Byline: LOUIS HANSEN, STAFF WRITER
Migdalia carries 1997 in a black, bound date book - water-stained, dog-eared and filled with prompts for a year of transient memories. Ink squiggles and slashes transverse the days like printed directions on an old road map.
March 27 is a blank box. Migdalia left the Norfolk apartment she shared with her two teen-age sons and worked her night shift as a nurse's aide in a Virginia Beach nursing home.
March 28: a dermatologist's appointment. A raspberry-colored rash on her face, arms and hands had receded, but the routine follow-up was punctuated by an extraordinary test result - AIDS.
She confided to her boss and her landlord. Within a week, she lost her job and her apartment.
``My biggest fear is being left out in the cold,'' said Migdalia, 47, who is in her fourth apartment in less than a year. ``It's bad enough as a stigma.''
On March 31, the lease on the three-bedroom apartment she shares with three roommates in Virginia Beach expires. She does not know where she will live.
Typical? Local AIDS workers estimate that at least 160 people in Hampton Roads - from street people to motel-and-shelter nomads - suffer chronic homelessness caused or complicated by the fact that they are HIV-positive.
About 3,300 people in Hampton Roads have been diagnosed as HIV-positive or with AIDS, according to state health department statistics. Although homelessness among this population is not a crisis, it is an emerging problem.
Marty Mendelsohn, director of Full Circle AIDS hospice support, said the number of homeless people approaching his agency for help has increased during the past two years.
Once a disease that primarily afflicted gay men, AIDS cases have spread rapidly through the mercurial community of intravenous users. ``Our newer clients tend to be poorer,'' Mendelsohn said.
Homelessness complicates public AIDS treatment. Unrestrained by drug counseling, some continue to practice dangerous habits - sharing infected needles, hustling and having unprotected sex with numerous partners.
Even a homeless person who is responsible and tries not to spread the virus can be difficult to treat.
Meanwhile, support from extended family and friends disintegrates in myriad uncertainties: What if we share forks? What if this relative uses my towel, toothbrush or razor blade?
The people with AIDS or who are HIV-positive in this story agreed to be interviewed only if their last names were not used. All feared further isolation if their conditions were known. None wanted their faces photographed.
``It's like an invisible population,'' said Urban League AIDS counselor Ramona Smith. ``You don't know how to contact them.''
Sampson chose his invisibility.
The slightly built, 56-year-old Vietnam veteran learned he was HIV-positive two years ago, while living in San Diego. He said his longtime girlfriend abused drugs, and he believes he contracted the virus from her.
``I cried for three days,'' he said. ``I thought it was the kiss of death.''
He returned to his hometown in the Great Smoky Mountains of Tennessee, where his three brothers and three sisters live. Friction soon developed among Sampson and his six younger siblings.
Even home-cooked meals turned bad. One table setting was plastic, always thrown away after the meal: Sampson's.
His sister-in-law followed his trips to the bathroom with a Lysol tempest. She told her friends that Sampson was HIV-positive.
``I just felt uncomfortable,'' he said.
He left his family. He had lived in Norfolk while stationed with the Navy, and he came back because the AIDS support services are more plentiful here than in rural Tennessee.
After doing odd jobs and sharing apartments, he soon became ``a camper.''
``I never use the word homeless,'' said Sampson, during an interview in a sparse office at at an outreach mission in Norfolk, where he volunteers. ``I use the word `camper.' ''
``In the summer, I've got a sleeping bag, and I sleep where I want,'' he said, declining to name his specific camps around Norfolk.
``It's hard to maintain this appearance and this attitude,'' he admitted.
He keeps a tidy duffel bag, filled with clothes and medicine, and toiletries in a plastic bag. A box of moist towels works for bathing. He trims his clean-cut, salt-and-pepper hair himself.
Most mornings he spends at the Norfolk mission or helping out at the Red Cross. He sometimes sits for hours - alone, unnoticed - at local restaurants, coffee shops and hotel lobbies.
He picks up a regular regimen of AIDS drugs, about $1,200 worth a month, at a Norfolk clinic. The cost is paid for by the federal government.
A common treatment program for HIV-positive individuals is a medicinal ``cocktail.'' A combination of two or three drugs must be taken consistently, and at regular intervals, to combat the disease, said Dr. Arnold B. Barr, director of the HIV Clinic of the Norfolk Health Department.
The cost of AIDS treatments can range from $12,500 to $150,000 annually, Barr said. For poor patients, the cost is paid for by state and federal funds.
``If they stay homeless, we don't tend to see them often, if ever again'' after an initial treatment, Barr said. ``It would eventually cause a problem for them and those people whom they could be infecting.''
