When Mary Adams first walks into the Robles Park community affairs office, no one notices.
The high-pitched chatter of childhood permeates the tiny room, bouncing off the dirty white tile floor, off the walls lined with posters advertising the Statue of Liberty and free summer lunches. Little girls in cornrows and pigtails and little boys with close-cropped hair crunch Rold Gold pretzels and sip apple juice from cartons. The sole adult in charge sits squeezed behind a table, her arms folded, her eyes weary. She sighs. No one was informed that Adams, a risk reduction specialist at Tampa Bay Aids Network, was planning to teach today.
In the middle of the room, four girls are practicing dances and cheers.
"Work it, and win it, until you just can't get enough," the girls shout in unison. Unhesitating, Adams, 39, jumps into the fray, shaking and bumping her larger behind against the shoulder of one of the smaller girls. They finish the cheer together.
"Don't bother us! Don't bother us! Whoo whoo you just too tough!"
The other children giggle. None of them has ever seen this tall woman in the jeans shorts and turquoise Hawaiian shirt, this woman with the attitude, who wears a black wig with red streaks in it.
With some effort, Adams convinces them to drag a motley assortment of plastic chairs into one corner of the room.
"My name is Miss Mary," she tells them in a loud, friendly voice. "Today we're going to talk about AIDS."
The lesson begins there and continues, with periodic interruptions, for about an hour. The children learn that the immune system is like Superman, that AIDS is like kryptonite, that transmission of the HIV virus _ which Adams explains is like a bug _ happens "if you stick something in your body that somebody else stuck in their body."
"Do the bug be crawling around inside?" asks a little boy with wide eyes. Adams patiently explains that it does not.
"I'm proud of you," she adds, enveloping him in a hug when the session ends. "You've been asking some good questions."
Adams walks outside with the children, and watches them make their way home. Afternoon heat reflects off the litter-strewn streets and empty basketball courts of the Robles Park public housing complex. Heat bakes the laundry, which clings stiffly to clotheslines strung across row after row of peach-colored two-story buildings. Heat wilts the feathers of a dead bird that lies face down on one side of the road. An emaciated woman totters out from one building with an empty glass bottle. She tosses the bottle into a trash bin, then retreats into the shadowed doorway. Several teenagers sit on a door stoop, gossiping in low tones. Adams smiles at them.
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Despite her easy demeanor, Adams is all too aware of the urgent need for AIDS outreach in Robles Park and communities like it. Fifteen years ago, when she first became involved working with AIDS services in Tampa, Adams was present when the first 12 people in Hillsborough County were diagnosed as positive for HIV, the virus that causes AIDS. Today, she notes sadly, the number of cases has increased to more than 5,000.
Infection rates are particularly alarming in the African-American community. In Hillsborough County, more than 50 percent of people infected with HIV are African-American, despite the fact that African-Americans represent only 15 percent of the total population. In Pinellas County, African-Americans represent 37 percent of those infected, but only 9 percent of the population.
A study released at the World AIDS conference in Barcelona this month brought the epidemic into focus: It revealed that a stunning 90 percent of HIV-infected young, gay African-American men in the United States are unaware they have the virus. By comparison, 70 percent of Latino men and 60 percent of white men were unaware.
Such numbers are emerging even as rapid advances in medicine are making it possible for those with HIV to lead healthy lives for years. In fact, many outreach workers say misleading marketing of AIDS miracle drugs and the much-touted good health of former NBA star Earvin "Magic" Johnson have combined to convince many people that AIDS is not necessarily a fatal disease.
"The pharmaceutical companies are sending images to people of muscular, healthy-looking men and women," says Lorenzo Robertson of Operation Hope, a St. Petersburg outreach organization that targets African-Americans. "They don't show the tons of people taking those medications whose body chemistry doesn't tolerate the medicine, who suffer side effects."
Despite her long experience, Adams' heart still breaks every time she delivers a positive diagnosis. The young victims remind her of her own four children. Sometimes she wonders if she is having any impact at all.
"You look at all the information and all the services and you look at the number of people who are infected and it is still climbing," she says. "Sometimes I wonder if maybe what I'm doing isn't as effective as it should be."
