays in with straights. The point is that, outside of a cluster of small agencies, these are kids without a port in a perpetual storm.

“No one’s set up for what’s about to come down,” warns Wirt. “Nationally, there’s God knows how many kids infect­ed right now. You’re going to need a whole array of new responses once those cases incubate.”

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Certainly, the old responses aren’t working; Covenant House loses two of every three kids who come into its care. The up-at-six-lights-out-by-10 Boys Town lifestyle can’t begin to compete with the street kid’s “deathstyle,” as Tru­dy Peterson, the director of the Streetwork Project, calls it. Peterson, a vivid blonde woman in her middle forties who’s been working with these kids for almost 20 years, says that what they’re aggressively engaged in these days is a kind of “slow suicide. ‘I’m gonna take a bunch of drugs, and I’m wiped out, and my immune system’s crazy, and it’s five degrees out, and… I’ll get in this car with three guys, knowing they’re sadists and will abuse me…’ ”

Kids are, by definition, creatures of the moment, oblivious to their mortality. But on the docks, the denial is double-walled. Behind the customary teenage omnipotence is the thick shale of grief and rage. “Virtually every kid I see here is a badly abused child,” explains Elizabeth Mas­troieni, Covenant House’s straight-shoot­ing AIDS educator. “So many of them were sold, or seduced, or beaten by their parents, or just flat-out abandoned… For a lot of [the kids], hustling is really a reenactment of what they grew up with, only now they’ve got the control. Instead of lying in bed helplessly waiting for the parent to come in, now they’ve got the power to say yes or no — and get paid money to do the thing, on top of it.”

By CH’s estimate, there are a million homeless kids hustling sex in this coun­try. In New York, they happen to be largely black and Hispanic, but in Miami and Fort Lauderdale they are overwhelm­ingly white. And in L.A., reports Wirt, just back from a fact-finding trip out there, the kids are in flight from split-­level houses. “We’ve never seen anything like it. There are little cities of kids thing under the Santa Monica Freeway.”

Nor does the thing hang neatly on the peg of sexuality. For every boy on the dock who acknowledges he’s gay, there’s another who’s vehement that he’s “got a girlie in Queens, and a little baby on the way.” No, the only thing these kids can be said to have in common is that they’ve been sabotaged by the very people life appointed to protect them.

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I WILL LIVE TO BE a hundred,” declares Diego, a sweet, expressive kid who bends like an antenna against the breeze. “I won’t get no disease, no one can’t hardly hurt me, ’cause life already used up all its bullets on me. If it wanted to finish me off, it woulda did so when I was four.”

We are walking the dock this balmy October evening, enjoying the false blan­dishments of Indian summer. Around us, the johns are positively buzzing, brought on by the mild air and some hallucination about romance. Diego ticks off their pre­dilections as they go by. “That one likes to get beat up a taste, got his own little custom-made paddle.… The blue Regal, he wants you to fuck his ugly wife for him, then go out and eat Mexican food with ’em after. And this knucklehead, he’ll take anything he can get, but what he really wants is for you to piss on his windshield. From his lips to God’s mouth, I say.”

We had been talking about his child­hood a moment ago, so when I tell him that his thing is evasion, he laughs out loud. “Oh, I can skate alright, honey! I’m the black Dorothy Hamill!”

 

The story that he unfolds is like so many others you hear that you catch yourself wondering if these kids share notes. There was his airtight relationship with his adoring mother, “who was to me like a saint, an angel on earth”; the fa­ther, a mailman who was so mean “he used to bite the dogs”; and there was Diego’s own sense, “from as early as I can remember,” that he’d been singled out of the family for the old man’s abuse. “I’m sorry, but I have to laugh,” he says, not laughing. “You’re going to beat my ass with a broom handle for something as two-cents as slurping my milk — and then an hour later come in and lay down with me? I know it’s not polite to say something against your family — but for that man, they should’ve brought back lynch­ing, baby.”

And your brothers and sisters? I ask. Did they come out of it alright?

“Pshuh,” he snaps. “They’re as happy as larks. Far as they’re concerned, none of this ever happened.” He pauses, peering down at the bright pageant of Christo­pher Street. “I guess I had to take the weight for the good of the family.”

That isn’t self-pity, it’s guilt, and it’s the deadliest addiction down here — this attachment to the idea that you’re the proper target of life’s sadism. Why, for instance, aren’t these kids selling crack instead of their bodies? Because dealing is an act of violence perpetrated against others; hustling your body to men who won’t wear condoms is an act of violence against yourself, a carrying-out of the sentence handed down in childhood. “Why the fuck should I hassle ’em to wear a rubber?” shrugged Chris, a very stoned metal kid in heavy leather. “I’m gonna be dead in two years, anyway.”

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ONE NIGHT IN LATE September, perhaps my second on the scene, I was walking up the dock taking the lay of the land when I heard someone shout, “YO, YOUR BACK!” I wheeled and saw three kids coming straight for me, closing hard and fast as linebackers. I froze, bracing myself for the hit, when a second shout brought them up short. They veered off right, hurling glares over their shoulders, and hopped the divider onto the highway. I put my heart back inside my chest and went to thank my benefactor, a squat black kid in two-tone denims sporting a fat welt over one eye.

“Ah man, fuck you,” he sneered, “I shoulda let ’em jay you, only I don’t need no 20 cops down here. I got like 60-something cents in my pocket tonight.”

I explained what I was doing, and of­fered to buy him dinner. He asked to see my press card. “Oh, this’ll make someone a nice souvenir. But you bullshittin’, I know you got back-up somewhere. You ain’t really out here by yourself.”

I assured him that I was, and on foot, to boot.

“Look around you!” he guffawed, sa­voring my stupidity. “You see all these hardnut crackheads? They ain’t here to get laid, they’re here to get paid, if you know what I’m talking about.”

There were kids sprawled sullenly on the hoods of cars; kids roaming the piers in packs of three and four, or huddled like cabals around someone’s boombox. Only at the far north end could boys be seen standing by themselves, arms across their chests in desultory attendance. “This ain’t Shangri-la anymore, this is 42nd Street South,” said Aubrey. “Any­thing up there, you can buy down here now. Drugs, car stereos, a whole trunk­load of guns — anything you want, except for pussy… but check back for that on Friday.”

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The joke reverberated. Just that eve­ning, I’d been talking to a couple of retail­ers on Christopher Street, whose bitter suspicion was that the cops were quietly redlining the West Village, pinching all the pandemic sins of Times Square down here. “Doesn’t the Sixth Precinct ever patrol this place?” I asked Aubrey.

“To protect who?” he snorted. “Ain’t nobody out here but a bunch of fags and baseheads.”

And into which of the two groups did he fall?

“Neither, nor,” he declared. “I’m a man with a plan. One day real quick, I’m gonna just… disappear.”

There was some thunder in that word, too. Trudy Peterson, whose love for these kids suffuses everything she says, told me that the hardest thing about her work “is that these kids just disappear. We don’t know if they went down to Florida to hustle, to Puerto Rico and their grand­mothers, or if they’ve been taken up to some rooftop by a gang and raped.”

Aubrey did in fact disappear — on his own steam, I hope — but not before I ran into him again that Friday night. He was standing by himself, looking like hell in a red hood, skeed off his ass on a crack­-and-smack jam. “Come here,” he said, hugging me. “I wanna show you something freaky.”

We walked down to the second pier. He pointed to a crawlspace about 40 feet out, where a kid was sound asleep perhaps a yard above the tide. “I never in my life been that fucked up,” he marveled. “I hope whatever he do tonight, he don’t roll over. That’d be a wet dream-and-a-half, boy!”

He was still tittering about this 10 min­utes later, wondering whose life would pass before your eyes if you drowned out there, your own or Charlie the Tuna’s, when the laugh suddenly caught in his throat. “Ho, shit, here comes the fastest way to die.”

