Subject: AIDS Heaps Hardship On Washington Slum Called 'the Graveyard' Date: Published: 11/4/87 270 lines Source: WALL STREET JOURNAL. Copyright Dow Jones & Co. Inc. Mean Streets: AIDS Heaps Hardship On Washington Slum Called 'the Graveyard' --- Victims Are Hard to Get To With the Help There Is; The Barriers to Education --- Gay Blacks and Needle Users --- By Rick Wartzman Staff Reporter of The Wall Street Journal WASHINGTON -- Almost any morning, Squeaky can be found here near 8th and M streets, N. W., resting on the stoop of a ramshackle house or, if he is too weary, sitting on the sidewalk with his long legs stretched into the gutter. Gaunt and red-eyed, he sings sad songs for passers-by while clutching a bottle of booze. He is in pain, he says, and he is convinced he won't live beyond this, his 39th year. "I don't want him to take me away," Squeaky says, gesturing with black hands at the open sky. "I'm afraid I'll die," he says, weeping. "They told me I got the virus." The "virus" is HIV, which causes AIDS. Squeaky says that earlier this year when he was a prisoner in Washington's Lorton Reformatory, his blood tested positive for HIV. More and more, AIDS is threatening to overwhelm inner-city people, who already endure enough hardship. Some say it is only a matter of time before the most important occupations at 8th and M -- prostitution and drug dealing -- are supplanted by the work of undertakers. Statistically, one black dies in the U. S. of AIDS every two hours, most often in poverty. Though they make up just 17% of the population, blacks and Hispanics account for 39% of the nation's 43,000 AIDS cases. More than 70% of the women and children who get the disease are from minority groups. Inner-city AIDS victims have had particular difficulty coping with their fatal illness. Intravenous drug users, among whom AIDS is now spreading the fastest, live in the shadows. Gay blacks, who so far account for more AIDS cases than any other group in the black community (47% nationally), find themselves a minority within a minority, treated as pariahs by many people -- black and white. At 8th and M, in the city with the fifth-highest incidence of AIDS in the U. S., the disease is impossible to ignore. Called "the Graveyard" by local drug users, this is a dingy neighborhood of $6 hookers and heroin shooting galleries, the last stop in life for many a local junkie. Talk of death here, which for years centered on gunshot wounds and overdoses, now focuses as well on the pneumonia that ultimately kills so many AIDS patients. "There are only a few places for people like me -- jail, the grave and, now, the world of AIDS," says Gloria Smith, a heroin addict whose AIDS was diagnosed about a year ago. Before she got sick, the mother of four visited 8th and M to buy drugs. "Why us? " she asks. A week spent recently in this bleak neighborhood illuminates the gargantuan problems created by AIDS in the nation's slums. Among them: the frustrations of educating people about a disease entangled with sex and drugs; the difficulties hospitals and other social-service agencies have treating the illness; and the overwhelming sense of hopelessness among residents fearful of contracting AIDS. Still, few institutions in the inner city acknowledge the AIDS crisis. The church, traditionally the black community's pillar of strength and guidance, is ambivalent about even discussing the sickness. At the 6,000-member Shiloh Baptist Church, a huge brick structure at 9th and P, AIDS does get mentioned sometimes, but clergymen are still grappling with how to confront the disease from the pulpit. "It's tough," says the Rev. Ronald K. Austin. "We'll probably have to do something about AIDS, but we don't know what yet." The black middle class also has been reluctant to offer support to people with AIDS, fearing the disease will be perceived as a black problem and thus increase racism. "It shames me for the color of my skin that my own people won't do anything to help," Ms. Smith says. National black organizations insist that AIDS education is at the top of their agendas. But, for the most part, the word doesn't seem to reach the streets. The real work is left to a handful of grass-roots groups that are diligently trying to teach the inner city about AIDS. They face a misinformed and greatly skeptical audience, which often disregards this basic appeal: Mitigate high-risk behavior by wearing condoms during sexual intercourse and by not sharing needles and syringes. That way, blood and semen are less likely to be exchanged. Culture complicates things. For many in the black community, condoms suggest involuntary population control -- white people trying to