Overall, Adams retains her optimism and her passion for her work. But she and other outreach workers argue that in order to effectively confront the AIDS epidemic in the African-American community, basic attitudes need to change. Public officials must increase funding and embrace flexibility for outreach workers, they say. Meanwhile, community leaders must work harder to eradicate the deep stigma surrounding AIDS and, especially, homosexuality.
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Despite the fact that AIDS in the African-American community has grown at an accelerated rate throughout the '90s, many advocates say that funds to fight the epidemic are unforgivably scarce. They say the number of outreach workers on the streets is simply insufficient.
The Florida Bureau of HIV/AIDS received approximately $131-million in total federal funding last year. Of this, $105-million went to patient care (treatment, prescription drugs and home care) and $19-million went to prevention. Of the $19-million, just $3.6-million went to community-based organizations that provide outreach, according to Vanessa Crowther, a prevention team supervisor for the bureau. Crowther estimates that 95 percent of these programs target minorities.
"Being that the epidemic is exploding now, there's always going to be a need for more funding," she says.
Outreach workers also contend that the funding that does come in may be accompanied by seemingly unreasonable stipulations.
"Five black AIDS organizations have closed within the past year in Florida," says Carl Devine, founder of the People of Color AIDS Coalition, an organization that has since gone out of business. "Some of them have given the money back to the state because they didn't want to be bogged down with the state's c_-."
Crowther says that these closures resulted after the organizations failed to fulfill certain contract obligations. She attributes this failure to a combination of weak administrative and fiscal management infrastructure. Georgia Foster, president of the Florida Black AIDS Network, says that these management problems are often the result of poor communication between outreach organizations and state project officers.
At Adams' organization, TBAN, some supervisors mandate an 8:30 a.m. to 5:30 p.m. day, despite the fact that Adams and three other workers stay until 8 or 9 most nights. The four workers reach approximately 2,000 people each month. In addition to providing counseling and testing, Adams does outreach with prostitutes, many of whom frequent bars and 24-hour coin laundries with bathrooms that serve as mini hotel rooms. To reach out to churches and community groups, she also often works weekends.
"People in Tallahassee never ask us, "Is that workable? Is that feasible?' " Adams says.
Adams's colleague, Ed Gadson, a former caseworker with Tampa AIDS Network (the organization that has since become TBAN), insists that nontraditional methods are as imperative as nontraditional hours when reaching out to high-risk populations.
A recovering addict who has been HIV-positive for 18 years, Gadson says too much AIDS programming is located in community centers and health fairs where no addicts or prostitutes are likely to go. During his time with the Tampa AIDS Network, he sometimes enlisted the help of drug dealers to reach substance abusers, a group with a particularly high risk of infection. He educated them about HIV transmission and provided them with cases of condoms to pass on to their clients.
Across the bay, Bill Miller, an outreach worker with Operation Hope, walks miles and miles every day, weaving his way in and out of parks, crack houses and brothels in St. Petersburg. Miller generally sets out in the wee hours of the morning, sometime between 2 a.m. and 5 a.m., entering neighborhoods that many people would be unwilling to visit even by day.
An Army veteran and a one-time NFL and NBA recruit, Miller is 6-foot-4 and weighs 250 pounds. But size and strength haven't always protected him from the dangers of the streets.
For several years, Miller was deeply immersed in St. Petersburg's drug scene. Then one evening a decade ago, a street-corner brawl downtown left him in a coma. He awoke four weeks later with minor brain damage that impairs his ability to speak. But the experience awakened a passion for outreach.
Outreach workers such as Adams, Gadson and Miller can act as models of commitment and innovation. But insufficient staffing and faulty methodology only account for part of the current failure to stem the AIDS epidemic among African-Americans. Outreach workers can make condoms readily available and can even show people how to use them. Sparking dialogue and confronting the community's deep taboos about sex have proven much more difficult.
Some school boards oppose sex education. Black churches, which have traditionally provided strong leadership and direction to their congregations and communities, have been markedly hesitant to embrace AIDS outreach.
Advocates say that healthy dialogue about sexuality is almost wholly absent from most pulpits and church social circles.
"The church says "don't do it, don't do it,' " says Ricc Rollins, founder of Brothasspeak, an organization for gay men of color. "But if you don't offer an alternative, then what? And the school doesn't offer an alternative. Then what? And the parents don't offer alternatives. Then what?"