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He pointed discreetly with his chin to a baby Benz sedan. which was circling the dock slowly, in a sort of taunting, Dave Parker trot. Its windows were down, revealing three b-boys in black, fronting enough gold to float a municipal bond issue. They sprayed the scene with their 12-gauge glares.

“Which one’s the dealer?” I asked.

“What, are you gonna go interview him?” he sneered. “Yo, man, quit lookin’ at ’em! You got detec written all over you. If they see me even talking to you about ’em…”

We averted our eyes as the Benz made another pass, then peeled out onto the highway, serenading us with the gentle strains of NWA:

Fuck the police, and Ren said it with authority 
’cause the niggers on the street is a majority
A gang is with whomever I’m stepping
And a motherfuckin’ weapon is kept in
A stashbox for the so-called law
Wishin’ Ren was a nigger they never saw…

“That was Markie’s crew,” said Aubrey. “He’ll send ’em after you if you’re like even five minutes late — and those niggers don’t even play.”

“Does Markie run the show down here?”

“Not really, he stays on the uptown tip. But some of these hardnuts go up and get 50 bottles [vials] offa him, then smoke the shit and don’t come back with the $200. That’s how niggers get shot down here.”

“Are there a lot of kids getting shot?”

Aubrey fixed me with his ready glare. “All these motherfuckers they be pulling out the river — what do you think, they fell off their yacht?” He wagged his head sadly, then murmured, “Dag, but that Benz was slammin’, though. All the mon­ey I made out here… I coulda bought that car three times.”

“Where is it all now, Aubrey?”

Wise and world-weary and, like so many street kids, theatrical, he waits two beats before saying, supremely, “Me, I might be crazy, but I ain’t stupid. I pay homeboy in full.”

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“THERE ARE KIDS TURNING up dead all over the city,” says Covenant House’s Mastroieni. “Sometimes, when cops find a body in a lot or a construction site, they’ll know to call us first. We keep a file on every kid we see here… very often, we’re the only ones who can identify a kid — or care to.”

A kid running the docks, she points out, is terribly vulnerable, the perfect crime waiting to happen. “They work by themselves, they’ve got no I.D., [and] they’re high out of their minds most of the time.… If you’re a dealer and a kid stiffs you, you can make a quick example of him for $20. And if you’re a john and you want to take a kid to Jersey and bury him — well, it’s not like he’s got a partner jotting your license number down…”

“Please understand that we’re trying to maintain good relations with the police,” says Mastroieni. “And generally we do. There are some very honorable cops out there, cops who tip us off when they see one of our kids where he isn’t supposed to be. But most of them?” she sighs. “Most of them don’t give a damn about these kids. As far as they’re concerned, who­ever’s killing them is doing the Lord’s work.”

How does a skinny 17-year-old stalked by johns and dealers defend himself? By arming himself, quite literally, to the teeth. There isn’t a kid out there without a gun or a knife, or at any rate a single­-edge secured in imaginative places. Bob­by, a delicate kid sitting on the hood of a Dodge, showed me how to conceal a razor blade between cheek and gum (“Keep the sharp side down, and don’t smile too much”). He told me what had happened to him and his lover, Raymond. They were walking west on Charles, “drinking a beer and smooching to try and stay warm,” when suddenly they were set upon by a carload of kids. “I’m not saying they didn’t fuck me up good — they did­ — but I know at least one of those boys will never forget me. I cut his shit from yay to yay, and the blade was rusty, too.”

Raymond, however, came away so banged up he had to go back to Puerto Rico. “He was really a nice guy, and I never expected that… I never had no one treat me with that respect before. And between us, we had like a little room in Flatbush. It wasn’t much, but at least I wasn’t out here till no four a.m., trying to get someone to take me to his place so I could catch a shower.”

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IF IT’S FAIR TO CALL kids living from trick to trick slow suicides, what do you call the grown men who cruise them? Write a piece on the johns, implored one outreach worker after another, meaning by all means bash those bastards. But the request betrayed a certain curiosity as well — who are these men, and why are they out sniffing after kids — and sad, sick, addicted kids at that?

“Ninety to 95 per cent of [the johns] are married men with families,” says Pe­terson. “They’re Boy Scout leaders, store managers, executives — men with money… One kid said to me, ‘You know, they open up their wallets to pay me, and I see pictures of their children in there and I think, if they’re paying me to do this, what are they doing at home to their own kids?'”

At 3 a.m., when the exchange rate on the pier is a bottle of crack for a blowjob, it’s the john who like as not is supplying the crack; the john who spurns the kid’s choke roll of condoms; the john who boosts the ante from sex to sadism. Al­most every kid I talked to, from the piers to Port Authority to the loop on 53rd Street, said he has at least one regular who engages him to do the “wilder thing,” i.e., the sort of act that only the most unfettered mind could construe as carnal. There is Peter, the lantern-jawed kid in greasy jeans, whose “Friday guy” forks over $200 to be yoked to two poles in the back of his van and have his nip­ples pierced with an ice pick. There is Maurice, who gets paid “stoopid money” to shit on a hot dog roll and make his client eat it.

I want to make it thuddingly plain that we are talking about so-called straights here, men whose sexuality is the ticking bomb under their two-family colonial. “Some day,” Peterson worries, “some guy’s going to wake up with AIDS, and give it to his wife. Then he’s going to come over here with a gun and shoot 10 street kids.”

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Given the fixity of their death wish — ­there are johns buying boys with conspic­uous lesions on their arms — it is impossi­ble that “some guy” hasn’t already awo­ken to that discovery. But what Peterson is putting her finger on is the john’s ca­pacity for projection, driving the stake of his self-loathing through the hearts of these kids. “With the transvestites, you know, the johns like to punch them in the crotch,” says Mastroieni. “The kid’s roll­ing around in agony, and the john’s up there laughing, going, ‘Hey, I just wanted to make sure you were a boy.’ ”

The other fraction of the john popula­tion, out gay men, tend to be vastly more benign to the kids. Many form attach­ments to their “steadies,” bringing them home for several days or even a stretch of weeks before the thing craps out over drugs or house rules. They’ll take a kid out to dinner, or occasionally pick him up a shirt, no small favor for someone who’s been wearing the same thing all week. Whether it’s empathy or romance or a rescue fantasy, something quite the ob­verse of sadism seems to obtain here.

The kids I spoke to were by and large grateful for these affairs, but the experi­ence of being cared for was also terrifying to them. On the one hand, they’re hungry for it, no matter how long they’ve been out here; on the other, they’re clinging fast to their hard boy swagger, to that uptown street affect by which they sur­vive. “I do what I gotta do,” goes the dogma of West Street, “but I damn sure ain’t nobody’s toy-boy.”

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“I’M A PRETTY NORMAL person. I wouldn’t consider myself a sex fiend,” says Peter. “But when I’m on that pipe, all I can think about — bang! — is fucking. Fucking, smoking, and fucking some more. And I’ll tell you what — when that head comes over me, I gotta go some­where and beat my meat, ’cause otherwise I’m liable to kill someone.”

In the centrifuge of crack, everything flies apart: neighborhoods, families, per­sonalities. But the drug also has an insid­ious side effect that hasn’t been suffi­ciently well-documented. Smoked in even modest amounts, it can be just a crazy­-making aphrodisiac, wiping all the other imperatives off the board. It’s like an infusion of pure id every half-hour — and these kids aren’t exactly overloaded with superego to begin with.

“Because of crack,” says Peterson, “there’s more sex and more desperate sex: multiple-partners, orgy-type sex in crack houses.… The drug itself drives you to it. You don’t care how many arms and legs and asses — the more the merrier.”

