Chasers: Chasing HIV For Benefits

Lo and behold, generations of neglect by the have's have resulted in something new for have not's to chase in order to survive: HIV. You read it right. A small number of the poor ain't running away from it. They're trying to catch it - for benefits.

On Monday and Tuesday, I attended an advanced HIV training seminar. The location was Baltimore. It's a one hour drive from my home.

This is where I almost missed my turn and almost got creamed.

The only way I know how to enter this seaport city of two and a half million residents is from the south. Each day I was rolling north up 95 to the 395 overpass. They don't call it an overpass for nothing. Yo' azz is so high up in the air as you drive over the water, that you know if there's an earthquake, you don't have a prayer.




So much for logistics. Right now, I'm gonna ask you fill in the blank:

"I like to chase ________, or
"I've always chased ________," or
"Lately, I've been chasing __________. "

So many words can be placed in that space.

I chase the paper $.
I chase sex.
I chase love.
I chase Jesus.
I chase higher education.
I chase the best jobs.
I chase beer with hard alcohol.
I chase my weed with beer.
I chase the dragon.
I chase wisdom.
I chase the American dream.

That's just a small example of nouns and adjectives one can use to describe the object of their desire or someone elses. Everyone chases something.

Chances are, HIV isn't on your list.

Below are snapshots of unexpected conversations I had with professionals about this. Names and a few details have been changed to protect the privacy of others. The folks attending have various levels of education and backgrounds. Some only have high school diplomas but are professional in every sense of the word.

Like their clients, they were black, white, and Latino. Remember this, because this story is not confined to impoverished black inner city Baltimore residents. Not at all.

Tonya is a slender Baltimore white girl of 23. She has very pretty face, an emo look, her hair is dyed black, and her eyes are stunningly blue. She reminded me of my son's Baltimore girlfriend last year, the one he met at a rehab, but four years older and more mature.

"How did you get into this work?", I asked.

"I used to be a dancer," she said easily, "down at the strip clubs. The money was good. I was never into tricking like some of the girls, but they were my friends. I wasn't doing well, though. A family friend could tell, and said he had a feeling I'd be good at this job."

Her office is a mobile van and she does outreach with sex workers and tries to convince them to get tested for HIV. Tonya's youngest contact in the field may be 12 or 13, and tricks with her mother on the streets.

"Can't you call Child Protective Services on them?", I asked.

"I don't know their names," she said, "and they won't get tested, at least so far. The girl is gorgeous too. She can pass for 16. If they eventually do, we can get them the medical help they'll need. Our goal is to cut down on the spread of infection."

Being an old CPS worker myself, I was fixated on the issue of an unprotected minor being pimped by her mother.

"What's this mom like?", I asked "You ever talk to her?"

"Yes. The two of them are proud of what they do. They enjoy the work and are very close."

"Can't you call the police when you see them?"

"We don't have proof of the girl's real age, last names, address, nothing. So what can we do? Nothing. Then there's the trust issue. Other addicts won't talk to us or get tested if they don't trust us."

Tonya isn't a social worker nor has a college degree. She's good at what she does, but I swear, her agency's approach freaked me out. I'm an old school social worker, and my brain would be working overtime to figure out a way to save this kid.

I also know that if I spotted them on the street and called the cops, all that would happen is denial, denial, denial when this family of two were confronted with questions. If this helps you understand the problem better, I'll say this: that's their job. Don't fuck with people's livelihood especially when their economic survival depends on it. They'll stonewall you and you won't get a thing out of them. Still.... I'd be pressed as hell to give it a shot.

Another one of her cases was just as bad.

"She's maybe 18, and met this guy in rehab. I've met him and the two of them are so in love. Once she disappeared all night and he cried and cried and was worried to death. She's a sex worker, he's an HIV+ IV drug user."

IV stands for intravenous, which means he uses needles to take drugs, such as heroin.