Adams says she thinks black churches may, very slowly, be changing their attitude toward AIDS education. For the first time in her 15 years in the field, she received a call a month and a half ago from a church in Brandon.
Could Adams give a talk about HIV and safer sex to the congregation? the caller wanted to know. And could she give a condom demonstration as well?
Adams brought her bag full of condoms to the church, and soon, adult men and women in their 30s and 40s were carefully practicing slipping the condoms over carrots. The minister approached Adams, and she shook his hand.
"I'm not deceived," Adams says he told her, "I know what's going on out there."
"I'll never believe I heard that from a minister," Adams says with a laugh.
Outreach workers say homophobia in the black community, and especially in black churches, is so deeply entrenched that most homosexual or bisexual African-American men refuse to identify themselves as gay. Outreach workers instead refer to these men as "MSMs" or "Men who have Sex with Men."
"Young black gay males are the hardest to reach, because of the cultural aspects of it," Adams says. "A young man is put in the position where he's got to disappoint mama and daddy, and grandma and granddad. So a lot of them will have girlfriends or get married to shield their identity from their families."
"On the down-low" is the term currently used to describe men who have wives and girlfriends in public, and sex with other men in secret. According to Lorenzo Robertson, co-executive director of Operation Hope, men who are addicted to crack and heroin will often turn to prostitution, seeking out wealthier men who are "on the down-low" to help fund their drug habits. They may then pass along HIV to their female sex partners. Many of these men prefer not to know their HIV status at all. If they do test positive for the virus, they might then be forced to tell their families and friends about their secret sexual identity.
Outreach workers say shame is one of the biggest barriers to getting help.
"You can have all the education in the world about what's safe, you can give all the free condoms in the world," said Wilson Williams, youth director for Face To Face, a youth group for gay, lesbian, bisexual and transgender teens. "But if the self-love isn't there, they're going to look at themselves as being bad, and they're not going to take care of themselves."
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Fifteen years ago, Adams barely understood what AIDS is. She was working as a Kmart stock clerk and nurturing only a vague ambition to save the world. She interviewed for what she thought was a job in aging and adult services. But during the interview, no one mentioned the senior population.
Instead, they talked about AIDS. And Adams found her true calling.
Now, she pushes open the glass door to the Boward Barber Shop in Tampa. The pungent smells of sweat and after-shave rush up to assault her nostrils. On the wall, rows upon rows of glamor shots of men's heads advertise an array of hairstyles available to clientele: close-cropped, clipped, shaved, zigzagged. Underneath, several men and boys sit, waiting their turns and watching three barbers wield clippers over the hair of three clients. Thick black tufts lie strewn about the gray tile floor.
Here, the clientele know her as "the condom lady" or "the AIDS lady" or even "the sex lady." Today, there are 12 men in the barbershop and no women. Adams marches right over to the corner shelf. She stuffs condoms into the empty plastic container and then begins to banter.
"They've got everything now," she grins at the men, "fruit-flavored, glow-in-the-dark, polyurethane for people who are allergic to latex, even something for the mouth." Adams always tries to offer a selection.
Initially hesitant, the men soon begin asking her questions.
Finally, a tall, thin young man in baggy jeans and a light blue T-shirt stands up and gets Adams' attention. Walter McFadden is 22 now. He has an earring and a goatee. But now that she looks at him again, yes, Adams remembers him, too. How long ago was it now? Eight, nine years since she had him in her AIDS/HIV class at the local Boys and Girls Club. He still remembers her. She was the only outreach worker he'd ever seen.
And does he remember what she taught him? Yes, he says. He remembers all of it.
And does he have any kids? Adams asks. Five, he says, by three women.
Really? Adams tries to keep her tone light. Really?
No, not really. He has two, with his girlfriend.
And does he know anyone infected with HIV? No, he says. At least, he doesn't think so.
Mary Adams, right, has spent 15 years working and talking about AIDS prevention. At Robles Park public housing complex in Tampa, she and Michelle McKinney, rear, talk with Alicia Pinnock, 16. The women work for the Tampa Bay AIDS Network.
At Charlie T's Barber Shop in Tampa, where Alice Jeffery, 72, has her eyebrows shaped, the condom jar gets refilled. They are free for customers.