“Look at these people out here,” Diego sniffs. “They don’t care what they look like, they don’t care what they smell like — crack whores, that’s all they are.… You come down here with 20 bottles, it doesn’t matter how old and ugly you are, you’re the Pied Piper of West Street.”

The only thing that’s dropped faster than the price of drugs in this city is the price of street sex. “I used to make good money out here, and I’m talking 50s, 100s,” says Diego. “Now, the johns drive up, they don’t even say hello. They just go, ‘Hey, you got a stem (a crack pipe) on you?’ And if you say yes, right then and there they know they got you… Three, four hits, you’ll be up in the back seat like a slave — you might even get out that car with no money. This boy Rickey talk about, ‘Oh, that man spent $300 on me.’ Really? I don’t see it. ‘Well, it was $300 in rocks.’ Oh. So you’re up in the room with him talking about six, seven hours, and when you came down you had to hop the turnstile to get back here,” Diego chortles. “I guess that’s why they call it dope.”

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Covenant House refers to this disas­trous tit-for-tat as “survival sex,” as if kids were blowing johns to keep a roof over their heads. CH ought to know bet­ter. Certainly, its outreach people do. Making the rounds in their baby blue vans, they see the same boys out there night after night — strung-out, exhausted, the odor of the subways upon them. The kids descend upon the vans in their em­barrassed way, ostensibly for a cup of cocoa and a peanut-butter sandwich, but also to talk to someone like Veronica DiNapoli.

A four-year outreach veteran, DiNapo­li’s blend of tact and tenderness often opens kids up on the spot. They hug her and hold fast to her hand or her sleeve as they pour out their sad packet of lies: Veronica, didja hear, I’m going away to college… Veronica, Herbie told you we found this fly spot in Queens? And she listens to it all, treading delicately around their claims, because she knows that’s all they have. On a particularly cold night, several of them will consent to come back to the residence, or take a ride to the hospital for the gash in their forearm. But these are children whose hope and trust have been ripped out like cables. In every blessing, they have been taught to suspect a beating.

“It’s so sad,” says Liz Russo, the tough, pretty former director of Hetrick-Mar­tin’s outreach team. “They get battered at home, they get battered in their neigh­borhoods, [and if] they’ve been kicked out by their parents, they get battered in the group homes… That’s why so many of them are down here in the first place­ — they actually feel safer on the docks.”

Even by the standards of this shame­less city, it is disgraceful that there is no sanctuary for homeless gay kids. In Los Angeles, a town not known the world over for its benevolence, there are several such places, notably Lois Lee’s group res­idence Children of the Night. In San Francisco, kids converge on Project Stepping Stone, a crash pad with staff in the Tenderloin. But in New York, it is either Covenant House or the East Third Street Men’s Shelter, where kids stand about as much chance as goldfish in a shark pool.

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What they need is a place that’s uncon­ditionally theirs, that welcomes them in all their pain and complexity. There’s been some talk among the loose consor­tium of small agencies about acquiring a space, but the thing is miles beyond their grasp. No, this is a matter for the next HRA chief, who can either start looking around for a facility downtown or laying in a supply of caskets for the new year.

In the meantime, the kids will go on wintering on the E train, or at a certain all-male theater in the West Village. Said one kid who’s passed his share of nights there, “You go in expecting to see a whole bunch of bizarre sex going on, and in­stead it’s all these young kids knocked out sleeping.… In the middle of February, you’ll be glad they let you stay there, but those seats get hard on your ass, boy.”

Ignoble as that is, it’s high living compared to last year, when kids slept in the backs of reeking garbage trucks, or in the Department of Sanitation’s salt storehouse on 16th Street. “They had the most casual rats in there,” Diego winces. “Big-ass ones that just walked right up to you and started chewing on your shit… If you count my father, I’ve slept with sick, dirty bastards for 13 years, but rats I cannot work with.”

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ONE NIGHT, THAT FIRST bitter stretch after Thanksgiving, I took a ride up to East 53rd Street. The Loop, as it’s known, used to be the Ritz of rough trade: clean, pretty boys, the majority of them white, available for the delectation of more discriminating palates. Enter crack, the great leveler. Such kids as have managed to steer clear of the pipe now do their business inside the bars, leaving the streets to the Dead Boys and the newly addicted. You see them staked out in doorways or phone booths, skinny and windburnt in their thin nylon jackets.

They tend, however, not to show up much before 3 a.m., working the docks and the ’Deuce for the earlybirds. So, just before midnight I walked the neighbor­hood looking for stragglers. I turned up 55th Street, marveling to myself at the high-speed sociology of crack, when I saw a kid skulking in the shadows. I’d been mugged just the week before, nailed as I left the piers by a bunch of kids yelling “Faggot!” so I broke left on instinct, cut­ting him a wide berth. As it happened, he was weeping. I came near, guilty and so­licitous, and saw a small Spanish kid with a flat, round face, hugging himself inconsolably.

“What happened?” I asked. “Did someone hurt you out here?”

Startled, he came out of his half-crouch and fixed me with a look that I will never forget. He had the heartbreaking eyes of an abandoned baby, wild and illingual in his pain and terror. He was convulsing in sections, his left and right sides going at cross-purpose spasms. He teetered against the building on stork legs. “Mau­rice!” he screamed at me. “Maurice, the motherfucker! I was ’sposedta been high from three hours ago!”

I backed up and look off down the street, looking for a cop, an ambulance. But the only thing that met me coming up Second Avenue was the wind making its announcement to Diego, and to Au­brey, and to Dead Boys everywhere, that winter, in all its maleficence, was here.

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The Money Trail

THIS IS THE LAST ARTICLE IN A SIX-PART SERIES

The woman stood at the mike, her hands shaking but voice steady as she told her story. She had already begun treatment for HIV when her baby daughter tested positive for the virus. At a time when her life was slipping into chaos, she now had to leave the doctors near her Bushwick home. They weren’t funded for pediatric AIDS care, so she and her baby would have to travel to Manhattan for treatment.

“I find it ridiculous that I can’t get family services care,” she bellowedinto the mike. “We should not have to settle for the crumbs that fall from larger groups in Manhattan.”

Behind her, other people living with AIDS and AIDS advocates waited in a growing line to speak last month at a public hearing organized by a coalition of Brooklyn community groups. Residents of East New York, Flatbush, Brownsville, and other Brooklyn neighborhoods told their congressional representatives about the difficulty of finding AIDS services in their areas.


“You had a wonderful mix of federal government, corporate funding and private foundations, individual funding and Hollywood interest. That’s not there now that the epidemic is blacker, browner, younger, and female.”


Mostly, they told of traveling to Manhattan by subway or paying as much as $40 for a taxi ride—a choice often dictated by their health—to get medical care, groceries and meals, counseling, or other necessities to keep them going another week.

In terms of AIDS funding, community-based organizations (CBOs) have seen the best of times and the worst of times during the last few years.

AIDS funding from public sources has been growing since the early days of the epidemic. In 1999, the New York City Department of Health allocated $11 million to organizations doing prevention work; the state health department spent $147 million for AIDS programs and services. Meanwhile, last year, the city received $97 million in Ryan White CARE Act money for medical care and services for people with AIDS. Other federal funds pay to house people with AIDS and to prevent the disease.

But some activists see the great era of AIDS funding, especially from private sources, coming to an end just as the epidemic is hitting communities with fewer resources. Advocates also question whether public funding increases are keeping pace with the epidemic. For every $10 the federal government spent on AIDS in fiscal year 1999, only 80 cents went to prevention. And as the Brooklyn funding crunch shows, the existence of government funding does not guarantee that it will always reach needy communities.

“You had a wonderful mix of federal government, corporate funding and private foundations, individual funding and Hollywood interest,” says Philip Hilton, senior vice president of the National Black Leadership Commission on AIDS. “That’s not there now that the epidemic is blacker, browner, younger, and female.”

