The New York Times

Monday, January 15, 2001

IN AMERICA

State of Denial

By BOB HERBERT

I asked Esther Ross if she had given much thought to H.I.V. or AIDS before she learned that she had become infected with the virus.

"No," she said. "I was young. I didn't think it applied to me. I thought it was all about people who were white and gay."

Ms. Ross, who lives in the Crown Heights section of Brooklyn, is 39 years old and black. She learned that she was H.I.V. positive eight years ago. She was stunned, which is a testament to the power of ignorance and denial. Given her lifestyle, it would have been almost miraculous if she hadn't contracted the virus.

Ms. Ross, who courageously agreed to talk on the record, has recently made a torturously difficult effort to turn her life around. She now counsels young people about the dangers of H.I.V. and AIDS. She is plagued by guilt and suffers from depression. Her story is terrifying.

"I don't really know how I got it," she said. "I was doing drugs - crack, heroin, whatever I could get my hands on. I didn't use needles, but I shared a lot of other paraphernalia with people who may have had the virus."

She most likely contracted the virus through sex. "There were a lot of people," she said.

I asked if she had ever traded sex for crack.

"Sure," she said, her voice low.

The H.I.V. test results came on a slip of paper handed to her by a young woman at a clinic in Brooklyn. No guidance was offered. No counseling. Ms. Ross saw the slip of paper as a death sentence. "I started crying," she said. "And then I got up and walked out."

I asked her what she did after that.

She said, "I went out and got high."

Reform would have to wait a few years. Ms. Ross promptly followed a course almost perfectly designed to spread the virus to others.

"I ended up using more drugs," she said. "I ended up prostituting."

She said she did not tell her johns - or anyone she was having sex with - that she was H.I.V. positive. Her reasoning was both brutal and complicated. In one sense, she tried to deny to herself that she had contracted the virus. But there was another, more malignant motive: "I said if somebody gave it to me, I'm going to give it to somebody else."

Ms. Ross continued to do drugs, off and on, for a few years. Once when she was high she fell onto the tracks in a Manhattan subway station. She eventually stopped turning tricks, but she continued to have unprotected sex with men.

This is not an extraordinary story. There are variations on this vicious theme in neighborhoods across the country. Conditions are especially rough in communities that are both black and poor. It is there that the plague of H.I.V. and AIDS is rampant, feeding off the dangerous sexual behavior, the widespread use of drugs, the ignorance and the denial about the disease, the shortage of preventive efforts and the chronic inadequacy of health services.

The result is an enormous tragedy that is not yet fully comprehended.

About four years ago Ms. Ross got into a program at the Bedford Stuyvesant/Crown Heights H.I.V. Care Network. She finally managed the difficult work of kicking the drug habit and confronted the reality of her behavior and her H.I.V. status.

She told me: "It's late for this, I know, but I am so sorry for the people that I may have infected. That is my biggest regret. I can't make anything up to them - I don't know them. I couldn't even tell you their names. But I am sorry."

Ms. Ross is now dedicated to spreading the word about the dangers of H.I.V. and AIDS. She's a peer counselor at the care network. She believes that some African-American youngsters are having sex as early as 9 or 10 years old, and intercourse by boys and girls in their early teens is common. "They are not thinking about consequences," she said, "and probably not wearing condoms."

When she talks to youngsters she finds that their attitudes are similar to those she once held. "They think that this is not about them," she said. "A lot of the women think that to show love to a man they shouldn't use a condom. They think they can recognize the people who have the virus. They think gay white men have the virus. They think their peers who have money or a nice car do not have it. It's tragic. When I ask them if they think I have the virus, they say no. When I tell them I've been living with it for eight years, it blows them away."