How Do We Reach the Hard-to-Reach
I call them Boys-At-Risk. The label is inaccurate. It puts human beings in a box we don’t want to look at, and it’s language as racism personified.
I loathe the terminology. But I am at a loss, not in terms of examining the many challenges, but how do I reach white people. They are unmoved.
It’s White America that’s hard to reach.
People ask me what the kids I deal with are at risk for. I invariably want to say: are you fucking kidding me.
But I try to keep it simple so that some, not all, white people can try to understand.
AIDS.
White people will shake their heads like they get it. They don’t. All my second selves know that white people will never get it. Why bother.
I do not know why bother. I have no clue. It’s like knocking on doors that are not going to open.
Question: how can someone who already has HIV be at risk if they already have the disease.
AIDS is different. It’s worse. It’s HIV riding shotgun on a freight train.
We know we can treat HIV if we can keep people in care. And then, we turn around and make it very difficult, sometimes impossible, to do exactly that.
The institution of Public Health has failed. Public Health officials and medical personnel engage in the wringing of the hands, especially over numbers. We’re reaching specific communities like men who have sex with other men. And then, we quit trying. Because we actually see HIV as a gay disease.
It’s not.
Women are neglected.
Young males who do sex work are neglected.
Kids who are IV drug users are neglected.
We have washed our hands of all of them.
Instead of calling them — the Hard to Reach — we should be calling them the Too Hard to Reach We Give Up.
Thirty million human beings still have HIV. Most of them do not know it. But the day will arrive — just like that freight train — when they will find out.
On average, we allow states to limit treating HIV in public health clinics to two clinics per state. What does that mean. It means that in places like Appalachia, still struggling with a huge opiate problem, a Big Girl Addiction — many people will have to travel hundreds of miles to reach a clinic that might or might not accept you.
Like anything else in life, your ability to pay will come into focus like a laser beam. Sometimes, there will be meds for you. Sometimes not. I have seen public health pharmacies tell people to come back next week. The poor are an afterthought. Money for HIV meds comes up in congress once every year. The day these old white men might say enough, is almost inevitable. It’s coming.
I don’t give a flying fuck what Trump says about anything. Trump and pigs have wings. Only one question is relevant.
Where’s the money.
The fact that the question has to even be asked should tell its own story.
STOP blaming the people you call the Hard-to-Reach for their poverty. Poverty is not their fault. No one is doing sex work because they’re immoral, and sex work is a rush. For a minor child, sex work is a grind, and one that can kill you, and I am not referring to disease. I am referring to the American pastime of violence. I am always accused of being politically incorrect (I am supposed to be in favor of decriminalization of prostitution, and I am, but when it comes to kids, it’s about poverty and survival), or I am accused of being sex negative. Actually, I’m violence negative. I have never met a kid, and I have met thousands, who was not abused before sex work came into the picture. Violence is the Bic Lighter that flames the cigarette. The kid just inhales and tries to appear to be a movie star.
Public Health is a one size fits all prescription. HIV clinics are invasive, abusive, and if you miss an appointment, or are late for one, they can drop you from the program rolls. For many kids, all of this is just too hard.
The kids we call the Hard to Reach are often just plain suicidal, and their numbers are ten times the numbers of suicides the general population has to deal with.
What does ten times mean.
It means you are always, always dealing with a kid who can be pushed over the edge way too easily. Tread carefully.
Do we look at HIV numbers among school drop outs. No. How smart is that.
Do we make it easy and confidential for a kid who has been doing sex work to come in out of the cold and access treatment.
No. We. Do. Not.
We want to know who and where the parents are.
Often, this is the last thing a kid who has been doing sex work will tolerate. Often, the parents are not involved with the kid anyway. Often, the kid just walks away.
These days, many public health clinics have cops at the door. Cops with guns.
Kids will run.
Why don’t we just put up a sign that says: YOU ARE NOT WELCOME HERE.
The system does not budge for anyone. The goody goody people who cheer that we are making progress at eliminating HIV have not met any kids doing sex work to survive.
We call them the Hard to Reach. But we don’t give them much to reach for. When they do reach out, we are usually there to slap their hands away. It’s white America that’s hard to reach.