Keeping the conversation going: HIV in Richmond

One of the oldest community clinics in Virginia is in the Fan District. While HIV and AIDS can easily be thought of as mere abstract ideas, they are real health concerns for many residents of the city. What one organization is doing to help, and what two people with HIV have to say to Richmond.

January 11, 2012; 6:00 AM • by Nathan Cushing

The 1000 block of North Thompson Street–an otherwise unremarkable block of business buildings at the edge of Richmond’s Museum District–provides a unique representation of Richmond.

To its north is the swarthy, commercial heavy Broad Street, the city’s main artery: gas stations, car dealerships, fast food, strip malls, and the occasional adult video store. To its south is Monument Avenue, lined with commemorative statues and opulent Colonial, Georgian, and Italianate homes that still sell for millions of dollars even in a tenuous real estate market. And surrounded by both of these streets is the Fan Free Clinic.

Unlike the Patient First building farther south on Thompson Street, the Retreat Hospital on Grove Avenue, or St. Mary’s farther down Monument Avenue in the West End, you can drive through the 1000 block of Thompson Street a several times and not notice the small sign for one of Richmond’s oldest-running community clinics.

Opened in 1968, the clinic initially supported women’s health and the prevention of sexually transmitted diseases–the first free clinic to do so in the Commonwealth. The advance of the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in the 1980’s inspired the clinic to an additional purpose: free testing, counseling, and financial assistance to those infected with HIV/AIDS.

“It’s the very first thing you think of in the morning, and the last thing you think about at night.”

— more from John Jessie on living with HIV can be found HERE

You don’t enter the building through the front. Instead you walk around back where the rear parking lot is next to the whurr of cars traveling I-195 just beyond and below a tall chain-linked fence.

Entering through the quote-unquote back door conveys a whole host of euphemisms and connotations. There is the idea that only the unsavory enter through the rear, away from the gaze of the more “normal” members of society. There is also the back door as a common and crude euphemism that pejoratively refers to sex among gay men, a group of people that has been mercilessly derided and scapegoated more than any other since the onset of the AIDS era.

In the 1980’s, when HIV and AIDS became a health crisis under the Reagan administration, gay men were particularly admonished. Jerry Falwell, a tele-evangelical preacher who founded Liberty University in Lynchburg, Virginia, said that “AIDS is the wrath of God upon homosexuals.” Reagan’s communications director, Pat Buchanan, said that AIDS is “nature’s revenge on gay men.”

“I cried for two months…I threw chairs…I kicked chairs”

— read more from Darlene Castro on being diagnosed with HIV HERE

At a time when an outspoken segment of the public was so resounding in their contempt for gay men and women who contracted HIV and AIDS during the 1980’s, the Fan Free Clinic decided to counter the sentiment, becoming a place where anyone would be given free testing and assistance. Speaking about the clinic’s reaction to the epidemic back in the 1980’s, the current Community Case Manager, Rodney Lofton, said that the Fan Free Clinic was “one of the first organizations in the city of Richmond” to do so.

Lofton, 43, speaks with a professional and genteel voice about those with HIV/AIDS: while the animosity towards those with with the disease has dwindled since the 1980’s, it is not an ideal world. “There is still fear.”

Lofton began his career in 1996 volunteering with an HIV prevention group in New York City. Later that year, he moved to Washington, D.C. and worked with Metro TeenAIDS, an organization with the explicit purpose of helping young people with HIV/AIDS. In 2004, he became a case worker at VCU. Between the years 2006-2011, he left HIV/AIDS organizations to work as an office administrator for an after school program. He began working at the Fan Free Clinic in May 2011. When asked why he returned to the field of HIV/AIDS assistance after a six-year absence, he is blunt:

“I lost too many friends.”

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To the left, after entering through the back door of the clinic, is the waiting area used for physical examinations. A door takes you to one of several examination rooms where there are swabs, tongue depressors, and a whole host of other medical paraphernalia. To the right is a slightly smaller area, complete with its own receptionist, where one waits to meet a case worker or a counselor for a weekly appointment. Downstairs, however, has a different feel.

Among the rooms on the first floor is a large pantry. Cans of food line the shelves in an upside down U shape. As part of its services, the Fan Free Clinic gives out two bags of groceries per month to individuals in need. In October 2011, 93 households qualified for the clinic’s groceries program, which gave food to 118 people, including children.

Across the hall from the food pantry is a conference room. Known as the “super cube,” the room, with its foldout chairs and large table, serves as a catch-all for movie nights, game nights, and regular support meetings.

“HIV is a disease of behavior,” said Lofton. It is not an indictment of a person’s worth and character. However, this distinction may not be the first thing that crosses one’s mind when a test result comes back positive. “There’s still that fatalistic approach,” said Lofton. People think: I’ve taken this test and it’s come back positive and it means that my life is over and I’m going to die. While many may choose to remain reclusive for as long as several months–even years–after they learn that they’re HIV positive, eventually some turn to acceptance and reconstruction.

At any point in a person’s struggle with HIV/AIDS the Fan Free Clinic offers group meetings. There are two groups. One for men and one for women. In May 2011, when Lofton took over his duties at the clinic, there was just one meeting facilitator and one meeting attendee for the men’s group. After Lofton took over, he said that the largest meeting had thirteen attendees, and now operates with a base of 25 men. Wanting to make the group helpful and meaningful, Lofton asked the men who had given up on the meetings what they wanted out of them. The ages of the men vary from 25-years-old to over 60. “Gay, straight, black, white, recently diagnosed, and long-term survivors,” said Lofton of the demographics. “They drafted their own guidelines.”

Each meeting takes on a specific theme. One meeting can be focused on specific biological information about HIV, while another could be centered around when and how to disclose to a potential romantic partner about having AIDS. One of the more recent ones, said Lofton, was “our perception of masculinity.”

Roughly eight women consistently attend the weekly women’s meeting. The ultimate goal of the meetings, for both men and women, is to “empower and educate,” said Lofton. To be able to say, “‘I can live with this disease.’” Learning to live with the disease, however, is not the only point at issue: one must learn to live with others, especially others who are afraid of those who have the disease.

Lofton recalls that, during his facilitation of a class on HIV, a woman maintained that the the virus can be transferred by mosquitos. Although Lofton politely refuted the (very false) urban legend, the woman remained skeptical. Being scratched by someone with HIV/AIDS, playing sports with someone with HIV/AIDS, and drinking from a water fountain after someone with HIV/AIDS will not transfer the disease. It is also extremely rare for someone to be infected with HIV/AIDS through a human bite or a French kiss–the latter only occurring if the infected person has bleeding gums or mouth sores. While science and education mitigate false concerns about contracting HIV/AIDS, there are those that still recoil in fear when finding out that someone has the virus.

“It’s easier to have sex with someone who does and not know it, than to have them tell you,” said Lofton. In matters of HIV/AIDS, the price for honesty and forthcomingness can sometimes be derision and alienation. And that’s how the Fan Free Clinic, particularly the groups, help. It’s a place “where folks are going to build you up, and not knock you down,” said Lofton.

For some, hearing that they are HIV-positive results in hiding their disease, if not also themselves, from co-workers, friends, family—from life itself. On this point, Rodney Lofton recites an old African proverb he heard early in his career.

“He who conceals his disease cannot expect to be cured.”

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photo by margaridaperola