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Services Support AIDS Sufferers

By Molly Hennessy-fiske

Strolling from class to class, lost in the everyday regiment of college life, students often ignore the problems facing folks outside the friendly confines of Harvard Yard.

Like AIDS.

But with the virus hitting the city of Cambridge and other Boston-area communities hard these days, helping people cope with the illness has become a matter of grave local concern, one that cannot be ignored by people in the area.

Even at Harvard.

Cambridge has about 2,000 HIV-positive residents. The number of women who are HIV-positive in Cambridge and Somerville has tripled in the past 10 years.

According to Cambridge Cares About AIDS Inc., a division of the city's AIDS Task Force, Cambridge has been among the top five Massachusetts cities in number of HIV cases since the disease was first reported.

Life for HIV-positive people in Cambridge and across America today entails a variety of obstacles, from the day-to-day strain of living with a usually fatal and often unpredictable disease to the trauma of discrimination in housing, employment and medical treatment.

For HIV-positive people, it is never easy to cope.

But an ever-growing support system in the Boston area is doing all it can to help sufferers in Cambridge.

One of the greatest concerns for Cambridge's HIV-positive population--especially those in the lower income brackets--is the search for housing.

"There's such a housing shortage [in Cambridge] that they're still setting limits," says Maureen Spofford, director of Cambridge Cares, a nonprofit organization that offers daycare services, educational outreach and case management to HIV-positive Cambridge and Somerville residents.

The group also offers temporary housing until a permanent home can be found.

Spofford says most cases involve individuals with mixed records--often former drug addicts and convicts--who find it difficult to obtain vouchers for public housing.

"A large number of our clients are homeless and in search of assistance," Spofford says. "They often don't have the references or the skills to find housing. They're on the bottom tier and we really have to work with the clients to get them back into the mainstream."

Kristins Hals, a project manager at AIDS Housing Corp. who spearheads several programs to handle housing issues for the HIV-positive, explains that each program services different needs within the HIV-positive community in Cambridge.

For example, the Open Door program targets singles, while the Home Connections program provides scattered confidential placement sites for families where the head of the household is HIV-positive.

"One of the best parts of Cambridge Cares is the housing advocate," says Hals, referring to Ken Alexander, who scours the city for available housing.

"He really casts a wide net and figures out whether to go to public housing, specialneeds housing or programs outside of Cambridge if the local programs are full."

They usually are.

None of the Cambridge Cares housing programs can house more than eight individuals at a time, and the transitional housing programs at the Cambridge YMCA and YWCA handle about 15 singles at once.

"It's getting harder and harder to find affordable housing for people who are HIV-positive," says Alexander, who heads the housing-advocacy branch of client services at Cambridge Cares. "Right now it's nearly impossible."

Alexander explains that all of his clients are homeless HIV-positive individuals in lower-income brackets looking for affordable housing in the area.

For most, Alexander tries to obtain federal Section 8 vouchers, which require tenants to pay 30 percent of their rent while the Department of Housing and Urban Development (HUD) picks up the rest.

But the number of vouchers has been drastically reduced in the past 10 years, to the point where Alexander says individuals can spend eight to 10 years on the waiting list.

"Right now I basically rely on connections to try to get clients pushed up the list," Alexander says. "Otherwise I would have to rely on the Public Housing Authority and that could take years."

Alexander recommends that HUD increase the number of Section 8 vouchers and that the city of Cambridge create more housing-assistance programs to serve the needs of HIV-positive Cantabrigians.

Alexander says he does all he can to keep his clients close to home.

"Most of the individuals I meet with want to stay in the area," Alexander adds. "They want to stay, if not to be close to their families then at least to remain in close proximity to their medical services."

Battling the Disease

As the primary AIDS medical care provider in Cambridge, the Zinberg Clinic at Cambridge Hospital provides a variety of medical services, from prescription assessment to acupuncture therapy.

