Miami Herald - July 6, 2000
Andrea Robinson

To make greater headway toward lowering Miami's No. 3 national ranking in HIV infections, health workers must take preventive measures into places that pose the greatest risk, such as nightclubs, bars and the streets.

That's one of the recommendations of crisis teams that recently completed surveys of four Miami neighborhoods that have high HIV infection rates, local health department officials announced Wednesday.

The teams also recommended that the county increase the use of mobile medical vans to reach residents of neighborhoods that have the greatest risk for virus transmission and that medical and outreach workers team up with bars and clubs to warn customers about the increased risk that comes when mixing drugs, alcohol and sex.

Miami-Dade Mayor Alex Penelas highlighted some results of the Rapid Assessment, Response and Evaluation survey during a ceremony with federal, state and local health officials as well as U.S. Congresswoman Carrie Meek of Miami. The announcement was made at Mount Tabor Baptist Church in Liberty City.

Miami is one of three U.S. cities chosen to launch RARE -- considered by officials with the U.S. Department of Health as a model for the rest of the country -- to track transmission and progression of the virus. The other cities are Philadelphia and Detroit.

In announcing the findings Wednesday, Penelas pledged $150,000 in the upcoming county budget for similar research in other areas of Miami-Dade County. The state will chip in another $50,000. The local health department will use the money to train volunteers from community organizations in using the RARE survey method.

"This gives us an opportunity to approach this disease with a new set of eyes," said Evelyn Ullah, Miami-Dade County's chief HIV/AIDS officer.

Already, AIDS has exacted a heavy toll in Miami-Dade, which ranks second in the nation in the percentage of cases and third among overall numbers. As of Monday, 23,465 people had been diagnosed with AIDS in Miami-Dade since 1981, said Tom Liberti, director of the state office of HIV/AIDS. Among adult cases, 49 percent are black and 33 percent Hispanic.

TARGET ZONES

During the study, which was conducted by a University of Miami professor, teams of up to three people were dispatched to four Miami-Dade neighborhoods identified with AIDS rates as high as 5 percent of their total population: Little Haiti, Liberty City, Little Havana and Edison.

For six weeks, team members went out after regular business hours -- a time that health officials suspect poses the greatest risk for infection. They observed the habits of drug users, alcoholics and prostitutes, and eventually mingled with them to gain their trust.

Later, team members would get them to talk about their sources of income, and their sexual practices. They also conducted focus group interviews with at-risk individuals who spoke about effects of HIV in their neighborhood.

Vincent Delgado, a trained social worker, walked amid the bus benches and crack houses along Flagler Street in East Little Havana at 2 a.m. to observe male prostitutes. He said the men were hesitant to talk, because they feared he was a police officer.

He gained the trust of a 33-year-old male drug addict who told him of married men who drove from West Palm Beach and Fort Lauderdale for sex.

"We blended in with them, so we could get [the information] we really wanted," he said.

Delgado later coaxed the man into taking an HIV test, which came back positive. He helped the man get into a halfway house, where he is receiving treatment.

But, Delgado said, the man also gave crisis workers some advice:

"He told me, `You not only have to educate the prostitutes, but educate the ones who solicit the prostitutes. Those are the ones who should carry condoms.' "

After collecting the information, the teams went back to their lead researchers to analyze the findings.

DRUGS, MONEY LINK

They noted that the highest risk of exposure to HIV occurred in settings where sex is exchanged for drugs or money.

In Little Haiti, for example, team members said customers from as far away as West Palm Beach and Key West would drive into Little Haiti to have sex with poor women who were desperate for money.

However, workers found, in the other test areas, the motivation was for drugs, especially crack cocaine.

000706
MH000703

Always watch for outdated information. This article first appeared in 2000. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2000. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .