A quarter-century ago, an unnamed disease began afflicting gay men in urban centers such as New York, Los Angeles and San Francisco. Its symptoms — the obvious ones — included red lesions that bloomed on the skin and increased susceptibility to pneumonia and fungal ailments such as thrush. Almost everyone infected by the illness eventually died a tortured, wasting death.
But while the country began to grapple with a mystery people were calling “the Gay Plague” and “Gay-Related Immune Deficiency” — avoiding handshakes and looking askance at public drinking fountains and toilet seats — life in sleepy Western North Carolina went on much as before.
That began to change in 1985, when Gaylen Ehrlichman arrived from eastern North Carolina to coordinate the Buncombe County Health Department’s health-promotion program. Soon after, she recalls, a visit from a man she refers to as “Randy” got her attention.
“He came to me, explained his condition, and said, ‘What are you going to do about this?’ I knew right then that AIDS had hit Asheville,” remembers Ehrlichman.
“Randy” died from the disease several years later, but part of his legacy is the Western North Carolina AIDS Project.
Begun as a county task force, WNCAP was officially formed in 1986 as a nonprofit vehicle for AIDS education. After weathering funding troubles and complaints of ineffectiveness over the years, the group has emerged as “a mature, viable and sustainable organization,” says Ehrlichman, who in December will complete her second term on the WNCAP board of directors.
WNCAP operates on two fronts: outreach and client services. The former involves AIDS education in the schools and among vulnerable populations such as intravenous drug users. The latter entails helping clients gain access to health-care services and meet their day-to-day needs. More than a third of the organization’s annual budget comes from fund-raising efforts, about 15 percent from state grants. The balance is made up of smaller grants, individual donations and some Medicaid reimbursement. WNCAP serves about 250 clients each month.
Statewide, roughly 1,000 people are diagnosed with HIV each year; Buncombe County accounts for about a dozen of them. But if Western North Carolina is a bit player in the unfolding global drama that is AIDS, the region nonetheless mirrors many national trends. Here, as elsewhere, more men than women are infected with HIV. Also, the African-American population is disproportionately impacted by the disease. (Statewide, HIV infection is the eighth most common cause of death among African-Americans; for whites it ranks 23rd.)
Though HIV infections are still on the rise, the first round of public alarm about AIDS in the United States has yielded, over time, to complacency. A whole generation has grown up at a comfortable — but deceptive — remove from those first dire warnings about the disease.
“The challenge, as always, is to get the right information out there,” notes Ehrlichman. “The best way to do it,” she adds, “is in the schools.” But the effectiveness of in-school outreach has been blunted, to some degree, by notions of propriety that have shaped school curricula in the state, she says.
The fact that sex is the primary medium of HIV transmission makes it difficult to give students candid information about the disease in North Carolina. A 1995 state law requires local school systems to use an abstinence-only sex-education curriculum unless they expressly adopt an alternative; most haven’t.
“For instance, we can’t discuss condoms in any useful way, or explain their use in detail. We can’t make condoms available either, except at the [Buncombe County] Health Center. … And because of that, I think we’re going to see a huge population growing up that is especially at risk for the disease.”
Citing the state’s high teen-pregnancy rate, Ehrlichman notes, “If young people are getting pregnant, they’re also at risk for HIV infection, not to mention any number of other sexually transmitted diseases.”
And while antiretroviral drugs, developed in the mid-1990s, have given many AIDS sufferers a reprieve from what was once a virtual death sentence, these medications carry a significant downside, emphasizes Ron Curran, WNCAP’s director.
“What people need to understand is that the treatments for the disease are themselves debilitating,” he says. “You’ve got a compromised lifestyle. Many people become housebound and are unable to maintain a job. Yes, they’re alive, but it’s not nearly the quality of life these people had before.”
Where the rubbers hit the road
Getting out in front of the disease is a big part of what WNCAP tries to do. Ask WNCAP Educator Michael Harney to describe his typical week, and the reply borders on exhausting.
Tuesdays he visits clients at the A Hope Day Shelter for the homeless in Asheville. Wednesdays he goes to the county jail to screen inmates for HIV, using both conventional blood-based testing and the newer 20-minute rapid test, which uses a swab from a patient’s gums. Thursdays Harney counsels substance-abuse groups. And many evenings, he hits the streets and local clubs, dispensing condoms and advice. “People call me The Rubber Man,” he says.
Harney has a ready smile, a disarming manner and mustache with Salvador Dali dimensions. The energy that drives his work, he explains, comes from “a power or source beyond me.”
“There are 200,000 people in Buncombe County, and at any given meeting I’m talking to just 15 or 20 people,” Harney says. “And I tell them, ‘How are we going to get the word out?’ We do it by not judging people. I’m not here to judge anybody’s lifestyle, and I’m not a prude about anything. I’m just all about educating people — and, hopefully, saving lives.”
The Western North Carolina AIDS Project will celebrate “20 years of love, care and prevention” with its annual Raise Your Hand dinner and auction, slated for Saturday, Nov. 4, at the Grove Park Inn and Spa. The event starts at 6 p.m. with a hospitality hour, followed by a silent auction and dinner. A live auction featuring work by local artists, travel packages and at-home catered dinners begins at 8 p.m. Entertainment will be provided by the Katie Kasben Trio and Speedsquare.
Tickets are $60 and $125, and reservations are suggested. For more information, call WNCAP at 252-7489, ext. 25, or visit www.wncap.org to download a reservation form. Reservations may also be made at Malaprop’s in downtown Asheville.