That’s why Brooklyn organizations are so alarmed. The borough has the largest number of blacks with AIDS in the city. Yet in 1998, the city defunded 16 Brooklyn groups and three hospitals that provided local AIDS services.

The coalition claims that Brooklyn’s funding dropped from $9 million in 1995 to about $7 million in 1998. And the groups that were not re-funded may not have another shot until the city opens the process again to new bidders, which won’t take place for several years.

This happened even though the planning group charged with deciding how the city spends much of its Ryan White funds wanted to assist groups serving needy communities. “The money is supposed to follow the cases, but that hasn’t been happening,” says Dee Bailey, coordinator of the Brooklyn United Community Coalition, made up of groups throughout the borough. “In Brooklyn, the AIDS cases are traveling to Manhattan.”

The dollar amounts may be less than what Manhattan received, but according to the city, Brooklyn got more than a third of borough-based contracts. “We felt it was important to give new agencies a chance to serve populations that they think it important to serve,” says Department of Health spokesperson Sandra Mullin. “That meant some agencies didn’t have the renewals of funding that they would have liked.”

CBOs have learned that securing AIDS funding, from governments and private foundations, isn’t just about how good the programs are, but how well they ask for money.

Brooklyn leaders acknowledge that some groups looked at the Ryan White application and realized that they didn’t have the resources to put together a winning bid. Others couldn’t compete with larger or older groups that have more grant-writing experience. “African American organizations didn’t have the wherewithal to get those dollars,” explains Tokes Osubu, network coordinator at the East New York/Brownsville HIV Care Network, which offers advice and assistance to AIDS organizations in the area. “Our agencies don’t have the capacity or the resources to devote to fundraising.”

In 1998, the Congressional Black Caucus secured $156 million in federal AIDS money for racial and ethnic minorities. This is just a start, say AIDS advocates, because the money, split nationwide among so many interests, including treatment, planning, and prevention, isn’t a lot.

But community groups will take any help they can get. Organizations doing fundraising have been essentially casting in a drying stream, as foundation contributions for AIDS continue to dwindle. Between 1997 and 1999, grants of $50,000 or more were down 22 percent, according to Funders Concerned About AIDS, a philanthropy advocacy group. Most foundations expect to decrease or hold steady their AIDS funding.

Interest in AIDS philanthropy has been on the wane as the public grows weary after 20 years of writing checks. Likewise, new therapies make people believe the crisis is over. “Even though we still have benefits and big-ticket fundraisers, it tends to be large institutions like Gay Men’s Health Crisis. Small minority organizations tend not to be able to pull that off,” says Paul A. Di Donato, the group’s executive director.

Now an unexpected source of revenue has answered the call—pharmaceutical companies. More of them find that funding local groups is a good way to get their brand names in the community. Bristol-Myers Squibb Immunology, for instance, is currently sponsoring an 18-week program called Test, Link, Care, which tests Harlem residents for HIV and counsels them either in prevention or treatment depending on the results.

These new business-community partnerships are not without controversy though. “Pharmaceutical companies sometimes want a particular message about the effectiveness of their drug, whereas the community group may not think that’s the message that they want to convey to the community,” explains Odell Mays, vice president of Community Access, a direct-to-patient education company that coordinated the effort in Harlem.

To fight AIDS in the black community, local groups will have to get a larger share of the remaining funding. “I don’t know if we are tapping into the nongovernment sources,” says Osubu. “Money is out there, but not many [CBOs] know how to tap into those dollars.”



AIDS AND BLACK NEW YORKERS, A SIX-PART SERIES:

Part I: Emergency Call by Kai Wright
How AIDS Is Hurting Black Communities

Part II: Black, Gay, At-Risk by Kai Wright
Homophobia, Racism, and Rejection Fuel Rising Infections

Part III: The Tuskegee Effect by Kemba Johnson
For Blacks, a 28-Year-Old Study Is One of Many Barriers to HIV Prevention

Part IV: Double Jeopardy by Kai Wright
In NY State Blacks Rank Highest Among HIV-Positive Inmates

Part V: Black Women and HIV by Sharon Lerner
Rising Infection Rate Reflects an Age-Old Gender Imbalance

Part VI: The Money Trail by Kemba Johnson
Dollars Don’t Always Follow New Trends in AIDS Cases

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Black Women and HIV

THIS IS THE FIFTH ARTICLE IN A SIX-PART SERIES



By the time she found out she was HIV-positive, Millie Ross was already used to hardship. She had gotten pregnant at 13, married at 14, dropped out of high school, been battered and cheated on. Even so, when she got her test results in 1988, pregnant with her third child at 24, HIV seemed like the end of the road. “It was just crash and burn,” remembers Ross, shaking her head. She hadn’t understood how to protect herself against the virus, which she—and most everyone else back then—thought of as a gay men’s problem. And even if she had known what to do, doing it was another matter. “There was no way I was going to be able to ask anyone to wear a condom,” she remembers.

Twelve years later, much has changed. A health educator with the Brooklyn-based AIDS group Life Force, Ross now talks about condoms and the intricacies of sex seemingly without the slightest hint of embarrassment. (“Condoms come in colors, flavors, sizes, they come in magnum—14 inches if that’s what you’re dealing with,” she booms to one group of women.) The son who had been growing in her belly when she got her diagnosis is 11, old enough to run down to the pharmacy and pick up the prescriptions that have kept Ross fairly healthy. He is HIV-negative, a fact Ross considers “a blessing.”

When she gave birth, no treatments were available to reduce the roughly 25 percent risk she would transmit the virus to her son. These days, drugs, sometimes along with cesarean deliveries, can lower that risk to below 2 percent. And cocktails of the new antiviral medications can all but eliminate the virus, as they have in Ross’s own bloodstream.

But even as scientists make huge strides forward, some things have not changed—not enough to stem the spread of HIV among women, anyway. While safe sex has been famously successful in fighting AIDS in some gay, male communities, the age-old power imbalance between the genders has stubbornly stood in the way of efforts to protect women. Still, women don’t have a widely available prevention method they can control themselves, and many feel unable to request—let alone demand—condoms for fear of violence or being abandoned.

The most recent data reflect this persistent power imbalance: Women represent a growing percentage of new HIV infections, now 30 percent nationwide. Black women, roughly 15 percent of the population in New York City, now account for 19 percent of all new AIDS cases reported in the city, up from 5 percent in 1983, according to the city Department of Health. Even though sex has recently outpaced drug use as the primary mode of infection for black women in New York City (when you include cases of probable heterosexual transmission along with proven ones), fears and behavior tend to be caught up in dated ideas about danger.

“We’re still trying to pigeonhole who’s at risk, even though the numbers clearly show we’re all at risk,” says Debra Fraser-Howze, president/CEO of the National Black Leadership Commission on AIDS, which supports African American leaders in the fight against AIDS. That means that women might consider themselves safe if they don’t inject drugs, even though they may still be exposed to the virus through sex.

Ross tackles such denial head-on when talking to patients in the waiting room of a Brooklyn OB-GYN clinic. “You don’t have a beeper on your man’s penis,” she warns, as some women shift in their seats and shoot wide-eyed looks at each other. “When he goes to the back door to get a delivery, you don’t know if the UPS girl has a big butt and a smile or just a package.”

If all women would prefer to deny the possibility of their risk (and the UPS woman), some women are even less likely to consider themselves vulnerable. Among Haitian women, for instance, discussion of AIDS is still very much taboo. “They try to avoid the topic altogether,” says Lorna Fairweather, director of social services for the Caribbean Women’s Health Association. “Those groups that make their voices heard will be visible, and money flows into those communities,” says Fairweather. In contrast, the relative silence, she says, means both less money and lower awareness.

