Crack Was His Life; AIDS Probably Will Be His Death, but He’s Coping

NEW YORK —  Crack was Carl Robinson’s life. AIDS will likely be his death. There won’t be much time in between.

Robinson, a muscular 27-year-old with a Magic Johnson smile, was one month into drug treatment when his HIV test came back positive. The life he had left behind--partying, promiscuity--would cut short the life ahead.

The test results made Robinson a member of a growing subset: recovering addicts with HIV, the virus that leads to AIDS. The number of those sharing the diseases of addiction and AIDS has more than quadrupled in the last two years at Phoenix House’s East Coast drug treatment centers.

The unique needs of people like Robinson are handled differently at Phoenix House. Experts at the national drug treatment center have developed a ground-breaking program to help the HIV-positive endure.

“I don’t see them as moving toward death. I see it as, what can we do to enhance their quality of life?” said Dr. Isidoro Gonzalez, who helped concoct a treatment that evolved nearly as fast as the need for it.

“When I was first here, the HIV-positive population averaged anywhere from 12 to 16 people,” recalled Gonzalez, who’s been on the job more than two years. “Now we’re averaging 70. It’s just going to keep going up.”

The shock of his HIV test result left Robinson considering a return to the streets, but “I decided to go back was insanity,” he recalled.

Hope is in short supply for Robinson, who knows the bottom line of AIDS: The disease killed his mother two years ago. But Gonzalez, the Phoenix House staff and a support group of fellow HIV victims helped Robinson get past the disease and go on with life.

What makes the program work?

No. 1 is the 36-year-old Gonzalez, a caring, energetic physician known to his patients as Izzy. His home phone number is common knowledge among his patients.

Then there’s the program itself: Patients are prepped for five hours and walked through the HIV testing process. Positives are united in support groups. Professionals are there to help when the group can’t.

National figures on recovering addicts with HIV aren’t available, but the percentage of drug users with AIDS keeps creeping higher. Nationally, they make up 21% of the AIDS population for men and 45% for women, according to the Centers for Disease Control and Prevention in Atlanta.

Among minorities with AIDS, the figures are similarly striking: 39% of all black and 40% of Hispanic victims are drug users, a higher percentage than homosexuals in those racial groups.

The people in Robinson’s support group reflect the increasingly varied faces of HIV: They range in age from 23 to 40. They are single and divorced, male and female, heterosexual and homosexual. Some have children, some are childless. Some contracted the virus through drug use, some through unsafe sex.

All five are black; they have come to regard one another as brothers and sisters.

“This is my family,” said 40-year-old Rose Woods, a single parent, in a soft rasp. “We share everything.”

Gonzalez’s own family experience led him to Phoenix House. Counseling HIV-positive recovering addicts seemed right after he saw an older brother die of AIDS--watching the highs, the lows, the inevitability of what was ahead.

“It was a roller-coaster ride. And I had to learn I couldn’t ride with him,” Gonzalez said. “I had to just sit tight and be there with him. This is what I began to see was going to be my career.”

On the day his brother died, Gonzalez watched with a strange mix of sadness and satisfaction.

“There’s a beauty in dying, the process of dying, that we’re never taught about,” he said. “And I was able to clearly see it with my brother.”

He sees it now in the faces of people like Craig Richardson, 25. The lithe, handsome man is a dancer who said he contracted AIDS from a prison rape. When his test results came back positive, he insisted they were wrong.

“At first I wouldn’t accept it,” Richardson recalled. “I didn’t want to believe it was true. I was afraid of dying.”

The fear is gone for him now. He’s making a comeback as a dancer, cheered on by the support group he shares with Robinson and Woods.

Gonzalez, with his staff of four full-timers and nine liaisons, personally oversees each group.

The key to the Phoenix House program is grouping HIV-positives to discuss their problems. Their common bonds are addiction and AIDS; they speak honestly and openly about anything and everything.

“I used to beat myself up for not saying anything,” Robinson said. “But little by little, I started talking about how I was feeling. You can’t zero in on the negative aspects of HIV. You have to focus on the life beyond.”

Robinson’s focus now is on beating his addiction. Long-term residential treatment at Phoenix House, which includes getting a job in the facility, lasts from 18 months to two years. Once completed, Robinson will attempt his return to a normal lifestyle.

Each person testing positive also gets an HIV-negative “buddy” for additional support.

The group members deal with specific disease-related problems, and most of all with denial. All addicts and alcoholics must face denial, and HIV patients are the same, said Gonzalez.

Getting past it is the first step in what will become a lifelong fight against addiction and AIDS.

“You know they may be a week away from dying, or a day away from dying, and they’re not going to give up,” Gonzalez said. “That’s astounding. We had a resident who passed away, but kept stressing that point: ‘I’m going to keep fighting.’ ”