An affiliate of the Cambridge Hospital Multidisciplinary AIDS Program (MAP), the clinic staff of about 22 full- and part-time physicians, social workers and nurses regularly serves about 350 patients.

"We work very closely with other Cambridge organizations... to provide comprehensive service to HIV-positive patients," says MAP Director Dianne Perlmutter.

Perlmutter stresses the importance of support groups, substance abuse counseling and family counseling to the clinic's holistic medical approach.

"We like to think of it as serving the whole family," Perlmutter says.

Physicians deal with patients individually and on a personal basis, Perlmutter says.

"[Physicians] work in partnership with patients to determine what care is best," she says. "They evaluate the pros and cons of a given medication and whether the patient is in a position to take them."

But recent controversy over new HIV-management drugs has put physicians--and their control over prescriptions--in the spotlight.

The drugs--protease inhibitors--are designed to be taken according to a strict schedule and can potentially strengthen the HIV-virus if taken sporadically.

"It's one of the most hopeful developments in a long time," says Perlmutter, "but if individuals take the drug and don't continue, there's the danger that if you start and stop you will develop a more resistant strain of the virus."

Prejudice or Fear?

Another issue for many HIV-positive individuals involves discrimination--in housing, employment and even health-care services.

"There does tend to be discrimination on the part of landlords," says Jeffrey Chatlos, a staff attorney at the Health Law Institute of the Justice Research Center (JRI), an organization devoted to the legal and mental care of HIV-positive individuals in the Boston area.

"I don't know if it's prejudice or fear on the part of the landlord, but [in the case of Section 8 vouchers] it's ridiculous," he says. "The rent's going to be there."

Chatlos explains that most of the cases the institute handles involve family law and issues such as estate planning, probate and health proxy.

"It's important to have someone you trust making medical decisions for you," Chatlos says.

"That way, when the crisis hits, you're prepared."

JRI also supports a mental-health clinic and educational outreach programs.

"We target the infected, the affected and those highly at risk of becoming infected," Chatlos says. "It's really all about getting informed and planning ahead."

Serving the Social Needs

Avoiding isolation--whether self-imposed or a result of familial and societal prejudice--is key for HIV-positive individuals, says Mariel Gonzalez, director of development for The Living Center, the only drop-in organization in New England devoted specifically to servicing the social needs of those with HIV.

"We are the primary care provider for the greater Boston area," says Gonzalez. "We've had many groups from around the U.S. and even the world--from Florida to Ireland--come to visit and research programs of their own."

At The Living Center, about 450 volunteers coordinate programs and activities designed to help HIV-positive individuals build social and working lives in the larger community.

According to Gonzalez, the center--the only of its kind in the region--provided 2,000 hours of service to HIV-positive people last year.

In order to become a member of the center and obtain access to all of its services free of charge--from legal assistance to holistic medicine--individuals are required to submit documentation of their medical status, meet5AIDSCrimsonMelissa K. CrockerCity Year volunteers at The Living Center in Boston arrange activities to help HIV-positive individuals maintain rich lives.

For example, the Open Door program targets singles, while the Home Connections program provides scattered confidential placement sites for families where the head of the household is HIV-positive.

"One of the best parts of Cambridge Cares is the housing advocate," says Hals, referring to Ken Alexander, who scours the city for available housing.

"He really casts a wide net and figures out whether to go to public housing, specialneeds housing or programs outside of Cambridge if the local programs are full."

They usually are.

None of the Cambridge Cares housing programs can house more than eight individuals at a time, and the transitional housing programs at the Cambridge YMCA and YWCA handle about 15 singles at once.

"It's getting harder and harder to find affordable housing for people who are HIV-positive," says Alexander, who heads the housing-advocacy branch of client services at Cambridge Cares. "Right now it's nearly impossible."

Alexander explains that all of his clients are homeless HIV-positive individuals in lower-income brackets looking for affordable housing in the area.

For most, Alexander tries to obtain federal Section 8 vouchers, which require tenants to pay 30 percent of their rent while the Department of Housing and Urban Development (HUD) picks up the rest.