Older black women also seem to fly beneath the radar of public consciousness. For the first time, more than 30 of the 230 women with AIDS who receive supportive services—from housing assistance to case management—at Iris House in Harlem are over 55; some are well into their seventies, according to Marie Saint Cyr, executive director of the agency. Yet, says Saint Cyr, “prevention hasn’t reached older women because we don’t look at them as sexually active individuals.”

The effects of illness tend to ripple outward for these older women, who, like many women, spend much of their lives tending others. “Grandmothers have often stepped in to take care of their grandchildren when their parents have become sick or died,” says Saint Cyr. “If they are getting infected, where do we go from here?”

Iris House also assists women with custody planning, arranging for their children to stay with friends or other relatives if their mothers or sisters are unable to help (as is often the case). Though women may be even less inclined to think about what their children will do without them as their medical outlook improves, Gloria Morales, who handles custody planning for Iris House, says women still need to face the likelihood of ill health and even death. “If they don’t plan, the child may end up in foster care or with someone who’s not responsible,” she says. “We’ve had it where they’re in here on Friday and Monday we get the call that they’ve died.”

Indeed, family responsibilities may in part explain why the new medications have yet to bring about as significant a drop in AIDS deaths in black women as they have in others. While the overall death rate for people with AIDS declined by 91 percent between 1995 and 1999, after the introduction of new drugs, the decrease among black women was about 88 percent.

So far, there is no medical explanation for the difference, only the fact that women’s hectic caretaking schedules can make taking medications as prescribed extremely difficult. There’s some evidence that women who had recently given birth became less consistent about taking their own medications. And the problem of getting child care or a ride to the pharmacy can also stand in the way of compliance. Such complications of being female may also contribute to women’s underrepresentation in clinical trials of AIDS drugs.

Another part of the explanation is the heavy burden many black women face. “If you have to worry about whether you’re going to be able to pay your rent or how you’re going to feed your kids, you’re not thinking about getting tested for HIV,” says Gwen Carter, Life Force’s executive director. Consequently, participating in a drug trial becomes even less likely.

Millie Ross tries to encourage women to clear these hurdles. “Become empowered, ladies, and get tested,” she says to the group of women in the waiting room. “Today you guys have lots and lots and lots of options.”



AIDS AND BLACK NEW YORKERS, A SIX-PART SERIES:

Part I: Emergency Call by Kai Wright
How AIDS Is Hurting Black Communities

Part II: Black, Gay, At-Risk by Kai Wright
Homophobia, Racism, and Rejection Fuel Rising Infections

Part III: The Tuskegee Effect by Kemba Johnson
For Blacks, a 28-Year-Old Study Is One of Many Barriers to HIV Prevention

Part IV: Double Jeopardy by Kai Wright
In NY State Blacks Rank Highest Among HIV-Positive Inmates

Part V: Black Women and HIV by Sharon Lerner
Rising Infection Rate Reflects an Age-Old Gender Imbalance

Part VI: The Money Trail by Kemba Johnson
Dollars Don’t Always Follow New Trends in AIDS Cases

Categories
NEW YORK CITY ARCHIVES NEWS & POLITICS ARCHIVES NYC ARCHIVES THE FRONT ARCHIVES

Double Jeopardy

THIS IS THE FOURTH ARTICLE IN A SIX-PART SERIES

“It’s been a slow night. We’re looking for sex workers, people living on the street, or users out looking for a fix. But we see only cops–and that worries everybody,” says Frenchie Laugier.

“Mama, you need condoms?” Laugier belts out when she finally spots a regular. “Sure, but dry,” the woman responds–she’ll be giving some blow jobs, and doesn’t want the lubrication.

Laugier also gives the woman a hot meal, a tuna fish sandwich, and some canned goods; then she throws in a scouting report on police in the area. “Be safe, honey; there’s a lot of po-po around.”

It’s learned advice. Laugier, a Latina, spent seven years upstate on drug distribution charges before coming to work for FROST—From Our Streets With Dignity—four years ago. She knows what people face in “the [prison] system,” which, to her, is just an extension of the streets.

Back in the van, Laugier and her partners—the driver, Alan Riddle, a black man who is a cabbie by day, and the chef, another Latina, formerly homeless, who asked not to be identified—continue their search for the regulars.

Finally, around midnight, a group of homeless men and women surface—they are all black, Latino, or a little bit of both. Laugier feeds them and is now comfortable calling it a night; she knows where to find her “babies” tomorrow, and she knows they’re not back in jail.

The lives of African Americans and Latinos overlap greatly. They make their homes in the same neighborhoods and face similar social pressures. Among the things they share most intimately is a difficult relationship with the criminal justice system. Both are heavily overrepresented in the prison population. As of 1997, 1 in 31 black men and 1 in 79 Latino men in the U.S. were serving time.

The truth behind these numbers is complicated. It includes everything from sentencing laws that excessively punish petty drug crimes to overaggressive policing of minority neighborhoods to cyclical poverty that drives many in those same areas to nonviolent crimes born of economics. And not surprisingly, HIV has burrowed into the populations that the numbers represent.

The resulting prison epidemic offers a magnified view of the disease’s impact on black and brown communities and reveals one more stealth route for the virus’s continued spread in minority neighborhoods.

Laugier’s clients are and have been the core at-risk group for HIV since the beginning of the epidemic. They are primarily injection drug users and sex workers—from straight women to transgender women to men having sex with men. They are people whose daily existence is shaped by the most risky behaviors for transmitting HIV on one hand, and an ongoing game of cat and mouse with the police on the other. So, there’s little wonder that the HIV infection rate in New York State prisons is higher than in any geographic area in the state.

According to the U.S. Department of Justice, prisons statewide have both the highest number of HIV-positive inmates in the country, around 7500 at the end of 1997, and the highest HIV infection rate—close to 11 percent of all prisoners are infected. In New York State, blacks and Latinos, are hardest hit, representing 48 and 45 percent respectively of the prisons’ HIV-positive population. Whites account for 7 percent.

“Drugs. Streets,” Laugier deadpans when asked to explain these numbers. “They’re in prison because they’re from the ghettos. The same forces that put people of color in jail,” she explains, “spread HIV.”

John Anthony Eddie, Peer Training Institute coordinator for the Staten Island AIDS Task Force, agrees. “The jail population is a direct reflection of what is happening in the greater society in terms of HIV and AIDS.” Eddie runs an HIV peer education program at the Arthur Kill Correctional Facility on Staten Island.

Every Tuesday morning, he greets about 40 new inmates and gives them an HIV 101: Use clean tools for tattoos, protect yourself when having anal sex (the state doesn’t provide condoms, so inmates often fashion makeshift rubbers from latex gloves), and come see the Task Force for help when you get out.

What happens when ex-offenders transition from prison back to the block is an area of great concern for those working to stem HIV’s spread in black communities. It’s unclear whether more people are getting infected while in jail, or if they are just finding out about their infections while locked up. Either way, because many prisoners do test positive for the first time while behind bars, programs like Eddie’s seek to capture their attention before they return to their neighborhoods—where they are likely to conceal an infection and return to at-risk behavior.

The question of how HIV-positive prisoners will behave when they reenter the community, with or without knowledge of their HIV status, is central to stopping the epidemic. “When I come back, it’s not like there’s a big stamp on my forehead telling everybody I’m positive,” says Lanere Holmes Rollins, who runs ACE Out, a group of female ex-offenders who do HIV prevention work in their communities. “I’ve been in prison working out, I look good, I’m physically fit. What do you know?”

Rollins’s colleague Antionettea “Dready” Etienne, like Laugier, was a member of the now famous ACE program while incarcerated at Bedford Hills Correctional Facility in Westchester County. The program is a national role model for peer education on HIV in prisons, having produced countless women such as Dready (as she prefers to be called) and Laugier and spawned replicas in both male and female facilities around the state. As a result of the program’s success, New York’s system is widely considered one of the best at educating inmates on HIV, providing services for those who are positive, and easing their transition back into the community.

