Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
The teen time bomb unsafe sex is spreading AIDS among Florida's youth
Miami Herald - Sunday, November 4 1990
Elinor Burkett, Herald Staff Writer
When Pedro told his father the news, Hector Zamora's body went rigid. It was news mainstream Miami can't fathom: teen-age AIDS. "I looked at my son -- my lovely, 17-year-old son -- and I saw a cadaver," the Hialeah gardener recalls softly. Zamora asked God: "Why not me? I'm an old man." * The price of sex in America is skyrocketing, and teen-agers are beginning to pay. Over the past 21 months, the number of teen AIDS patients in the state has doubled. The culprit: Sixty percent of local teens are having sexual intercourse, and virtually none of them use condoms. The actual numbers are comfortingly small: The CDC reports only 585 full-blown AIDS cases in teens nationwide, only 63 in Florida, 10 in Dade. But the reality is uncomfortably stark with a viral infection that takes up to 15 years to develop its full disease potential. Consider: * Four of every hundred Florida teens examined at public health clinics are infected with HIV, the virus believed to cause AIDS, according to the state. * One percent of 15- and 16-year-olds randomly tested on admission to local hospitals carry HIV in their blood, according to the Centers for Disease Control. The real infection rate is probably higher, they say, because the statistics are based on kids admitted for things like appendicitis, tonsillitis, broken legs. Patients who seem at high risk for AIDS -- teens on drugs or with sexually transmitted diseases-- teens admitted for diseases associated with AIDS, with cancer, hemophilia, even gunshot wounds are excluded. * While the number of teens with full-blown AIDS has doubled over 21 months, the number infected with HIV is doubling every 14 months. * More than half the Florida teens with AIDS are girls, and more than half of them were infected through sex. "We are sitting on the top of a volcano that is going to explode in the next generation," says Dr. Karen Hein, director of the Adolescent AIDS Program at Montefiore Hospital in New York. * Marsha Goldberg might be the first member of her temple sisterhood to struggle with AIDS in her family. She isn't sure: AIDS isn't something her neighbors in Kendall talk about. In her suburban world, you don't come out and announce that your daughter has just been diagnosed with AIDS. Goldberg wishes she could, with her real name and photograph. But her daughter Susan doesn't want people to know that she's not just another University of Miami student. For the moment, the family is hiding behind pseudonyms. And Marsha Goldberg knows secrecy is part of the problem. "We have only two choices: We can recognize that AIDS is a time bomb and talk to our kids about sex, or we can watch a generation die. Don't let anyone kid you, there is no third option. "Fear, fear, we have to teach our children fear. I didn't teach my daughter to be afraid, and she's going to die." * Pedro Zamora and Susan Goldberg are but two of the Dade teens struggling with a fatal illness most still believe is the scourge of hookers, addicts, homosexuals and hemophiliacs, of people who aren't like them. Pedro, whose family came to Miami on the Mariel boatlift, was an honors student, science club president and cross-country runner at Hialeah High School. He was Hialeah Youth of the Month in 1987. He volunteered in the cancer ward of Hialeah Hospital. Now he sells menswear at Burdines. He hopes he has enough time left to get a college degree -- so he can become a death counselor. Susan, who was an honors student at Palmetto High School, spent her junior year abroad in Israel. A '60s-style teen with ripped jeans and long hair, she wore an antique dress to her senior prom. Now a popular junior at the University of Miami, she thinks a lot about going to Europe and bumming around, carefree. Pedro and Susan never shot up heroin or smoked crack. They never ran away to the streets or worked as prostitutes. But theirs was high-risk behavior: They were sexually active. Even three years ago, there were few Pedros and Susans among the nation's infected teens. The young people Dr. Hein saw in her New York clinic, the nation's first facility for adolescents with HIV, were 18- and 19-year-old boys who lived on the streets, who worked as prostitutes and used drugs. Now, she says, her patients are younger and more likely to be female. Now, most of her patients have homes and families. "These kids never considered that they were at risk because they didn't do drugs and they didn't sleep around. But no one tells them that all you need is one partner if it's the wrong partner." * The danger of AIDS to teens is a secret. It hides behind a virus that waits five, 10, even 15 years before making its destructive powers felt. AIDS generally destroys the immune systems of adults, but the CDC reports that in more than 20 percent of the nation's patients, the disease took root while they were still teens. A young woman who at 14 has sex with the wrong man knows nothing about the consequences of her behavior until she is out of college, experts explain. A young man who shares a needle with his buddies on the high school football team when they shoot up steroids has no idea of the risks he has run. The danger is veiled by adult disapproval of teen-age sexuality that prevents frank discussion of what teens are, in fact, doing. "The adolescent population is ripe for AIDS infection because of