limit the number of blacks -- and therefore are an abomination. Moreover, unbridled sex remains an expression of machismo for many men. In the District of Columbia, 67.1% of black births are out of wedlock. Eighth and M isn't far from the parks and monuments of the nation's capital. But it is virtually impossible to walk up 8th toward N -- past the piles of garbage heaped in front of Mac's filling station and the burned-out clapboard facade of the New Fountain Baptist Church -- and not find someone who has been touched by the disease. One man, nicknamed Dog, has seen two friends die of AIDS in just the past few weeks. Francine, who like others in the neighborhood is unwilling to give her last name, was close to two people who died, and she says she has seen many familiar faces grow thin and sickly and suddenly vanish from the streets. Skip, an intravenous drug user, thinks he might be an HIV carrier, but he is afraid to be tested, and he is afraid of getting AIDS from the women he sleeps with. "These days," he says, "I go to bed with a girl -- and then I just pray." The strain on the system is great. At Washington Hospital Center, a private facility, limited bed space has been made all the more so by the 300 AIDS patients treated there since 1981. The most tragic cases, says Dr. Charles Levy, are those who come from the slums. "It's really America at its worst," he says. The personnel in unit 1-E of the hospital nod knowingly when they hear the words "8th and M. " Usually, says nurse Mary Reilly, AIDS victims from such neighborhoods are so sick when they arrive, they are "scooped up in a comatose state, dumped here, diagnosed, and then they die." That relatively few AIDS patients in Washington receive Medicaid and other benefits for which they are eligible is another part of the AIDS tragedy in the inner city. Although an impoverished person diagnosed with AIDS is automatically eligible for the District of Columbia's General Public Assistance program, only about 75 AIDS victims have applied for it in the past two years. One reason, officials say, is the daunting red tape involved in applying for these benefits, which usually come to about $225 a month. Additionally, Medicaid will pay all medical expenses for the very poor. But people around 8th and M often don't know how to apply. Those who do get help live precariously. Cedric, 32 years old, was diagnosed as HIV-positive in 1985 -- he says he thinks he got it from a woman he picked up at a bar -- and since then he has developed AIDS-related complex, symptoms that often lead to a diagnosis of AIDS. He survives on $229 a month from Social Security, in perpetual fear of being cut off. "I guess I'd have to turn to a life of crime," he says. "Or I'd be back out on the streets." Caring for addicts presents the greatest challenge. "People can't go to the i.v. drug abuser and say, 'we don't care about the rest of your self-defeating behaviors, only about AIDS,'" says Ed Pitt, the director of health and environmental services at the National Urban League. He believes that getting people to stop injecting drugs with dirty needles requires doing something about the underlying causes of addiction -- including poverty and the despair that goes with it -- while also improving available drug treatment. District of Columbia social workers have been very successful at finding housing for people with AIDS, but many junkies can't stand the regimentation of life under someone else's roof. So they head back to old haunts, where addicts share needles and fresh hypodermics sell illegally for as much as $3 each. "So many people use dope today, they don't care which way they go," says Kevin Matthews, an 18-year-old now serving time in a juvenile detention center for dealing drugs on the streets of Washington. "They're just down on their last misery." For Reed Tuckson, the District of Columbia's health commissioner, AIDS results in difficult dilemmas. "I'm fearful of the choices we'll have to make when given only so much money to spend," he says. "AIDS will compete for resources." Dr. Tuckson's office will spend $3.6 million -- about 4% of its total budget -- specifically to combat AIDS in fiscal 1988. Even if limitless sums of money were available, he adds, fighting AIDS still wouldn't be easy. "You have to learn the subtleties of culture," says the 36-year-old District of Columbia native, who watched his best two childhood friends ruin their lives with drugs. One has spent most of his life in prison; the other died of an overdose. "You're really asking people to change their life styles." At 8th and M, that seems impossible. All day, every day, people here are engaged in activities that