Rather than focusing on those living on the street, Dready targets young people and the drug lords they look up to. These teens are the sort who overlap with current and ex-offenders and form the link between HIV in the prison and HIV on the block. “When we talk to kids, we don’t just go in there flappin’ about HIV,” Rollins explains. “We talk about how it’s connected to drugs, how it’s connected to violence, how it’s connected to jails. Then they can relate to that. And they can relate to how that girl who’s all up in the drug dealer’s face ’cause he got a lot of gap in his pocket and drives a nice car might be willing to open her legs to him, not even realizing he might be HIV-positive.”

But as with so many ills in the community, Dready says the biggest roadblock is that many of the teens she meets don’t have much of a vision for tomorrow or much faith in their ability to survive to see it. Again, the forces that push some to commit the crimes that are sending black and brown people to prison erode others’ belief that protecting themselves from HIV is worth fretting about.

“Some of them really have some powerful dreams and goals,” Dready sighs, “but they don’t have the feeling that they’re gonna make it to see them accomplished.”

“I talk to kids who feel if they make it to 25 they’re old.” says Rollins. “They believe,’If I make it tomorrow, yo’ man I’m good.’ There’s something wrong with that.”



AIDS AND BLACK NEW YORKERS, A SIX-PART SERIES:

Part I: Emergency Call by Kai Wright
How AIDS Is Hurting Black Communities

Part II: Black, Gay, At-Risk by Kai Wright
Homophobia, Racism, and Rejection Fuel Rising Infections

Part III: The Tuskegee Effect by Kemba Johnson
For Blacks, a 28-Year-Old Study Is One of Many Barriers to HIV Prevention

Part IV: Double Jeopardy by Kai Wright
In NY State Blacks Rank Highest Among HIV-Positive Inmates

Part V: Black Women and HIV by Sharon Lerner
Rising Infection Rate Reflects an Age-Old Gender Imbalance

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The Tuskegee Effect

THIS IS THE THIRD ARTICLE IN A SIX PART SERIES

Where the northern tip of Central Park brushes Fifth Avenue, AIDS educators from seven Harlem groups are combing the streets, trying to drive home the message of HIV prevention. They wish it were going better. Two months into an 18-week pilot program, “Test, Link, Care—A Community Partnership,” only half of those who took a free HIV test have come back for the result.

“You can’t prevent what you don’t know,” says Odell Mays, program officer at Community Access, a health-care communications firm, which is coordinating the TLC street outreach in East and Central Harlem. “It’s about protecting your loved ones,” he says. “You can’t do that if you don’t know [your HIV status].”

These outreach workers, and others around the city and state, are realizing that HIV prevention is no longer just about handing out health information but about understanding the barriers to acting on that knowledge.

But it’s not that simple in the black community, where there’s a great deal of medical mistrust—much of it related to the infamous 40-year government-funded Tuskegee Syphilis Study, conducted by the U.S. Public Health Service from 1932 to 1972, in which 399 black men in Alabama were purposely left to die from untreated syphilis.

“As long as we have people still alive who remember, who can say ‘Tuskegee’ and know what that means, we will have people who will have a problem [overcoming that mistrust],” says Deborah Levine, vice president of the health initiative at Harlem Congregations for Community Improvement (HCCI). “I tell people, ‘Yes, it did happen. Yes, the government did try to pull the wool over our eyes. But this is different, we want you to know your HIV status.’ ”

AIDS educators are fighting more than just the shadow of Tuskegee in black communities. Poverty, poor education, homophobia, widespread denial, hopelessness, and religious conservatism are a few of the reasons why many black New Yorkers are not protecting themselves, even though they may know how to. Add to this a lack of emphasis on, and resources for, prevention in the nation in general, and the result is deadly. So deadly, in fact, that in 1999, 51 percent of those newly diagnosed with AIDS in New York State were black.

Many black AIDS activists lay much of the blame for the crisis at the steps of the black church, long a cornerstone of the community, which some contend waited too long to flex its muscle on the AIDS issue. “Churches were feeling a tension between abstinence and prevention; they would say things like ‘We ain’t got any gay folk in our church,’ ” recalls Reverend James Booker, an AIDS outreach coordinator with HCCI and a pastor himself at Allen Temple A.M.E. in Mount Vernon, New York. “But now the choir members, deacons, and ministries are getting sick, and they don’t necessarily fall into the stereotype.”

HCCI has been training interested churches in its 90-member association on HIV issues and prevention, helping pastors, deacons, and other church workers become more compassionate volunteers and better AIDS educators. It’s a prevention message with a decidedly Christian feel, complete with scripture-backed slogans. “Everything doesn’t have to be so graphic or explicit to get your message across,” adds Levine.

Church leaders are realizing that you can’t save parishioners who are no longer alive. “Jesus didn’t say, ‘Now, wait a minute, how did you get leprosy?’ ” Booker points out. “It’s hard to run a revival in a graveyard. I think folks’ attitudes have changed.”

But getting the chair of the usher board to think that AIDS could enter her life—let alone her body—is a different story. Frankly, even though the disease has hit black communities hard, many deny that AIDS will ever touch them personally, even if a friend or relative is HIV-infected, or has AIDS, or has died from it. Some of that denial is internal classism, where middle- and working-class blacks believe AIDS is the problem of junkies and unwed mothers having lots of babies. Some of it is also the legacy of an early, effective HIV prevention campaign targeted to the gay community which left the lingering, incorrect perception that AIDS is a gay white disease.

From 1992 to 1993, a Brooklyn-based minority health education group, Health Watch Information and Promotion Service, set out to take the pulse of the black community about HIV prevention and AIDS. With funding from the state health department, the group assembled 24 focus groups, conducted 92 interviews with health professionals, and held follow-up sessions with black subgroups, including adolescents, gay and bisexual men, heterosexual men, substance users, and women to elicit feedback about its proposed prevention strategies.

However, Health Watch’s recommendations to the state’s department of health mostly went nowhere. But its findings are still valid for those picking up the AIDS prevention mantle in black New York. One common thread is how closely racism, poverty, low self-esteem, and hopelessness are interwoven into the AIDS crisis in the black community. If people don’t believe a positive future awaits, how motivated will they be to protect themselves or their partners?

Some black heterosexual couples are also locked into a disturbing catch-22. Health Watch’s project showed that most black women (one of the fastest-growing groups among new AIDS cases) want their partners to use condoms. But they may not speak up for fear of physical or verbal abuse, or losing their partners when so many young black men are caught up in the criminal justice system or otherwise ineligible.

“We have to recognize that in a society with few eligible men, she may sacrifice her self-esteem to keep that man,” says Dr. Norma Goodwin, president and founder of Health Watch.

Meanwhile, men in the study reported that they would use condoms if women said they had to. This request is even more important when men who cheated said that they rarely practiced safer sex—it ruined the moment and they weren’t about to discuss sexual history with a stranger.

This project underscored the fact that programs which, for example, help women assert themselves or leave abusive relationships will be more successful than ones that merely tell them to use condoms. Similarly, a trickle of HIV prevention programs look to stabilize people’s lives as a way to keep them HIV-free, realizing that often HIV is the last thing on the mind of someone who’s worrying about eviction, unemployment, domestic violence, or substance abuse.

“Simply zooming in on HIV/AIDS is not effective,” says Tokes Osubu, network coordinator at the East New York/Brownsville HIV Care Network, which coordinates services and programs for AIDS organizations in the area. “There are family issues here, like ‘I don’t have a job.’ ”

To deal with these issues, AIDS prevention programs will have to form partnerships with other service groups in the black community or expand their own offerings. It’s a huge, expensive mandate, especially in an era of disappearing AIDS funding.