experimentation and risk taking," says Wanda Wigfall-Williams, director of the National Initiative for AIDS and HIV Prevention Among Adolescents at the Center for Population Options. "People can't afford to have their heads in the sand thinking that not talking about it will prevent kids from doing it." The average American girl has sex by her 16th birthday, the average boy some six months earlier. Only one-quarter of the girls use contraception regularly; few choose a method of birth control that protects them from sexually transmitted diseases. So every year, one in every 10 teen-age girls get pregnant, one in six teens needs treatment for an STD. The danger also lurks behind a federal bureaucracy that cannot -- or will not -- make the dimensions of the adolescent epidemic clear. The American Red Cross collects statistics on the infection rate among all blood donors and could make it public by age, says the local chapter's medical director, Dr. Bruce Lenes. The organization refused to make it available. The CDC is surveying infection rates among military recruits, Job Corps applicants and pregnant women. But few figures are available for publication by age, fewer still by state. "There is a paucity of appropriate data available to scientists for monitoring the spread of HIV in the teen population," concluded the National Research Council in its new report on the epidemic. The council recommended that the CDC break down its information on the epidemic by narrow age groups to allow for separate consideration of teen-agers. Meanwhile, the bare outlines are alarming. Surveys of blood taken at student health centers on selected college campuses nationwide revealed that one student in 500 was HIV-positive. A center for runaway and homeless youth in New York City recently turned up a 7 percent infection rate. Almost 1.5 percent of teens tested anonymously in Florida had the virus in their blood. And while heterosexual intercourse accounts for only 5 percent of the adult AIDS cases nationally, it accounts for more than one-third of teen-ager cases in Florida. "Among adolescents," state AIDS authorities recently reported to the Legislature, "this is a heterosexual, not a 'gay' infection." That's what worries Dr. Marilyn Broman. Every year, the director of adolescent medicine at the University of Miami sees more infected young people who are not drug users, who are not members of traditional "high-risk" groups, who are "nice" kids from "good" homes whom no one has taken seriously as candidates for a fatal illness. Broman knows how infections like HIV multiply. She has watched other sexually transmitted diseases begin with a single student, then spread throughout an entire student body. AIDS is a sexually transmitted disease. The first students already are infected. "We are sitting waiting for the floodgates to open," she says. * Last Tuesday, Pedro Zamora, 18, returned to Hialeah High, his alma mater. During seven class periods he gathered the students he used to greet in the halls together in circles to talk about AIDS. "Teen-agers think they're immortal, that they can never get AIDS, that they can never get cancer, that they'll live forever," he told them in his soft voice. "I know. I was one of those teen-agers. "I was wrong." Pedro found out he was not invulnerable as a 16-year-old junior in high school when a letter came from the American Red Cross asking him to call or stop by. He had just donated blood. He knew what the letter meant. He ignored it. Two months later, he went to his family doctor and asked to be tested. The results weren't good: There was HIV in his blood. Pedro's mother had died of cancer two years earlier. "I didn't know how to handle it," he says, shyly but with no shame. "I went out looking for the love I wasn't getting at home. I went out and used sex to replace love." So his test results weren't entirely surprising. Four months after the doctor gave him the news, Pedro wound up in the emergency room at Jackson Memorial Hospital with his face misshapen by shingles, certain he was about to "kick the bucket." He was 17. By the end of his two-month hospital stay, Pedro had discovered anger: "at the government for not caring, at people for not seeing us as real people with a real disease, at society for not teaching us anything about AIDS." "I could never connect a face with the disease. No one ever sat me down and talked about it. Our parents and teachers tell us to have safe sex, but no one ever told me how. "If they had, maybe I wouldn't be in this situation now." Pedro has turned his anger into a mission. As a member of the speakers' bureau of the AIDS Education and Prevention Program of the Dade County Schools and a volunteer at Health Crisis Network, he carves out time from his work schedule to go wherever young people don't know enough about sex, enough about AIDS. That seems to be virtually everywhere. One pregnant teen-ager in a Miami Beach clinic insists she suffered contraceptive failure. "What method did you use?" she was asked. "Jelly," she replied. "What type of jelly?" "Grape," she responded. One 17-year-old Miami boy finally got a demonstration of how to use a condom. "I've been doing it wrong for two years," he said afterward. "I thought you had to poke a hole in it so your testicles wouldn't explode." Stacy Block, a reporter for the student newspaper at Coral Gables High School, says that in the classroom she has never heard more than a passing reference to AIDS. (It's a different matter in the hallways, where AIDS