"She was negative earlier this year," Tonya said. "Currently she's four months pregnant, crack addicted, has a lump in her breast that may be cancer which runs in her family, and they're both homeless. She likes to talk with me, but so far, hasn't agreed to get tested or any services for her medical problems. She is interested in help for her drug problem. I'm working on getting her a placement now, but she won't get tested."


Can you imagine being 18 and having all that shit on your plate? I'm old enough to know that at 18, you're still a child in so many ways. It's an age where your biggest decision should be what you're going to do if and when you finish high school, and if that's too big to handle, what you'll wear when you go out.

Yet, these are real people with real problems, the invisible and sad side of America that you never see on CNN - not that it would make a difference in Congress more generously funding social programs and rebuilding our country from the ground up. Since 40% of whites and 50% of blacks never finish high school, this is where society should invest our money. Won't happen now, because nation's piggy bank is currently being robbed.

Shit is bad out there. Bad beyond bad. While the rich boyz on Wall Street feel pained that they won't be raking in six and seven digit salaries, there are people in NYC and a few hours away in Baltimore and other cities and towns who don't know where they're going to sleep tonight nor have money for their next meal.

We can hang onto our stereotypes and dismiss them all as drug addicts who are getting what they deserve. This is true for quite a few, but it's hardly the whole picture. Some are just damn poor, or have mental health issues or serious learning disabilities or borderline intelligence or are so starved for love that loneliness has compromised their judgment. Or a combination of any of these.

This is how bad and shocking this shit has become for some people:

"Doing counseling with the chasers is the hardest," Evelyn said. She does testing with another program.

"Chasers?", I asked.

"Yeah, they want to get infected."

"What? Why?"

"They'll say things like, I need the benefits. I'll get them quicker if I'm HIV positive."

Several other counselors and testers nodded their heads in agreement. A few people there like myself, who do not work exclusively with HIV populations, were shocked.

This conversation wasn't even part of the program. It came up unexpectedly from the front line workers.

I disbelief, I repeated what she said. "There are folks out there doing this for benefits?"

At least a half dozen folks in the room said yes, plus the teacher. I was dumbfounded, and knew I had to talk with them during our two breaks and lunch.

Like myself, Ellen was one of the few social workers in the group, and had been doing this work since the 80s.

"Yes," she told me during break. "They know they can get housing and food stamps if they're HIV+, and they're so desperate that they don't care. They figure they can treat it with medication."

"But they can get that anyway if they're poor," I replied.

I paused in thought. I added, "Well, at least if if they have kids."

She nodded in agreement. "That still leaves a lot of people who have no way to survive, except the men getting out of jail. If they have nowhere to go or family support, they get housing and food stamps. Everyone else gets nothing unless they have a disability. It's weird. I had one lady who had a stroke and was partially paralyzed on one side of her body. She worked a job that paid minimum wage. All SSI (Social Security Insurance) would give her was $20 a month. Can you imagine? She kept coming in for testing and every time would look disappointed when I told her she was negative. She finally told me she wanted to be positive because she could get benefits. Then life wouldn't be so hard."


Damn. That woman was chasing the disease to alleviate poverty stemming from her medical disability.

Tonya told a disturbing tale about one man. "He had a small home and mortgage but a crappy job. He had been laid off several times and was worried it would happen again soon. He got tired of tired of all, and decided to chase HIV so he'll get benefits and finally get the rest he needed."

As my late father used to say, there's no rest for the weary. I understand that. I began working at the age of 15. It was a part-time after school and weekend job. The conditions were so bad that I was glad I was fired after a few months. I worked off and on in a variety of jobs through high school, college and beyond. The one thing that struck me the most was that the people who worked the hardest and have to take the most shit in work conditions and the way they are treated by employers are the ones who get paid the least.

A good education, phat salary and a couple lucky real estate investments spared me of a lot of misery. Even with all this, the grind of life can wear you down.

As an educated black woman, I haven't been exempt from sexism and racism even on my last full-time job. That was very stressful.