But the good news: These shifts have already begun, although tentatively. For instance, the Caribbean Women’s Health Association in Brooklyn tackles immigration issues in addition to AIDS, since many immigrants are afraid to use public services, including health programs. And Harlem United works with agencies that distribute clean needles to gain access to drug users, and refers clients for legal, domestic-violence, and psychological counseling services.

“It’s really about that person as a whole, not just about HIV,” Osubu says. “They are a mother, a sister, a churchgoer; it’s about bringing all these things to the table.”


AIDS AND BLACK NEW YORKERS, A SIX-PART SERIES:

Part I: Emergency Call by Kai Wright
How AIDS Is Hurting Black Communities

Part II: Black, Gay, At-Risk by Kai Wright
Homophobia, Racism, and Rejection Fuel Rising Infections

Part III: The Tuskegee Effect by Kemba Johnson
For Blacks, a 28-Year-Old Study Is One of Many Barriers to HIV Prevention

Part IV: Double Jeopardy by Kai Wright
In NY State Blacks Rank Highest Among HIV-Positive Inmates

Part V: Black Women and HIV by Sharon Lerner
Rising Infection Rate Reflects an Age-Old Gender Imbalance

Categories
NEWS & POLITICS ARCHIVES THE FRONT ARCHIVES

Black, Gay, At-Risk

THIS IS THE SECOND ARTICLE IN A SIX-PART SERIES

It was to be a triumphant day in Washington, D.C. The Congressional Black Caucus had convened hundreds of people from around the country to announce that the nation’s black leadership was launching a head-on strike against AIDS.

But at the back of the packed hall, a circle of black gay men stood conferencing, furious at the predictable absence of their issues on the stage up front. Out of a panel of some twenty-odd speakers, representing black people from all walks of life, not one represented black gay or bisexual men. This, when almost 40 percent of the cumulative AIDS cases among black men nationally were transmitted through same-sex sexual behavior.

“It was just ridiculous,” sighs Kevin McGruder, executive director for New York City’s Gay Men of African Descent on West 14th Street in Chelsea, recalling the 1998 gathering. It was at this event that the Clinton administration first unveiled its Minority AIDS Initiative, targeting federal AIDS funding for programs in black communities. The men circled in the back were concerned that their issues would be equally invisible when it came time to divide up that money.

“We’ll be an afterthought,” McGruder remembers thinking. “It was almost like black people in a white environment raising issues about race and people saying, “Well, that’ll come as we get all these other issues [taken care of].”

In New York City, black gay and bisexual men account for almost a quarter of both black men living with AIDS and gay and bisexual men living with AIDS. A 1998 city department of health study found that these black men are twice as likely to die from AIDS as their white and Latino counterparts. A 1999 Centers for Disease Control and Prevention study of men who have sex with men, ages 15 to 22—conducted in seven cities, including New York City—found that blacks are almost five times as likely as their white counterparts to be HIV-positive. In sum, as the CDC recently declared, black gay and bisexual men are one of the most at-risk groups for HIV.

McGruder and others believe that risk stems largely from the fact that too many black men who have sex with men have been rejected by the larger black and gay communities, and seldom find the affirmation of their sexual identity that individuals need to sustain healthy relationships and a sense of self-worth.

“There are places where I can get support around my racial identity, but not my sexual identity,” says Timothy Benston, who manages a Gay Men’s Health Crisis program for black men, called Soulfood.

“The white gay community is built around just that—white gay men. And there’s no real support [in the black community] around a sexual identity. No places where black gay men can go and be gay. So we tend [to meet at] cruising places, like parks, where everything is undercover, ‘on the down low,’ as they say now.”

Gene and Terrence (who requested that their last names not be used)—who have been dating for almost two months—come to GMAD’s support groups together. They are in a supportive relationship. But that bond developed only after traversing the unhealthy sexual relationships that Benston describes.

Last summer, Gene, 35, at the request of his family, returned home to Brooklyn after living around the city for years. He had been sleeping with men—or as he describes it, “in the life”—since he was 19, but had hidden it from his family. One night his mother overheard him discuss being gay in a telephone conversation; the family disowned him.

Six months later, in March, he tested positive. He had never considered his own risk for HIV before that, even though several friends had died from AIDS. After testing positive, exiled from his family, Gene fell into depression. “[The depression] didn’t hit me until I found out I was, you know, HIV-positive,” Gene explains haltingly. “It just all at once hit me.I always thought I was strong.” He quickly adds, trailing off, “Still, I’m strong.”

His partner, Terrence, reassures him, “[There’s] only so much you can take.”


At 30 years old, Terrence is also positive. He says that unlike Gene’s mother, his mother has always been supportive. But after coming out to her three years ago, he fled from his family in Pennsylvania and moved to Washington, D.C., where he developed a drug habit and began dating older men who gave him money to sustain it.

Having never received the guidance—subtle or overt—generally thrust upon young straight men when they are discovering sex and sexuality, and instead learning that their sexual preferences are a source of shame, many gay men end up either seeking anonymous sex or locked in sexual relationships in which they have little power over their bodies. In either situation, they are not likely to demand the use of a condom, or do not value themselves enough to consider the risk of not using one.

Roger Adamson, who counsels the couple at GMAD, says these stories are too common in the black community, where many families and community leaders still won’t embrace gay men and women. “They don’t want to hear that,” Adamson says of black leaders. “So [they say], ‘We don’t want this around here,’ or ‘We don’t want to hear about this issue. That’s y’all’s issue. Take it down there to the white area, don’t bring it here with us.’ ”

Benston notes that while such homophobia is not more common in the black community, it is felt more acutely because of the “dual identities” it creates for black gay men, who need identification with the black community to counter racism in the larger society. It is one thing to be rejected by society at large; it is another to be cast out by the community in which you take refuge from that rejection.

Others trace the roots of the black community’s rejection of homosexuality to early discourse about black power. As black gay activist and author Keith Boykin has written, the most virulent antigaysentiments have come from those who see black homosexuality as a white trait, passed on by the same racist forces that have ripped the black family apart and robbed the male of his masculinity.

Many argue that this association of the gay lifestyle with white people, coupled with an association of AIDS with gay people, has hindered the black community’s response to AIDS. At the least, it has pushed black men who have sex with men to the community’s margins. As a result, an already at-risk group becomes more difficult to reach with HIV prevention messages.

The goal for both Soulfood and GMAD is to bring men in for sessions such as Adamson’s Thursday-night sex and sexuality group. In one recent session, as Adamson playfully urged the 20 or so participants to reveal the maximum number of times they’ve jacked off in one day, it was not immediately clear where the HIV prevention work came in. But the point, Adamson explains, is to make the men more comfortable expressing their sexuality. Many have hidden that sexuality for years. Others, McGruder notes, have turned to the larger gay community only to have their sexuality objectified by white men looking for mythic black sexual monsters. One of the most frustrating parts of his job, McGruder says, is weeding through e-mails hereceives from such men, who mistake GMAD for a dating service.

But the larger point to these sessions is to build community among black gay men. Through that community, black gay men can give each other the support they haven’t found in the larger black or gay communities. “Do brothers feel entitled to be healthy? Do brothers feel entitled to a community that speaks to them?” asks Benston. That sense of entitlement, he concludes, is the only way to truly defeat HIV.