allow AIDS to thrive. The mornings belong to the addicts. And the nights belong to the drag queens. About 10 a.m., the ghetto awakens. Scores of men and women wander about, looking for an active "oil joint" so they can get their first fix of the day. "Sunkist, Sunkist," a drug dealer barks out, using a local term for heroin. Others act as "hitters," charging about $5 to find for a buyer a vein that isn't already collapsed from repeated injections. Many times a hitter will place the needle in a groin, a neck or, most desperately, a forehead. One man pulls out a wad of bills -- a shot of heroin costs about $40 or $50 -- and then doesn't even wait to get indoors to shoot up. Standing in someone's dusty front yard, he pumps the needle into his arm, ignoring several bystanders. Most of them seem uninterested anyway. When the sun goes down, sex is for sale. Locals say that on some nights, the traffic gets so heavy on 9th Street at N -- a spot where men solicit other men -- that it approaches gridlock. But even in Washington, where 71% of the black AIDS cases have involved homosexual contact, this promiscuous subculture is a taboo subject. Gay blacks say they are scared of being harassed by the straight men in their neighborhoods, who perceive homosexuality as a sign of weakness. Many black homosexuals and bisexuals can't bring themselves to admit that they have sex with other men, and they don't think of themselves as gay. Some who have AIDS have created a fictitious history of intravenous drug use rather than confront the real reason for their illness. Such denial creates a group difficult to reach with messages imploring condom use and other so-called safer-sex techniques. Meanwhile, women who are intimate with bisexual men can become unsuspecting conduits to other heterosexuals, as can women who go to bed with needle users. "You've got to tell these people they need to wear condoms," says Adrianne Blackwell, an outspoken community activist and 33-year-old transvestite who serves drinks at the Brass Rail, a black gay bar. "They are not going to abstain." On this night, many of the men will leave the saloon at 13th and I and go to 9th street in search of a little action. Such reality has motivated Ms. Blackwell (who prefers to be thought of as a woman). She says she constantly answers patrons' questions about AIDS and even leaves her home phone number behind the bar, so anybody inhibited about asking a question face to face can call for advice. "There's more to me than a song and dance," she says, "because we've got to do something about this." For many gay blacks, it is already too late. With relatively little support, blacks say they must turn to traditionally white gay institutions, where it is more difficult to find people they can relate to. For instance, without housing provided by the Whitman-Walker Clinic and without a monthly check from Social Security, James McLaurin says he would have perished long ago. Since last year, when his AIDS was diagnosed, the 37-year-old has lost his job as a house painter. He no longer has health insurance, and he was evicted from his apartment after fellow tenants intimidated the landlord. Mr. McLaurin, no stranger to hardship, grew up in downtown Washington and hid his bisexuality for most of his life. He fought in Vietnam and lost his first wife, a Cambodian, and their twin daughters to a Viet Cong attack. "For some reason," he says, "death seems to follow me around." But AIDS for him has been more overwhelming than his other miseries. Until last year -- believing that AIDS was a disease of white people -- he didn't think much about it. Since being diagnosed, though, he has learned of at least 40 acquaintances who have died of AIDS. "I'm almost all alone," Mr. McLaurin says. Nights are the worst, he says, because he often can't sleep. When he does manage to doze off, an alarm clock rings every four hours, reminding him to take his AIDS medicine, azidothymidine. Even with AZT, an extremely expensive drug paid for in his case by Medicaid, the once-muscular Mr. McLaurin finds his energy sapped. He has been in and out of the hospital and once was in Washington Hospital Center's intensive-care unit with pneumonia. He says he can't go through that again. A handsome man with a touch of gray in his beard and a melodic voice, Mr. McLaurin has asked two friends to kill him if he is ever completely incapacitated again. He says they have agreed. [This article is made available here by Dow Jones Co. for the personal and non-commercial use of callers to this bbs, in the hope that it will be of some help to those who are suffering from the disease and others who are seeking to help them.]