With an estimated 1.2 million Americans living with HIV, the Joint United Nations Programme on HIV/AIDS (UNAIDS) reports that the U.S. is home to "one of the largest HIV epidemics in the world." Racial and ethnic minorities represent especially risk-prone populations. In 2005, African Americans accounted for 48% of new HIV or AIDS diagnoses in the United States.
In the Bronx, New York, reports The New York Times, city health officials are implementing a program of universal, voluntary testing for all of the borough's adults.
• "Push in Bronx for H.I.V. Test for All," The New York Times, June 26, 2008.
The New York City health department plans to announce on Thursday an ambitious three-year effort to give an H.I.V. test to every adult living in the Bronx, which has a far higher death rate from AIDS than any other borough. The campaign will begin with a push to make the voluntary testing routine in emergency rooms and storefront clinics, where city officials say that cumbersome consent procedures required by state law have deterred doctors from offering the tests....
While Manhattan has long been the epicenter of the AIDS epidemic in New York, with the highest incidence of both AIDS and H.I.V., the virus that causes it, the Bronx, with its poorer population, has far more deaths from the disease. Public health officials attribute this to people not getting tested until it is too late to treat the virus effectively, thus turning a disease that can now be managed with medication into a death sentence.
Though he tested positive for HIV while he was writing And the Band Played On, San Francisco Chronicle reporter Randy Shilts requested that his doctor withhold the result from him until he finished his book, which became the first chapter of the story of the global epidemic. Shilts died of AIDS-related complications in 1994, having done, as writer/activist Larry Kramer put it, "more to educate the world about AIDS than any single person."
• And the Band Played On, by Randy Shilts, 1987.
"He's had some kind of seizure."
Uptown on Columbus Avenue, Enno Poersch frantically tried to revive Nick. A friend who had been staying with the ailing youth said tearfully that he had heard a shriek in Nick's room before Nick lapsed into unconsciousness. Enno had raced over and was kneeling beside the bed, trying to raise a flicker of awareness.
"We've got to get him to a hospital," Enno cried.
Even if he's unconscious, Enno thought to himself, I should explain it to him. Nick might be aware but just unable to talk.
"We're dressing you so we can take you to the hospital," he said.
Nick threw up a clear, yellowish liquid and had a bowel movement. Enno cleaned him, dressed him, and cradled him gently as he carried his lover down four flights of stairs.
"We're taking you downstairs, out the door," Enno shouted.
Cabs raced along the Upper West Side streets. None would stop for the tall man who was holding the wasted form in his arms. Enno realized that, because it was Halloween, the cabbies probably assumed they were drunks from some costume party.
The next morning, Dr. Michael Lange peered into Nick's room at St. Luke's-Roosevelt Hospital. A neurologist had found three massive lesions on the young man's brain during a CAT scan. Lange had been called in as an infectious disease specialist. Nick was slumped to one side of the bed. His gray eyes were covered with a milky white film and the left side of his face seemed to sag. His fever was escalating. Nick had been dying in slow motion for a year, the doctors told Lange, and nobody could say why.
The sight lingered with Lange for years, long after such deathly visages had become familiar and Lange became an international authority about such things. Lange would always recall that first moment, staring into the hospital room at Nick, as the event that separated his Before and After. Years Later, Lange could instantly remember the date, the way he could recall the anniversary of his marriage or his kids' birthdays.
It was November 1, 1980, the beginning of a month in which single frames of tragedy in this and that corner of the world would begin to flicker fast enough to reveal the movement of something new and horrible rising slowly from the earth's biological landscape.
By the end of 2007, sub-Saharan Africa was home to an estimated 68% of the world's HIV-positive population.
• "Testimony," by Nosi, 2007.
My name is Nosi. I am from Port Elizabeth in the Eastern Cape in South Africa. I found out that I was HIV-positive in December 2001. I was pregnant and had to do the test so that I can take precaution measures for my baby. On the 15th of December 2001, I was told I am positive. I knew that I could be because earlier on that same year, an ex-boyfriend of mine had come to tell me that he is HIV positive and has been for a while and would like me to go for a test as well. I kept on postponing it until I got pregnant and then I had no choice.
On February, 2, 2002 I gave birth to a beautiful baby boy. He is now four years old and is the reason I am alive today. I went through depression and thought I was going to die, but I did not. I lived because I was carrying him, I talked to him while he was in my stomach, I apologized for bringing him to the world with such a risk at hand. Fortunately by God's grace when I tested him in January this year, he tested negative. I thank God for him because I do not think I would have been able to live with myself if he had tested positive.
I told his father after a year, he was in shock and in denial for years but this year, he did the test finally and told his mother. He keeps on drinking and living a reckless life so, we broke up last year in September. Its been a year and a few months now since we broke up and although I miss him but I know that we have a dysfunctional relationship and he brings me down. My son loves him so much and I would love us to be a family but I don't think its gonna happen.
The good news though is that in May this year, I met a man whom I told immediately that I am positive and he was okay with it, he is still around. He makes me so happy. He has brought so much joy in my life and I know that when I look back at my life I can smile because he loves me and has loved me and nothing else matters because he loves me. I would love to get married to him but sometimes feel that it will be unfair to him to do that because we cannot have kids, although he has a child and I have one. My dream is to marry him and become his wife. He is a gentle soul and loves me so.
Lapham's Quarterly is available at bookstores and newsstands nationwide. Or, subscribe here!