By Ted Kleine
Katrina Holmes is like your junior high school sex ed teacher. She's a small, proper woman with sensibly cut hair who has no problem using terms like "precome" and "unprotected sex" in front of a room full of strangers.
Holmes, an HIV prevention specialist with Access Community Health Center, does this every Thursday night at Haymarket House, where she leads circles of recovering drug addicts through a course on AIDS.
"It is running rampant, anyone can get it, and with the lifestyle some of you guys are living I'm sure that you put yourself at risk at every opportunity," she lectured a crowd of 15 men and one woman. No one wants to be here--drug-treatment programs make attendance mandatory--but they all sit up in their chairs and pay attention to the soft-spoken woman in charge of the room.
Holmes passes out a handwritten true-or-false quiz on the virus, then starts asking the group for answers.
"True or false," she recites with precise diction. "You need to protect yourself from HIV."
"True," the woman responds.
"That's right," Holmes says with a note of congratulation in her voice. "A lot of women think, 'I've been with my guy, and we've been cool. So why should I use a condom?'"
"'Cause you know what you did, but you don't know what he did," the woman returns.
Holmes nods. "Very good. This is a real good group. I'm impressed.
"True or false," she continues. "HIV can be spread by sharing needles."
A curly-haired man in a gray sweatshirt raises his hand and earnestly shares what he knows about the danger of needles.
"If you shoot up and dispose of your needle improperly and a kid plays with it, he can get HIV," the man says.
The next question provokes a dispute: "True or False. You can get HIV by working with a person who has HIV."
Most of the group says false, but a big man in a flannel shirt insists it's true. "Yes, you can get HIV on the job. Two people working on a porn set. Think about that. He's fucking her."
"Man, I'm talking about a regular job," one of his neighbors retorts.
But Holmes defends the man's position. Prostitution is a job, she points out.
"Some sex workers, they call their work 'work,'" she says. "That's their job. That's their profession."
At the end of the two-hour lesson, one of her students for the day stands up and calls out, "Thank you, Katrina. Let's give Katrina a big hand."
Holmes leaves to applause.
"You know how you always wonder in life, what is my mission?" Holmes says. "Even when I was a child, I wanted to be a nurse. Little did I know I wouldn't actually be in a hospital, drawing blood."
Holmes isn't a nurse. Before she got into this line, she worked maintenance at a Soft Sheen factory, and she was wise to the ways of the street. She saw drugs lead many men and women into selfish relationships based solely on opportunism. Drugs and sex "go hand in hand," she says. "I meet Jim this week, it's Friday, he might have just got paid. On Sunday, he might not have money, so I'm not going to bother with him, but Fred might. Any means necessary. It's all about the money."
A few years ago some friends encouraged Holmes to volunteer on the needle-exchange van for the Chicago Recovery Alliance. The work suited her so well that she decided to become a full-time health educator. First she worked for Genesis House, the women's health center. She visited the county jail and walked the streets, looking for prostitutes who would accept a pamphlet or a condom. Last year she joined Access Community Health Center, and since then she's been lecturing to addicts and riding in the needle-exchange van.
Holmes believes in a controversial method of AIDS prevention she calls "any positive change." You don't tell a prostitute to practice celibacy. You give her a condom. You don't tell a heroin addict to go cold turkey. You give him a clean needle.
The 51-year-old mother of three has a frank, caring demeanor that makes it easy for her to talk about AIDS with people caught up in the life. Once, when a member of one of her groups complained that he was having trouble keeping a condom on, Holmes asked him to lift up his two fingers and roll the sheath over it. It was discovered he was wearing his condoms inside out. Holmes corrected him, then offered this advice: "You've got to go with the flow."
While the gay community has cut its rate of infection by publicizing the importance of safe sex and testing, AIDS is still a taboo topic in black and Hispanic neighborhoods. According to the Illinois Department of Public Health, African-Americans accounted for 59 percent of new AIDS cases in the state last year. Holmes meets many men who still think AIDS afflicts only homosexuals. Even if they've had sex in prison, or with a prostitute, some men refuse to get tested because they believe a positive result will mean family ostracism, followed by death.
"I had a group at Haymarket, and my question was 'How many of you have been tested?' One Hispanic guy told me the reason he hadn't been tested is that he wanted to get his priorities in order. He wanted to get a steady job. Another guy said he wasn't 'there.' He said, 'I'd have to notify all my partners.' At the end of the evening, both of them made an appointment."
On Mondays Holmes rides in the needle-exchange van, a mobile AIDS prevention unit packed into an old bread truck. It's stocked with skeins of condoms, some of them mint-flavored. There are bins full of individually wrapped needles, and a basket containing cookers--small, bottle-cap-shaped vessels in which addicts prepare heroin. There are alcohol swabs for cleaning an arm before the needle goes in and sterile water for cooking heroin or cocaine. On the wall a chart demonstrates the proper technique for using a syringe. "LOVE SAFELY, SHOOT CLEAN" declares a sign above the windshield.
The van has everything a junkie needs, except drugs, so Holmes has been accused of encouraging abuse. But if you want to cure an addict, she responds, you've got to find him first.
"I try to reach people where they're at, not to my personal beliefs," she says. "What we're trying to do is harm reduction, to stop the spread of HIV and AIDS. We have a lot of participants that come on the van, they want to stop. We refer them to the clinic.
"This is the first stop. A lot of them come here and they just want to talk. Just having that listening ear is enough. A lot of times this is the first link to someone caring about them. They think they aren't worthy of someone caring about them because they use drugs. I see a lot of people at Narcotics Anonymous who started out coming to this van."
It's a dismal, damp morning when the van pulls into a parking lot at Madison and Keeler. When junkies talk about going to the west side, they often end up near this corner. There's a methadone clinic nearby that provides steady business for the van.
Most people want condoms. The staffers hand them out in plastic grocery bags. One woman comes for needles: she turns in 18 used needles and gets 20 new ones in return. Another is in search of a cheaper methadone program. She's managed to stay off illegal drugs, but now the woman she lives with is claiming "all my money" for rent. Holmes recommends a new program and, when the woman leaves, curses the high cost of drug treatment. Methadone programs typically charge participants hundreds of dollars.
"They still have to do the same things to get the methadone as they did for the drug money," she says. "I think the solution is to lower the fees."
In the early afternoon, just before the van is scheduled to move to its next location, a timid, scrawny woman comes to the door. She's afraid she has AIDS, she tells Holmes. But she's more afraid to find out.
"I'm scared to get that test," the woman moans. "What if I got AIDS?"
"Knowledge is better for you than wonderin', wonderin', wonderin'," Holmes says soothingly. The van has its own HIV-testing kit. "It doesn't take that long. It's just like a toothbrush that goes between the cheek and gum."
The woman promises to return for an examination the following Monday. If she does, it'll be a victory for Holmes and the most effective anti-AIDS weapon there is: truth.
Art accompanying story in printed newspaper (not available in this archive): photo/Robert Drea.