![]()
LEAD STORY
A PLAGUE OUT OF VOGUE
Three years ago AIDS was a cause célèbre.
Now it's just another disease.
BY PATTY WENTZ
pwentz@wweek.com
HIV is the leading cause of death among African Americans between 25 and 44 years of age.
Private dollars for AIDS are drying up, but public money is still available. Last week President Clinton announced $200 million more dollars for housing assistance for AIDS patients and their families and $10 million for AIDS orphans.
"It was almost as if this huge steel wall came down in terms of funding. It was boggling."
--Judith Rizzio
Oregon receives
$3 million annually from the Ryan White Fund, established by Clinton
in 1990, to be distributed to AIDS groups around the state.
AIDS patients say their illness is no longer the "disease du jour," having been supplanted by other, more palatable diseases such as breast cancer.
A reliable source of funding for AIDS organizations has long been bequests from people who died or donations in memorandum. With the declining death rate, those funds are disappearing.
HIV infections remain steady across the country. In Oregon, they have dropped 16 percent since last year.
The Oregon AIDS hotline number is 800-777-AIDS.
The Multnomah County Health Department reports that the number of clients using HIV clinics who live below the federal poverty line has increased from 69 percent in 1994 to 85 percent in 1997.
Cascade AIDS Project reports that 31 percent of its clients are heterosexual, 15 percent are women and 22 percent are people of color.
Although combo-drug therapies are reducing deaths in North America and Western Europe, AIDS is ravaging Africa. Two-thirds of the 33.4 million people in the world infected with HIV are African.
Celebrity support often brings out the bucks. Since Christopher Reeve's accident left him paralyzed, support for victims of spinal-cord injuries has flowed. Now, after his recent diagnosis, Michael J. Fox is stumping for Parkinson's Disease.
IN XES: A Look Inside Portland's Newest Sex Club
It was the party of the year in 1995.Three years ago, on a warm August evening, Portland's corporate and cultural elite gathered in the heart of the city. More than 2,700 people mingled outside the Arlene Schnitzer Concert Hall, waiting for the première of the Broadway play Angels in America.
The opening-night gala was a Fabric of Life fund-raiser. It was the the finale of a monthlong effort in which interior decorators donated their time to design window displays in upscale stores from Saks to Mercantile.
The glitterati of corporate philanthropy were there, including George Passadore of Wells Fargo, Judy Hofer of Meier & Frank, P.J. Carlesimo, then-coach of the Trail Blazers, and Nick and Lynne Greve of Carl Greve Jewelers.
After the play, the partygoers filed out of the Schnitz to find thousands of glasses of champagne. They toasted themselves for a job well done. That night they had raised $162,000 for various AIDS groups.
Now, in the waning days of 1998, it's clear that the party is over.
There was no Fabric of Life event this year. And another top AIDS fund-raiser is nearly non-existent. In 1995, thousands of people marched in the Walk of Life. This year, the event was combined with the Portland Marathon, and only 150 walkers took pledges to raise money for AIDS.
Last week, World AIDS Day was celebrated in Portland with a muted ceremony and a crowd that was a fraction of the size of previous years.
For 17 years, Oregon, like the rest of the country, was gripped by a disease that rendered tens of thousands emaciated, blind and demented before killing them--all with a swiftness that left us reeling. While AIDS spurred a backlash against gay culture, the plague inspired an extraordinary outpouring of political and financial support.
Today, the picture has changed dramatically. Protease-inhibitor drugs, which slow the growth of the virus in the body, have cut the mortality rate from AIDS by almost 50 percent in the last year alone.
As morbid as it sounds, the fact that more people are living with AIDS rather than dying from it has eroded the support for AIDS groups--even though the need to provide care is as great as ever.
In addition, today's AIDS victim is less likely to be a gay white male whose death is mourned in prominent social circles. He is more likely to be poor, Black or Hispanic and addicted to alcohol or drugs.
With minorities and women making up a larger proportion of people infected with HIV, the disease has lost its luster.
"It's not our friends who are dying anymore," says Gary Maffei, a longtime AIDS fund-raiser who organized the Fabric of Life, "so it's difficult to get people to care."
It's going to be a tight Christmas for Cascade Aids Project. The largest AIDS service agency in the state counts on private donations and grants for almost one-third of its $3 million budget. This year it raised $180,000 less than it did the year before. 1999 will be worse. The organization is already down $100,000 in the first four months of fund-raising. As a result, CAP has frozen spending and cut $200,000 worth of expenses and is temporarily leaving unfilled positions open.
Our House, the Southeast Portland end-of-life care home, is down at least $140,000, and Allyson Jenkins, the executive director, says the organization will have to close if things don't turn around. Reports suggest there are plans to shut down Care House, its Vancouver, Wash., counterpart. (The executive director of the Vancouver home did not return Willamette Week's calls.)
Thomas Bruner is CAP's new executive director. The dynamic worker, who moved here from San Antonio, Texas, has earned his reputation from more than 12 years as an AIDS activist and a passionate spokesman for patients.
With fewer people dying, the urgency that came with the onset of the crisis is gone, he says.
"It's always easier to rally the troops to fight against something really bad, like death, than to rally the troops to fight for something really good, like life," says Bruner.
Judith Rizzio, development director of Our House, says reports of the end of the plague have pulled the rug out from under fund-raising.
"It was almost as if this huge steel wall came down in terms of funding," Rizzio says. "It was boggling."
