Raised in South Philly, very little intimidated Marky D., not even the HIV diagnosis he received in the late 1980s. Through persistence, a dream body followed a dream job: By the ’90s, he owned a custom leather shop, earning $100 an hour.
Four years ago, Marky D. weighed in at 175 pounds of solid muscle. Then there was the cancer that hit him in March 2006 and with it, a nosedive in his T-cells and a rapid progression to AIDS. “I was a 130-pound weakling,” he says. Consumed by medical bills, he moved from his Dallas apartment to Williamstown, N.J., at the behest of his father, who could no longer pay his son’s rent.
Today, at 48 years old, he has regained his weight but not his independence. Receiving disability insurance, he still lives under his father’s roof. “That was the biggest mistake I’ve ever made,” he says about the move. “I’ve been stuck here in this rut and I can’t get out. But I didn’t have any other choice.”
Marky D. represents the growing number of Delaware Valley residents faced with the double burden of fighting HIV/AIDS and staying afloat financially. While some officials point to an economic recovery, the region’s HIV/AIDS organizations are worried about a recent surge in clients unable to meet their own basic needs.
In Philly, major HIV/AIDS service providers—ActionAIDS, the Mazzoni Center, Philadelphia Fight and Bebashi—express concern about their ability to keep up with the growing demand.
“More people need help with concrete things,” says Kevin Burns, executive director of ActionAIDS.
There is nothing new about patients not being able to pay for their own medication, which costs upward of $20,000 a year and is subsidized by the government. But Burns says he’s not used to so many requests for basic needs—such as food, housing and transportation—which used to be the domain of clients’ own friends and families.
“In the past, we’ve been able to work with clients so their needs can be met through social networks,” he says. “ActionAIDS was built on the concept of friends helping friends. That’s a huge resource that’s diminished because of the economy.”
Gary Bell says that 14 years ago when he joined as executive director of Philly-based Bebashi, which supports about 800 minorities living with HIV/AIDS, it didn’t have a food bank. After seeing the urgency—HIV medications can be nauseating on an empty stomach—Bell opened a pantry, but says demand has doubled over the past two years. “We have been inundated with people coming for food,” he says.
AIDS organizations’ concerns come at a time when Pennsylvania’s October unemployment rate dipped to 8.8 percent. However, Philadelphia lags behind the rest of the state, with a jobless rate of 11.2 percent, well above the national average of 9.6 percent. Likewise, Camden County fares second worst in the region.
Jennifer Stephens, coordinator of the Mazzoni Center’s food bank for people with HIV/AIDS, has kept track of many clients who can’t find a job. “It’s especially hard for older clients to find work and those without degrees,” she says. “Even those who are very hirable are having a lot of difficulty.”
On top of unemployment, recent figures show that Philadelphia’s poverty rate surpasses that of the nation’s largest cities. The city also has a rate of HIV infection five times the national average—no coincidence, advocates say, pointing to a July Centers for Disease Control study linking poverty with HIV infections in inner-city neighborhoods.
Bell has experienced the correlation firsthand. He says that his clients earn an average household income of $400 a month. HIV/AIDS organizations PhiladelphiaFight and ActionAIDS also report that at least 90 percent of their clients are in poverty.
Nurit Shein, executive director of the Mazzoni Center, estimates that half of the HIV patients seen at the medical practice are in poverty and lack essential items such as housing. “If you don’t have running water, you can’t take medication,” she says. “Poverty is affecting those who are HIV positive more than other people.”
Meanwhile, the organizations complain that the growing demand for services has not been met with growing dollars. Federal funding has remained flat, but doesn’t cover the cost of care, according to Shurin. “We are constantly adding people to the system but not adding resources,” she says.
Philadelphia saw a 34 percent cut in HIV/AIDS funding from the state starting July 1. All of the organizations also report a significant decrease in private, corporate and foundational giving since the recession.
“Our donations are way down,” Bell says.
Because state funding cuts targeted HIV prevention, many educational efforts had to be scaled back or cut altogether.
Keila Canate is the program manager of the Northcentral MOMobile, which operates RESPECT, a five-week program educating low-income women about HIV prevention. She says that without renewed government funds, the program is set to end in December. “It was very valuable,” she says. “We were meeting high-risk women at high schools, at shelters and wherever they were.”