Miami Herald, - Sunday, September 10 1989
Jeffrey Kleinman and Steve Rothaus - Herald Staff Writer

"On this tiny island, I live a block away from the grocery," she said. "I always run into someone with it on my way to the grocery store."

Ana Weekley runs a downtown grocery. From her customer service counter, she sees dying people come into her store every day.

"You look at their color, and you could tell they're really sick," she said. "I say a prayer for them and hope they don't suffer too long."

AIDS is so prevalent in Key West that most people on the island know someone who has the disease or has died from it. Many have it themselves.

The island has long enjoyed a reputation as a free-wheeling tourist mecca with a visible gay population. The mayor is openly gay. There's a gay business guild and dozens of gay guest houses.

But gays are among the most frequent victims of AIDS, and the disease's impact on this island has been dramatic. The local hospital is buried in unpaid bills. The local bathhouse has closed. Gay bars hand out free condoms and put posters advocating safe sex in the restrooms. And the Chamber of Commerce fears tourists will stop coming.

Monroe County has one of the highest AIDS rates per capita in the United States: 121 cases per 100,000 people in 1988, according to the state of Florida, which keeps statistics by county. The Centers for Disease Control, which keeps statistics for metropolitan areas of 500,000 population or more, reports that San Francisco had a rate of 102 cases per 100,000 from August 1988 to July 1989. New York City had 63; Greater Miami, 45; Greater Fort Lauderdale, 37.

Mark Jones, a registered nurse, works with AIDS patients every day through his at-home care service. He started the business in 1986 and soon learned that 75 percent of his patients were suffering from acquired immune deficiency syndrome.

"It tears you up," he said. "Nurses do a lot of talking among themselves to cope. We talk about our frustration, our anxieties, our fear, our grief. We let it all out with each other."

Jones makes sure to slip out of town on weekends, just to get away. Still, he is not sorry to be treating AIDS patients.

"I have a sense of satisfaction," he said. "We have one of the most compassionate communities in the country."

Straight and gay alike, many in Key West believe that care here is more understanding than elsewhere. And although no reliable statistics exist, social workers say many AIDS patients are coming to the city for treatment and to die.

But a reputation for compassion could overwhelm the local health-care system and stifle Key West's primary industry -- tourism.

"If this is a great place to die, then it's not a great place to have your winter vacation," said Harkow, the social worker.

That scares members of the Greater Key West Chamber of Commerce.

"The impact on this community could be tremendous if we have AIDS patients come into Key West for their last days," said John Parks Jr., chamber president. "We don't want to advertise that this is a place for AIDS patients to come."

Parks said the chamber this year identified the AIDS problem as potentially devastating.

"If the negative gets out that there are a large number of AIDS cases in the Key West area, then people have the fear of not coming to Key West," he said. "This can be an explosive situation to the community."

Public education about the disease and how it is spread is the key to reassuring frightened tourists, Parks said.

Since the county first started keeping records of AIDS cases in 1982, 217 people have been diagnosed with the disease in the Keys, said Dave Nolan, who handles statistics for the Monroe Public Health Unit. That number does not include those who were diagnosed elsewhere and have moved to Key West. Of the 217 people diagnosed in the Keys, 132 have died.

Key West businessman Bill Conkle has several friends fighting the disease.

"There are so few people here that you're bound to know a few of the people who have been affected," he said "I am aware of a lot of sickness around. It's a very heavy thing."

The Keys' spiraling AIDS rate has left the county's only public hospital, Florida Keys Memorial, in financial tatters. By the end of September, administrator Donald Mayer expects the hospital to be stuck with at least $1 million in AIDS patients' unpaid bills.

That figure amounts to a third of the hospital's unpaid bills, Mayer said, a significant bite from a budget with only $13 million in revenues. Since the beginning of the 1989 fiscal year, 85 AIDS patients have not paid for their stays at the hospital.

"AIDS is a big chunk of our financial problems," Mayer said. "But we will continue to provide the care."

Lee Brooks spent the last nine months of his life in Florida Keys Memorial. He died there in March, with no medical insurance, at the age of 36.

"Down here, because the community is so small, when anyone dies, it affects a lot of people," said Brooks' lover, David Kuhn, 53.

Kuhn and Brooks, who had been living in Miami, were both diagnosed as HIV-positive, or infected with the AIDS virus, in 1981. They moved to Key West five years ago to run a guest house.

"When I worked at the guest house, people would call for reservations and ask if this was a gay guest house or straight," Kuhn said. "I would tell them it was mixed. Some would say, 'Oh, if there's someone gay who is swimming at the pool who might have AIDS, I wouldn't want to stay there.' "

Kuhn, a member of an AIDS support group in Key West, says he has known about 150 people who have died of the disease. And he has seen somber changes in Key West since AIDS became prevalent.

"Key West is not as gay as it used to be," he said. CAPTION: PHOTO: David Kuhn holding photo of Lee Brooks (AIDS); photo: Mark Jones with Robert Smith

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