The irony is that services for people with AIDS are needed more than ever. The dying don't need apartments, but the living do. The dying don't need long-term care. The dying don't need counseling to learn how to live when they didn't expect to.
In 1994, Cascade AIDS Project had 1,100 clients, most of whom died within a short time of contacting the organization. Today, CAP has 1,981 clients, many of whom expect to live a long time. Last year, the group spent nearly $256,000 on housing assistance; it also provided permanent housing for 22 people.
Organizations all over town are strained. Over the last three years, the average length of stay at Our House has increased from 63 to 96 days. The caseload of the AIDS ministry at Catholic Charities has increased from six to 70 over the same period.
The declining morbidity rates--combined with the exhaustion of people who have been on the front lines, fighting the disease--partly explain the shrinking support for AIDS groups. But there is another, more discomforting explanation.
To be blunt, when the contributions were flowing, many of the men who had contracted AIDS and were dying were friends of the rich. By 1995, we had lost Dennis Spaight, the resident choreographer of Oregon Ballet Theatre; William Jamison, the highly regarded gallery owner who instituted First Thursday; Ric Young, the dynamic force behind Storefront Theater; and Keeston Lowrey, aide to Commissioner Mike Lindberg.
In the last three years that situation has changed. Fewer people are dying, certainly. Middle-class, well-educated men have learned about safe sex, and those who are already infected have the resources to get help. But there is still a group of people who continue to contract and die of AIDS. Straining the system now are the euphemistically titled "multiple-diagnosed," the drug addicts, the poor, the mentally ill, the people who have never learned to take care of themselves.
"It isn't the gallery owners or hairdressers," says Bruner. "It's not the guy who does flowers for all your parties."
It's people like Jeffery Dickson.
Dickson is a fund-raising nightmare. He is a 42-year-old gay drug addict who lives with his sister and niece in a one-bedroom apartment on Northeast Killingsworth Street.
He was diagnosed with HIV in 1982. Even after his brother died of AIDS in 1992, Dickson continued having unprotected sex.
While the disease was breaking down his body, he says, he used cocaine and crack for more than a decade, sometimes spending his disability check on as many $20 bags of crack as he could get, sometimes selling his belongings when the money ran out. Now, he believes, his lifestyle has turned his diagnosis from HIV to AIDS.
"I didn't know I was forcing my illness," he says. "I didn't know what I was doing."
In 1996, he switched from crack to crystal meth because AIDS had destroyed his libido and he could no longer enjoy sex without meth.
By last summer, the meth had weakened his body so much that he couldn't walk.
Dickson entered Our House in February of this year and began a regimen of protease inhibitors. Three months later, he was strong enough to walk out the door, leaving his doctor's carefully constructed cocktail behind.
"I couldn't do both street drugs and his drugs," Dickson says. "I was thinking about partying."
Dr. Ken Brummel-Smith, medical director for Our House, says his clientele used to be quite different. Our House flourished because of the people it served. "They were the major players," he says. "The upper echelon came here to die."
Now, Our House has a much higher percentage of people like Dickson, people without political power or community who have spent a lifetime engaged in self-destructive behavior. They are the most needy and the most difficult to raise funds for.
"We now have the AIDS patients who cost the most--the mentally ill or IV drug users with no family or friends," Brummel-Smith says.
Victoria Frey, who owns the Quartersaw Gallery, sits on the Our House board of directors and has been an unwavering advocate for AIDS patients for 11 years. She says until recently at least one bed in Our House was occupied by someone in her social circle. Now, the new arrivals are strangers to her.
According to Frey, middle-class gay white males contributed generously for three reasons: They had lost friends or lovers; they felt that if gays didn't help themselves, then no one else would; or they thought an offering would keep the plague away from their own doorsteps. Now those men are gone.
Many of them have died. Those who remain and their friends and families, who were also strong supporters, are exhausted after years of fighting or no longer feel threatened by AIDS.
The glamour is gone from the disease, Frey says, lamenting that the new face of AIDS is not compelling enough to inspire check writers.
"They are on the fringe of society," she adds. "The drug addicts. How beautiful is that?"
For Bruner, the disease is more political than ever. AIDS organizations such as CAP were formed out of passion and zeal by gays who were able to turn the tide of public opinion about the disease, he says.
Today's patients don't have the political cohesion to hold parades or picket Salem to demand more funding, nor are they compelling images for donors.
And many of them are so caught in the cycle of poverty, sickness and addiction they will never escape it.
"Who speaks for IV drug users? Who are on welfare with three children?" Bruner asks. "Who haven't held a job in 15 years? What is their advocacy equivalent of Act Up?"
Bruner warns that AIDS is not over. Infection rates of HIV remain steady across the country, and AIDS continues to be the leading killer of people under 25. The drug cocktails don't work for everyone, and no one knows how long they will keep the disease at bay.
There are also those who worry that researchers will lose the race with the virus, which mutates rapidly, and run out of new protease inhibitors with which to fight it.
For some, the drugs have already stopped working.
Two years ago, Our House celebrated a first-time event: One of its patients got well enough to leave. Now, he is preparing to come back, very ill, because the drugs have failed.
Even if the drugs continue to work for years, AIDS groups must strive to serve the growing and changing population. Without the glamour of the old days, however, they may be facing the battle alone.
To Rizzio, the lack of public support means that if the plague returns, we will once again be caught unawares and unprepared.
"The money that created these places doesn't exist anymore," Rizzio says. "We will not be able to restart them."
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Willamette Week | originally published December 9, 1998