Sometimes Sampson forgets his medications, but he's been vigilant. His ``viral load'' - the measurable amount of the HIV virus in his body - is near zero.
His family is sympathetic and sends him money and clothes, but they don't always understand. ``They're very ignorant of the disease,'' he said.
Sampson won't go back to Tennessee. ``There's no room for me, they say.''
Hampton Roads has no hospice dedicated to housing indigent AIDS patients. Housing is often shared in the network of hotels and shelters available to the estimated 2,000 homeless individuals in the region.
AIDS case workers report other hurdles when trying to place their clients into permanent housing.
Al Torres is the director of client services at Tidewater AIDS Crisis Task Force, the largest service agency for the HIV-positive population in Hampton Roads. It has a $67,000 budget from federal funds devoted to emergency and long-term housing.
Torres said it is not uncommon for landlords to get cold feet when they hear that a prospective tenant, or one struggling to meet the rent, has the disease.
``Immediately, they say, `Oh, we can't help you,' and the client is evicted,'' Torres said, although federal law prohibits such discrimination.
The search for food and shelter often subordinate treatment of the disease. Often, mental disorders and drug abuse complicate housing problems. Rent money might be used to buy drugs.
``When you're a substance abuser,'' said Ramona Smith from the Urban League, ``that's the first thing you think about.''
At 27, Bruce wonders where his life has gone. This is how he tells it:
He ran away from his middle-class family in Chesapeake at 12, became homeless - ``somewhat by choice'' - hustled on the Ocean View strip, smoked pot and a little crack, sniffed and shot heroin and stole, stole, stole.
After shifting in and out of juvenile detention centers, drifting back home, then to the streets, the beach, flophouses, and hourly rate motels, the state settled his residency problems for 10 years, sentencing him to prison for sundry grand larcencies. He was 17.
That same year, when he could have been graduating from high school, he learned he was HIV-positive.
After serving 10 years in prison, he is free. During his six months of freedom, he has lived on the streets, at various shelters, with various friends, in various apartments. He has yet to gain a stable regimen of AIDS drugs.
``I'm untrustworthy,'' he said from behind a pair of black, Jackie O-style sunglasses, which announce a broad, soft face. ``Believe me, I earned that.''
The primary cause of HIV transmission in Hampton Roads is male-to-male sex and intravenous drug use, although heterosexual sex accounts for a growing percentage of the cases.
Bruce is gay and has shot heroin.
He sometimes shared needles when he didn't have his own, he said, soaking their tips in bleach in hopes it would kill the virus. To get money for drugs, he ``tricked'' as a petite blonde drag queen named Ms. Erica, along Church Street in Norfolk.
``Sometimes I wonder if this ain't hell,'' he said.
Lately, he's had help. He volunteers for TACT, and the agency has helped him set up his own apartment in Portsmouth.
He wants to turn his life around - and no one but a demon of an addiction would argue against it. He has not shot heroin since December, he said. ``If I ever want to be something, I have to work at it.''
He recently stayed 2 1/2 weeks at a Portsmouth drug rehabilitation center, but left early for ``personal reasons.''
Migdalia has worked as a phlebotimist and as manager in a doctor's office. She thinks she caught the virus from a needle prick or a transfusion she had in 1983, shortly after her third son was born.
After the first eviction last year, her 15-year-old son moved to Delaware with Migdalia's sister. Her 19-year-old son has moved to Virginia Beach.
She has not told her roommates about her condition, and she worries they might shun her if she did.
For money, she baby-sits, although she would like a full-time job, and an apartment, to get her youngest son back to Virginia. After treatment ups and downs, and a $2,800-a-month retinue of drugs, her viral load is nearly imperceptible.
``It's the pills or the coffin,'' she said. ``I don't want the coffin, yet.''
More than 16 years after the epidemic was discovered, uneasiness and mistrust still abides in dealings with people infected by the AIDS virus.
Although they take different routes, Migdalia, Sampson and Bruce each search for something beyond a cure to their disease - a steady job, a safe place.
Migdalia doesn't have real estate broker appointments in her 1998 calendar, or even a ready map for her future.
``It's a big cloud,'' she said. ``Doors close very quickly once they know.''
CAPTION(S):
Color photo
LAWRENCE JACKSON/The Virginian-Pilot
Migdalia is partially shown behind the AIDS medication that she must take three times a day.
Graphic
The Virginian-Pilot
LIVING WITH HIV AND AIDS
SOURCE: Commonwealth of Virginia Department of Health
(For complete graphic, please see microfilm)
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