But the number of vouchers has been drastically reduced in the past 10 years, to the point where Alexander says individuals can spend eight to 10 years on the waiting list.

"Right now I basically rely on connections to try to get clients pushed up the list," Alexander says. "Otherwise I would have to rely on the Public Housing Authority and that could take years."

Alexander recommends that HUD increase the number of Section 8 vouchers and that the city of Cambridge create more housing-assistance programs to serve the needs of HIV-positive Cantabrigians.

Alexander says he does all he can to keep his clients close to home.

"Most of the individuals I meet with want to stay in the area," Alexander adds. "They want to stay, if not to be close to their families then at least to remain in close proximity to their medical services."

Battling the Disease

As the primary AIDS medical care provider in Cambridge, the Zinberg Clinic at Cambridge Hospital provides a variety of medical services, from prescription assessment to acupuncture therapy.

An affiliate of the Cambridge Hospital Multidisciplinary AIDS Program (MAP), the clinic staff of about 22 full- and part-time physicians, social workers and nurses regularly serves about 350 patients.

"We work very closely with other Cambridge organizations... to provide comprehensive service to HIV-positive patients," says MAP Director Dianne Perlmutter.

Perlmutter stresses the importance of support groups, substance abuse counseling and family counseling to the clinic's holistic medical approach.

"We like to think of it as serving the whole family," Perlmutter says.

Physicians deal with patients individually and on a personal basis, Perlmutter says.

"[Physicians] work in partnership with patients to determine what care is best," she says. "They evaluate the pros and cons of a given medication and whether the patient is in a position to take them."

But recent controversy over new HIV-management drugs has put physicians--and their control over prescriptions--in the spotlight.

The drugs--protease inhibitors--are designed to be taken according to a strict schedule and can potentially strengthen the HIV-virus if taken sporadically.

"It's one of the most hopeful developments in a long time," says Perlmutter, "but if individuals take the drug and don't continue, there's the danger that if you start and stop you will develop a more resistant strain of the virus."

Prejudice or Fear?

Another issue for many HIV-positive individuals involves discrimination--in housing, employment and even health-care services.

"There does tend to be discrimination on the part of landlords," says Jeffrey Chatlos, a staff attorney at the Health Law Institute of the Justice Research Center (JRI), an organization devoted to the legal and mental care of HIV-positive individuals in the Boston area.

"I don't know if it's prejudice or fear on the part of the landlord, but [in the case of Section 8 vouchers] it's ridiculous," he says. "The rent's going to be there."

Chatlos explains that most of the cases the institute handles involve family law and issues such as estate planning, probate and health proxy.

"It's important to have someone you trust making medical decisions for you," Chatlos says.

"That way, when the crisis hits, you're prepared."

JRI also supports a mental-health clinic and educational outreach programs.

"We target the infected, the affected and those highly at risk of becoming infected," Chatlos says. "It's really all about getting informed and planning ahead."

Serving the Social Needs

Avoiding isolation--whether self-imposed or a result of familial and societal prejudice--is key for HIV-positive individuals, says Mariel Gonzalez, director of development for The Living Center, the only drop-in organization in New England devoted specifically to servicing the social needs of those with HIV.

"We are the primary care provider for the greater Boston area," says Gonzalez. "We've had many groups from around the U.S. and even the world--from Florida to Ireland--come to visit and research programs of their own."

At The Living Center, about 450 volunteers coordinate programs and activities designed to help HIV-positive individuals build social and working lives in the larger community.

According to Gonzalez, the center--the only of its kind in the region--provided 2,000 hours of service to HIV-positive people last year.

In order to become a member of the center and obtain access to all of its services free of charge--from legal assistance to holistic medicine--individuals are required to submit documentation of their medical status, meet5AIDSCrimsonMelissa K. CrockerCity Year volunteers at The Living Center in Boston arrange activities to help HIV-positive individuals maintain rich lives.

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