Pubdate: Mon, 26 Sep 2005 Source: News Journal (DE) 09260350/1006/NEWS Copyright: 2005 The News Journal Contact: http://www.delawareonline.com/newsjournal/opinion/index.html Website: http://www.delawareonline.com/newsjournal/ Details: http://www.mapinc.org/media/822 Author: Esteban Parra And Lee Williams Bookmark: http://www.mapinc.org/find?143 (Hepatitis) Bookmark: http://www.mapinc.org/heroin.htm (Heroin) Bookmark: http://www.mapinc.org/rehab.htm (Treatment) AIDS HITS THE STREET ON INMATES' RELEASE WILMINGTON -- Along some sections of Fourth Street in Delaware's largest city, prostitutes and drug addicts mix with young families -- Puerto Ricans, Mexicans, whites and African-Americans. More than any neighborhood, this is the state's melting pot. It's also where HIV spreads at epidemic rates, where people with skin lesions and open sores are turning tricks and ex-cons from Delaware's prison system -- one of the worst in the country for AIDS-related deaths -- come to hang out. "They say they use condoms, but they cost money -- ain't no condom when you're looking for a fix," said Robert Rodriguez, owner of Rodriguez Hot Stylz, a clothing store on Fourth Street. His daughter Jessica, who just turned 21, sells Italian Ice from the store's window. "I am nervous," Jessica said. "You never know who has it (AIDS) and who doesn't." Spanish is the language of the street here. Lunchtime smells of fried pork, rice and plantains. There are good sections. And bad. Israel Gonzalez, who moved from Puerto Rico to Wilmington 20 years ago, said he has no problem with people who have AIDS, unless they keep it a secret from their sexual partners. Then, he said in Spanish, "They are assassins." Delaware's AIDS rate of 26.1 cases per 100,000 people far exceeds the national rate of 15.2 per 100,000, according to a Kaiser Family Foundation report released this month. It's based on 2003 numbers, the latest available. Transmission of the virus occurred most frequently through intravenous drug use. About 43 percent of all Delaware AIDS cases were caused by IV drug use. Male homosexual sex, the second leading cause, accounted for 32 percent of the state's AIDS cases, followed by heterosexual contact, which accounted for 15 percent of cases. More than 40 percent of the state's HIV and AIDS cases were in Wilmington. Many of the cases are prisoners or former prisoners, who are spreading the virus. Neighborhoods At Risk On a recent day in Riverside, the Rev. Vincent Oliver is watching kids run inside the Kingswood Community Center for an after-school program. On the next block, dealers are slinging heroin. Behind Kingswood, a safe haven in a decaying neighborhood on the city's east side, kids are playing basketball. From there, you can see Gander Hill prison. AIDS is hitting this community hard, said Oliver, Kingswood's executive director. "We're aware there are health issues coming out of the prison," he said. "Inmates are bringing hepatitis and AIDS back into our community. I hold the prison system accountable. They should be screening these people upon exit and working with their families and significant others. I know it's not popular, but it has to be done." Renee Beaman, a registered nurse and executive director of Beautiful Gate Outreach Center in downtown Wilmington, receives former inmates infected with HIV referred to her center. And she has no doubt they've "caused our rates in Delaware to increase." Cons With AIDS Oliver Ash knew he had AIDS when he arrived at Gander Hill late last year. But Ash didn't want anyone to know -- even if it meant missing his medications and getting sicker. "I was scared," Ash said. But that didn't stop him from having unprotected sex with his cellmate. Eventually, the prison's medical staff found out he had AIDS and sent him to the infirmary. Ash, in prison for driving with a suspended license, was released after pleading guilty and paying a fine. Ash, 42, recently talked about his struggle with drugs and the virus while sitting in Stapler Park, near Trolley Square in Wilmington. He believes he has been living with HIV for almost 20 years. Ash suspects he became infected in the Army, while stationed in Korea, where he says he had unprotected sex with prostitutes. It wasn't until his brother died of AIDS in 1999 that Ash began trying to take better care of himself. While Ash was in the Gander Hill infirmary, the nurses were unable to find out from his regular doctors what medicines he was supposed to be taking. By the time Ash was released, he had missed nearly two weeks of antiviral treatment -- the sort of lapse that can cause mutations in the virus. "There are so many things I've done," he said. "I don't know if I'm going to heaven." The narcissistic and impulsive behaviors that are common among some inmates lead to higher rates of infection, said Dr. Carol A. Tavani, a psychiatrist who has worked in Delaware's prisons. "That's part of a criminal mentality," she said. "They don't think of the other guy. They simply think about their needs or wants." Sex between prisoners, which is illegal in Delaware, is just one way HIV can thrive inside prison. Tattooing with dirty implements -- guitar strings, safety pins or pens -- is another. Heroin and needles, smuggled inside, are also vehicles for infection. The prison - -- an incubator for mutations -- also serves as the breeding ground for new HIV cases outside prison. "When people go in they don't know they have it," Robert Rodriguez said. "They come out, have sex with females, next thing they find out they have it and so does she." His family has seen the nastiness. Rodriguez knows one woman who found out she was HIV-positive in prison. "She's still active -- hooking with AIDS," he said. "It's frightening. Somebody gotta let people know." Controlling The Problem Estella Moody of Wilmington, who lost two brothers to AIDS, said more programs are needed to fight the spread of the virus. "I try to stay educated," said Moody, who talks to her 13-year-old daughter about the virus. "She's not sexually active, and I hope she stays that way until she gets out of college." Controlling Delaware's AIDS problem has been difficult: *Long waits for residential drug treatment are common. *Delaware's poor areas have doctor shortages. *Delaware has no program that allows addicts to trade used needles for clean ones -- an exchange that has reduced HIV rates in other places, such as New York City. The percentage of New York City's HIV-positive population who were IV drug users dropped from 50 percent to between 12 percent and 18 percent. *Agencies serving high-risk populations in Wilmington struggle for state funding. Michael Hollaway is a counselor at Beautiful Gate. Three times a week, he walks around Wilmington passing out pamphlets and encouraging HIV testing. Recently, he stopped to explain to a man that HIV could be transferred through breast milk and blood-to-blood contact. "I didn't know you could get it that way," said Victor Beltran. "A couple of years ago, I was doing some crazy things. I got drunk, high and I did crazy [stuff]." Hollaway estimated about 25 percent of those he talks to get tested. Getting The News Of the nearly 14,000 who were tested last year at Delaware community-based centers such as Beautiful Gate, 142 tested positive for the virus, according to the Delaware HIV Consortium. Those diagnosed are encouraged to get immediate treatment. Although there has been no study on how Delaware inmates affect the state's AIDS rate, the founder of a Wilmington health education agency said she sees a strong connection. "It has mass ramifications on the community," said Alyson Lang, executive director of Each One Teach One. "Once they get out, they take their particular strain out into the community. "In terms of the American culture, it has always been accepted that men have more partners. So one man comes out and infects, what, 10 women? It's an outrage," said Lang, who works with former prisoners. "The one at home ... is the one I worry about because she's going to be the one most trustworthy." - --- MAP posted-by: Elizabeth Wehrman