Andria E-Mordaunt Woman of substance
December 1986, I began working in drug rehab. I felt honoured
to be asked and, like many who suffer from chronic low self-esteem, jumped
at the opportunity ‘to give something back’ to the community (something
chemically-dependent people are told they must do). This rehab at Phoenix
House in London was just beginning to respond to the HIV issue among its residents
by trying to design and implement appropriate policies.
It was a highly structured programme: 6.30am-11pm, working all day in the
kitchens, gardens and on admin, plus regular counselling. The three cardinal
rules were: no violence, threats of violence or drug use, though we were allowed
to smoke ourselves to death of course. And woe-betide if you were ever caught
playing sexual games, let alone having actual sex.
When concerned residents and staff suggested condoms should be placed in the
bathrooms, we were told: forget it. For readers who may not know, coming off
drugs, especially heroin, often makes you feel (temporarily) extremely horny.
But this was the beginning of the Aids crisis in the UK and few workers were
willing to change the old policies of the house.
Staff were paralysed by a ‘we-don’t-know-what-the-hell-to-do-now’
feeling. It didn’t last long because 13 per cent of the intravenous
drug using community had already been diagnosed with HIV. So it was a steep
learning curve. Opiate painkillers were completely forbidden for obvious reasons,
but when an HIV positive woman resident developed Bell’s Palsy manifesting
in pain and facial deformity, the staff woke up and she was finally prescribed
the necessary opiate-based analgesia. I wish I could describe to you what
a victory that was for us ex-heroin injectors in 1986.
Back then it was possible for people to plead ignorance about HIV. But 20
years on the story is not so different when it comes to IDUs, and HIV infections
are again going up among injectors.
Could it be that yet again the powers that be are going down the wrong policy
road and ultimately couldn’t care less about which antigens kill us
because we shoot dope? Could it be that drug policy, as it affects IDUs in
the UK, is becoming more punitive and more driven by a crime reduction agenda
rather than a blood borne disease prevention agenda? The fact drug policy
and its budgets are controlled by the Home Office, rather than the Department
of Health, speaks volumes.
So
what can we do? As far back as I can remember, it is HIV-affected communities
(in or out of the closet) and their allies in power who have made damn sure
that the safer sex and/or safer injecting message got out. And when we couldn’t
find the funding, or opportunities to spread the message, we would literally
just tell each other repeatedly; please be careful, here’s a clean set
of works for you only dude. And when it came to the availability of condoms,
compared to many other countries, we were often in a more fortunate position.
So why are we dropping the ball and allowing drug users to contract HIV again?
The media rarely talks about Aids outside of Africa, which sends out the message
that problems here are under control; the prevalence of HIV in the ex/current
IDU population is only five per cent, so who cares? Finally the condition
is now treatable, we cannot die from it, so why be so concerned?
We overlook the fact that some anti-HIV medicines cause appalling side effects,
including lipodystrophy. Or that they only work for around 50 per cent of
us. On top of that, drug users are renowned for assuming that if their life-partner
isn’t HIV positive they needn’t use condoms; romantic fools! And
then there is hepatitis that is killing far more of us, so why worry about
HIV?
Injecting drugs users have only ever been targeted as IDUs. The fact we also
had mostly unprotected sex was marginalised in the media and even in drug
treatment sometimes. We are not just drug injectors, we are citizens who care
about the spread of these infections in our community and who often spend
millions of often-unpaid hours in HIV prevention street work.
Lets be frank; our lowish HIV figures are only comparatively something to
be proud of. So when we in the UK drop the ball and behave as if Aids is over,
what kind of message does that send to our peers in countries like the Ukraine
where 70 per cent of their HIV population are IDUs?