HIV prevention and support programs for black gay men:

Gay Men of African Descent
248 West 14th Street, 2nd floor, NY
(212) 414-9344

Gay Men’s Health Crisis
SoulFood Program
119 West 24th Street, NY
(212) 367-1000

The Audre Lorde Project
85 South Oxford Street, Brooklyn, NY
(718) 596-1328

Harlem United
LGBT Peer Prevention Program run by Bali White
123-125 West 124th Street, NY
(212) 531-1300

People of Color in Crisis
468 Bergen Street, Brooklyn, NY
(718) 230-0770


AIDS AND BLACK NEW YORKERS, A SIX-PART SERIES:

Part I: Emergency Call by Kai Wright
How AIDS Is Hurting Black Communities

Part II: Black, Gay, At-Risk by Kai Wright
Homophobia, Racism, and Rejection Fuel Rising Infections

Part III: The Tuskegee Effect by Kemba Johnson
For Blacks, a 28-Year-Old Study Is One of Many Barriers to HIV Prevention

Part IV: Double Jeopardy by Kai Wright
In NY State Blacks Rank Highest Among HIV-Positive Inmates

Part V: Black Women and HIV by Sharon Lerner
Rising Infection Rate Reflects an Age-Old Gender Imbalance

Categories
Neighborhoods NEW YORK CITY ARCHIVES NEWS & POLITICS ARCHIVES NYC ARCHIVES THE FRONT ARCHIVES

Emergency Call

THIS IS THE FIRST ARTICLE IN A SIX-PART SERIES

In a six-part series the Voice will explore many issues that cloud understanding of a complex public health crisis which disproportionately affects black communities in New York State. Even as AIDS deaths decline among other groups, the disease remains the leading killer of African Americans aged 25 to 44. The series will highlight the efforts of community leaders working to stem the rise in cases.


Lenox Avenue from 132nd to 137th buzzes with people—all of them targets for Tyrone Johnson’s cadre of HIV-positive outreach workers—milling about bodegas, playgrounds, and fast-food eateries. The goal is to get people into a van parked nearby for a free HIV test. Johnson’s got it down to a science. “They see free, and they’ll stop,” he says.

Four years ago, when Johnson first walked these streets handing out condoms, new drugs emerged that finally beat back AIDS death rates. People with AIDS whispered of relief; the media screamed victory. “When Plagues End,” a New York Times Magazine cover story, explored the aftermath of the epidemic since AIDS had become a chronic disease rather than a death sentence.

But in black communities like Harlem, the plague was just beginning. “What you see uptown, it’s almost like a whole different world. It’s almost like HIV/AIDS in 1983, 1984,” sighs Johnson’s boss, Harlem United’s deputy director for prevention, education, and policy, Soraya Elcock.

Nationally, AIDS is the number one cause of death for African Americans between 25 and 44 years old. One in 50 black men and one in 160 black women are HIV-positive—compared to one in 250 and one in 3000 white men and women. The U.S. Centers for Disease Control and Prevention in Atlanta estimates that almost 60 percent of all new HIV infections are occurring among blacks.

New York State mirrors the national trend. Over 40 percent of the state’s cumulative AIDS cases to date are among blacks, who account for only 14 percent of the population. Over 56 percent of all children under 12 with AIDS are black. In counties outside of New York City, blacks and Latinos account for around 10 percent of the population and 60 percent of the cumulative AIDS cases.

So in the last two years, black policy makers and community leaders have begun sounding alarms. “We’re looking at the funding numbers, and [asking] why doesn’t the money go to where the epidemic is?” says Christopher Gray, a Long Island AIDS activist who recently convinced the HIV Prevention Planning Group, an advisory body to the New York State AIDS Institute, to recommend a new focus on blacks.

For years, Gray and others argue, public health officials and community groups alike have failed to target resources appropriately. As early as 1983, African Americans accounted for 26 percent of national AIDS cases. In New York State, African Americans have accounted for at least a third of reported AIDS cases yearly since 1982.

“Even in the beginning, there was a disproportionate representation [among blacks],” laments Dr. Helene Gayle—who is black—director of the National Center for HIV, STD, and TB Prevention at the CDC. “People did not necessarily pay as much attention to it.”

That is gradually changing. The CDC began earmarking funds for minority community initiatives in 1988, but those funds were relatively insignificant until the Congressional Black Caucus prompted President Clinton to declare AIDS a “state of emergency” in the black community in 1998. In reaction, Congress has annually earmarked $245 million for initiatives in communities of color. State health officials, skittish about declaring a hard number, estimate the state spent almost 80 percent of its total HIV-prevention funds (separate from the federal funds it receives) on programs targeting communities of color in 1997, and they plan to increase that share in coming years.

But if the epidemic has had a disproportionate impact on black communities, why are public health officials, AIDS activists, and black community leaders only now, 20 years later, pointing it out?

Harlem United’s Elcock blames both the CDC and local AIDS groups for excessively focusing on injection-drug users and gay men, allowing everyone else to avoid confronting their own risk. “And any time you looked at the television or read something, it was about the Gay Men’s Health Crisis, it was about white gay men, it was about ACT UP. And so the black community separated from that; [AIDS] didn’t belong to us.”

Nor did the black community want to own it. The virus’s impact among black injection-drug users and black gay and bisexual men has always been visibly dramatic. It’s the straight black women, blacks upstate, seniors, and middle-class blacks, Elcock says, who are now getting infected and driving the epidemic to a new level.


Video clips courtesy of the National Minority AIDS Council


As he patrols Lenox, Johnson looks around and offers a more basic reason for both HIV’s spread in the community and the delay in noticing it: Black folks don’t take care of themselves, never have, so why should HIV be any different? “Ask some of these people when was the last time they went to the doctor,” he challenges. “We don’t go to the doctor unless something is burning, turning colors, or about ready to fall off.”

From heart disease to diabetes to asthma, the black community has always led the nation in health problems. Therefore, activists say, prevention must become part of a larger discussion about health and the social forces that threaten black community wellness.

Elcock, who serves as community cochair for the New York City HIV Prevention Planning Group, adds, “The whole family gets disrupted. Mom is dead, Grandma is raising those kids, and she hasn’t got a clue herself. She may know her ‘baby’ died from HIV, but not what an adolescent or a little one might need. So she’s raising, for me, that next level of HIV incidence—that adolescent whom nobody has talked to.”

The black church presents another challenge. The Balm in Gilead, a Manhattan-based coalition of 10,000 black churches and ecumenical groups, has been trying to engage religious leaders for 10 years. Founder Pernessa Seele says she’s seen a marked jump in the spiritual community’s response in thelast three years. Last week, Balm launched a national multimedia initiative, “The Black Church Lights the Way,” urging people to get HIV tests.

“It is essential for the black church to be involved in our community, because in our community we mobilize around the pulpit,” Seele says.

Meanwhile, the Caribbean Women’s Health Association’s Verna DuBerry warns that everyone must remember that in New York City, African American communities greatly overlap with Caribbean and Latino communities. The understanding of AIDS in Harlem may be only at 1980s levels, but Brooklyn’s Caribbean community still will not even name the virus. DuBerry says most people don’t admit they are positive until they are on their deathbeds, and then their families call it cancer or pneumonia.

Johnson, however, is confident in the community’s proven ability to fight uphill battles. “We’re not powerless over this virus,” he insists. “When you look at the numbers, it looks like we’re powerless. But we can stop spreading it.”

Shrugging, he acknowledges the obvious. “We are behind.”


AIDS AND BLACK NEW YORKERS, A SIX-PART SERIES:

Part I: Emergency Call by Kai Wright
How AIDS Is Hurting Black Communities

Part II: Black, Gay, At-Risk by Kai Wright
Homophobia, Racism, and Rejection Fuel Rising Infections

Part III: The Tuskegee Effect by Kemba Johnson
For Blacks, a 28-Year-Old Study Is One of Many Barriers to HIV Prevention

Part IV: Double Jeopardy by Kai Wright
In NY State Blacks Rank Highest Among HIV-Positive Inmates

Part V: Black Women and HIV by Sharon Lerner
Rising Infection Rate Reflects an Age-Old Gender Imbalance