has become a joke among students, replacing "cooties" as the term of contempt.) The results are obvious in the rising rate of sexually transmitted diseases among teens, in their refusal to use condoms. The ignorance about the disease became almost palpable recently when the CDC published a survey of the nation's high school students. In Miami, more than half said you can get AIDS from insects or by giving blood. While almost all know that intravenous drug use is dangerous, more than one in 10 didn't know you could get the virus if you had unprotected intercourse. "Everyone has to pass a CPR test to graduate, but you don't have to know anything about AIDS and how to prevent it," says Block. "It would be more useful to require everyone to pass a test on how to put on a condom correctly. It would save more lives." Last month Joseph Fernandez, superintendent of Dade County schools until he took over the New York City system earlier this year, proposed that New York high schools institute a program not only to teach and demonstrate condom use but to hand condoms out to the kids. Almost 14 percent of the nation's teens with AIDS live in New York State. More than 10 percent live in Florida. Florida law requires all schools to teach students about AIDS in fifth, sixth, seventh, eighth and 10th grades. The AIDS Prevention and Education Program trains teachers to explain what the disease is, how it is transmitted, how it destroys the immune system. Some show videos about teen-agers with AIDS. Others hand out pamphlets to assuage their fears, demolish their myths. All are required to preach abstinence. "The virus doesn't care if parents don't approve of teen sex," says Dr. Hein. "It doesn't care if school boards think abstinence should be taught. "If we can't learn to say the 'C' word -- condom -- at home and in school, we're not going to save this generation." Pedro Zamora says the "C" word as frequently as local high schools will let him. He talks about condoms, he shows them to students, he explains how one might have kept him from infection. "Do you think you're going to die?" the students ask him, inevitably. "I don't think about death," he insists. "I live day by day. If death comes my way tomorrow, I'll deal with it tomorrow." He leaves the students in tears. He does not know whether he leaves them convinced about safe sex. * Susan Goldberg does not go out and speak about her disease. She does not tell her friends about the weekly alpha interferon injections that keep her hands and vulva clear of the warts that encrusted them. Only her family understands that she can't lose those extra pounds because the AZT she takes daily keeps her weight up. Susan does not talk about her freshman year in college, when the lingering fevers and swollen glands finally led to her diagnosis. She does not want to talk about AIDS, she insists. She doesn't want to think about it. She wants to live a normal life. The rest of her family thinks about AIDS all the time. Her younger sister Robin, 19, gives lectures on the disease, on safe sex, to the other freshmen at Miami-Dade Community College. "My name is Robin. My sister has AIDS," she repeats dozens of times a year. Her mother Marsha organizes fund-raisers for local AIDS organizations. She puts to use in the AIDS community the skills she gained with 20 years of volunteerism for Jewish causes. She reads everything she can find about the disease and the latest treatments. "I hope you're not doing this for me," Susan tells her mother. "Oh, shit, how did this happen?" was her grandfather's response to Susan's diagnosis. Her mother was not sure whether her father was really being naive. She knew the answer: sex. She even knew the boy: He had been Susan's boyfriend for more than a year. While Susan struggles to sandwich in normalcy between doctor appointments, her mother struggles to figure out when to respond to her older daughter "as a sick kid and when she is just acting like an ordinary adolescent brat." She errs on the side of caution. Susan is studying at the University of Miami, dreaming of a return trip to Europe, planning a career in merchandising. Her mother is planning her funeral, all the while insisting: "It's not supposed to work this way; a mother isn't supposed to have to plan to bury her daughter." Her sister has already told Susan that she won't be at her bedside when she is dying. "She knows I just won't be able to see her suffer," she says matter-of-factly. Robin plans to name her first daughter Susan. * Hector Zamora is not planning his son's wake, although he expects he will have to. "I have faith, but I don't believe in miracles." Like Pedro, he already is thinking beyond his personal tragedy. "Suppose life tells me that within a year, I'm going to lose my son? Should I stop worrying about AIDS? What about those coming behind him? Am I not going to worry about them? If I eat fruit today, it is because someone was there to plant it for me 10, 20 years ago. We have to plant today to save the kids of tomorrow. "Everyone knows what AIDS is, but they don't realize it is a time bomb that could be living in any home and you never know when, how or if it is going to arrive. It can attack the son of George Bush or the superintendent of schools as easily as it can attack the son of Hector Zamora. "I am incapable of asking God to save my son without asking him to save all the others. So I pray to God to save all of them, knowing that among them is one of mine."
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