Bleaching a Virus : A Street-Wise Experiment in Stemming the Spread of AIDS
LONG BEACH — Nighttime comes as an old friend to the drug addicts who prowl the western edge of this city.
Just over the bridge spanning the Los Angeles River amid the liquor stores and cheap motels, intravenous drug users engage regularly in the nightly rituals by which they live. Hidden comfortably in the shadows of Pacific Coast Highway or the darkness of the houses beyond, they sometimes share their needles and thereby their blood.
One result, researchers say, is that about 8.7% of them--one in every 11--are infected with the AIDS virus. The percentage is nearly double the countywide figure and puts IV drug users at higher risk for the deadly disease than any other group except homosexual males.
Another result is that this is the weekly staging area for the Community Health Outreach van. Its mission: to help stem the spread of AIDS among IV drug users and, in the process, gather data on the relative effectiveness of various approaches to changing risky behavior. The method: blood tests and bleach kits for the subjects; detailed questionnaires for the researchers.
“It’s a population that not much is known about,” said Donna Yankovich, director of the program funded through Cal State Long Beach by the National Institute on Drug Abuse. “There are pockets of drug users all over (the city). Instead of asking them to leave their neighborhoods, we are going to them.”
And instead of convincing them to stay off drugs, she said, they are trying to prevent AIDS by teaching them to take drugs safely. To elicit cooperation, Yankovich said, the program even pays participants $10 per visit. The tactic, while not uncommon among research psychologists, has raised a few eyebrows in Long Beach. “It’s an incentive,” she said. “Their time is worth something.”
Most of that time is spent filling out detailed questionnaires documenting specific drug-taking and sexual behaviors considered risky. “What we’re after,” said Fen Rhodes, a CSULB psychology professor overseeing the project, “are the things they do that spread AIDS.”
After being questioned, participants are exposed to various educational presentations--including a 12-minute video produced locally for the purpose--aimed at convincing them not to share needles or, if they do, to sterilize their syringes with bleach, he said. Those who are willing are also tested for the AIDS virus, and everyone is given bleach kits and condoms along with instruction in their use.
The intention, Rhodes said, is to do follow-up interviews at six-month intervals to determine which presentations were the most effective in curbing risky behavior. To make that possible, Rhodes said, drug-using participants are initially screened to make sure they have permanent addresses. A team of outreach workers is assigned to maintain contact.
Although the program has already tested and interviewed about 625 subjects, Rhodes said, no statistical results are available yet. But he said participants seem to be really impressed with the video--an emotional compilation of testimonies by Long Beach area drug users who have been infected with AIDS.
The seriousness of the disease did not seem lost on those gathered one recent Friday night for the van’s weekly sojourn to the city’s west side, an area where drug use is rampant. Despite the party atmosphere created by the cookies, coffee and soft drinks provided by the van’s staff and the scores of people chatting on the sidewalk while waiting for appointments, the occasion’s underlying purpose seemed apparent in the solemn tones evoked whenever the subject of the virus came up.
“I came to find out if I have AIDS,” said Mark Danley, 29. “A lot of people don’t realize they could have it and be passing it on. I’ve been at places where three or four people used the same (needle); it’s kind of insane.”
Said Manuel Garcia, 28: “When you’re sick you don’t care. When you’re on the streets and someone offers you a syringe, you’re gonna use it no matter who else did.”
Not everyone in town endorses the project.
David Dusenbury, deputy chief of police in the detective bureau, said that while he appreciates any effort to combat AIDS, he also sees the potential for problems in a program that puts money into the hands of drug users. “I think that in a small way that $10 goes toward supporting their drug habits,” Dusenbury said.
Mayor Ernie Kell said he has major philosophical disagreements with teaching people how to shoot up properly rather than urging them not to take drugs at all. “I’m not sure this is the correct approach,” he said. “I think the money could be better spent on education and treatment to get people off drugs.”
Project organizers respond that that’s not their job. While being generally supportive of efforts to overcome addiction, they say, emphasizing non-use among their clients would not only skew the results of their research, but would probably discourage many drug users from participating altogether.
“Education and behavior change is the only effective way we have to combat the disease,” Rhodes said. If acceptance of a drug user’s habit is what it takes to lessen the chances that he or she will contract AIDS, the psychologist said, then so be it. “There’s a good chance this will work,” he said. “I think we’re making a difference.”