Parenting had unexpected twists and turns when my son's behavior led me to symbolically hanging off a cliff when he nose-dived into alcohol, drugs, gang banging, suicidal attempts and homicidal threats when I'd try to make him go to school or even clean up after himself, along frequent visits by the police to our home. Sometimes they'd bring him home in handcuffs because I'd refuse to pick him up and wanted him charged as a juvie - which almost never happened because the police are trifling with teens around here who do minor shit - and other times the cops would come because I called when he'd violently flip out and needed to be escorted to a mental hospital.

At the exact same time, both of my elderly parents became frail and needed a lot of help. They died within six months of one another.

My job, my parents, my oldest kid... it's like my whole life blew up at once. Hell, it's a wonder I'm sane.

In life, shit happens whether you're rich or poor. Had I not had a decent savings to fall back on, the luxury of not having to work full-time for the past few years, and two kids who relied on me, eating my gun would have been easy.

My point is that the poor, because of their chronic lack of resources or ability to navigate their way through life or have the social supports which we all of need to survive well, doesn't have jack shit to fall back on.

They can't wake up one morning and say fuck it all, I'll quit working and just sell a piece of property for money and sit on my ass to recover from the traumas I've been through. Many turn to alcohol and/or drugs, other forms of self-destructive pleasure seeking or even suicide for relief from chronic and unbearable stress.

Suicide comes in many forms.

And now we have this new tiny group turning to HIV so they can get a needed break from life, a roof over their heads and not starve to death. Damn.

I pulled the instructor to the side during break and asked her about benefits. She said, "The bad thing about SSI (social security insurance for disabilities) is that now you need an AIDS diagnosis to get it. Having HIV isn't enough. It used to be that if your T-cell count was 500 or below, you qualified as having full blown AIDS. Not anymore. So many people are infected that this rule was changed to 200 or less."

Clearly, there are a number of folks out there who have given up in a brand new way. Life is too hard, too complicated and too demanding. The present and future are so damned bleak that they've taken the fuck it approach to life to a whole new level.

I did a little research on this when I got home. On the Internet, there are a number of stories about chasers. In January 2003, Rolling Stone magazine did an article called Bug Chasers: Men Who Long To Be HIV+.

Excerpt: "In this world, the men with HIV are the most desired, and the bug chasers will do anything to get the virus... or "initiated into the brotherhood." Like a lot of sexual fetishes and extreme behaviors, bug chasing could not exist without the Internet, or at least it couldn't thrive."

Well, I got news for those mofo's. It's thriving just fine among a very small segment of the poor and homeless in Baltimore and in other cities. They don't have the Internet and could care less about any loony ideas of 'brotherhood' by primarily white gay men.

This new group has been poor for generations, they're tired of it and just want the economic benefits that comes with HIV. This is a helluva roll of the dice, but if you're at the point where you feel you have nothing to lose, it might look like the best game in town.

It isn't. On meds, a lot of people can live 20 years or more before getting super ill. To get benefits, however, the solution would be to not take meds. This involves going through a lot of sickness, from frequent diarrhea and oral thrush in the early stages, then to a form of pneumonia that's specific to people with low immune systems, to various cancers and other severe illnesses that can occur after those T-cells drop to a federally-approved level to get funding.

Hell, by that time the immune system is significantly impaired. Turning to medication might not even work.

For example, Janice, an HIV tester and counselor whom I spent part of lunchtime with, looked sad when talking about one of her clients. She described a young woman in her 20s who had never been a drug user, became infected from deadbeat, live-in boyfriend who used hard drugs on the sly and cheated "a few times".

"They had both tested negative at the beginning of their relationship," she said. "He messed around, got burned, and didn't care because he could get benefits to help pay the rent. He didn't tell her, and infected her. None of the meds worked for her. She died only a year after diagnosis."

Janice said that woman had not been a chaser of the disease, but she was victim to a man who was what could be called a passive chaser. This branched out to her discussion of other clients who were.

"There was this other client I had, a young girl. She was in love with her best friend, and he wasn't even straight. They never sex, but she loved him. He's an HIV+ gay man. She wanted the disease so they could share the experience. She was open about this."

"Hmmm. That's bizarre," I said. "Was she mentally ill or mildly retarded?"

"If she was, I couldn't tell," Janice said. "She's not the only one in my caseload who does this. I have another woman whose living with a HIV+ man. They never use protection when they have sex. She says she doesn't care, that whatever happens, happens."

"Are they drug users?"

"He is, she isn't. The problem with these women is that they're desperately lonely, then fall in love with a guy so hard that they'll do anything to please him even when they know this will cut their lives short. Nothing matters to them but being loved."

"Janice," I asked, "is it hard getting a boyfriend or girlfriend in Baltimore if you have HIV?"

"Not at all."

"Why is that?"

"So many people have it. They think it can be controlled with meds if they get it accidentally. And a lot of these teen and young adults just don't care."

Just don't care.

That's a sentence I heard a lot in describing the inner city, underclass youth of Baltimore. Just don't worry about it might be a more accurate sentence. Teens are notorious for not worrying about matters that give adults pause. They're reckless due their brain not being fully developed in areas that are associated with wisdom and caution.

Several people present at this training were HIV+. One young woman, Cherise, became infected at the age of 15. She was raised in Baltimore, and at the age, never thought it would happen to her. She's been living with the disease for over ten years and does counseling to HIV+ teens. There are around 80 teens in her caseload, and most of them are homeless and gay.


I've worked with quite a few gay teens. Mine were generally more creative than the average person, and on the surface appear more sexually impulsive. Gay males just have more opportunities for sex compared to straight males who generally have to work a little harder to get a female to give up the sex. This also presents more opportunities for infection. This applies too when some of them get locked up in juvie jail.

I didn't need to ask Cherise why so many of her gay teen males are homeless. They tend to be runaways or throwaways due to family stress and/or rejection. Throw in grinding poverty and you get the idea of the hell a lot of them go through from the day they're born or at least hit puberty and become targets of their family's homophobia.

Cherise also mentioned that she has a daughter. I wondered if the child is HIV+, but didn't ask. I was afraid my negative feelings would show. I know there's a decent chance that when a HIV+ woman takes medication during a pregnancy, the baby will be negative. But what if it's not? Why push that burden on another human being and your own child?


At the same time, I understand the powerful need many people have to have a family. It's an unconscious, biological imperative that demands we reproduce or become extinct. Cherish rolled the dice. I hope her baby won the HIV negative lottery.

I also spent time talking with Carlos, a self-described gay man, immigrant and HIV tester at a predominantly gay men's clinic. He's in his late 20s and is also HIV+.

Carlos described two chasers. One was after the benefits. He's heard of a few others from colleagues who also test for the virus and provide counseling.

His other client, however, young, uneducated and poor like many of them, had the need to 'connect' with his lover by becoming infected.

"I've met with them both," he said. "His partner says he's tried to keep it safe, but the one who wanted the disease would act very seductive so they wouldn't always use condoms. I figured out what was going on because he'd come for testing too often, and look disappointed when the test result was negative. I tried to talk him out of this behavior and did counseling with both him and his boyfriend. He wouldn't listen. Finally, though, he got his wish."

"How did he react when he found out?"

"He smiled. He brought his partner with him, who cried."

Carlos looked off into space as he surely pondered the lunacy of this. "Cried really hard," he said again, repeating himself.

As I sit here now, I can't cry over any of it. It's too crazy. It makes me numb, so numb that I wrote most of this on Tuesday night but couldn't pick it up again to finish it until the wee hours of this morning.

How can I, you, or any of us fathom poverty so deep and right here in America, that there are people are chasing HIV for benefits? I can barely fathom anyone doing this for love or to feel 'connected', but for food, shelter and money, here in the USA? It's incomprehensible.

In some Third World nations, the poor will sell a kidney for cash. Prove to me that what I learned in Baltimore isn't the equivalent.

Well, it isn't. It's worse.

The extent of our growing national poverty, like an HIV-impaired immune system, is still deeply hidden.



How long before it becomes full blown?