|A Perspective from the Bronx|
he Bronx is one of the five boroughs of New York City. With a population of 1.2 million, it is larger than all but five U.S. cities. It is infamous for its urban decay, crime rates, and extremes of poverty. It is also the hardest-hit of all U.S. communities as regards AIDS among IDUs and heterosexuals.
Dr. Jerry Mandel, a key member of the professional staff of the original MidCity Consortium to Combat AIDS, lived in the Bronx for four years during the early 1990s. With his considerable ethnographic skills, he was able to make keen observations about a diverse street scene which included Puerto Ricans and other Latinos (60-65%), blacks (25%), and some whites. In some ways the heavy-drug environment of this part of the Bronx was very different from those of the Bay Area: the density of population was much greater, living conditions among the poor were generally worse, the streets were far more alive with human commerce and socializing, and drug dealing was very open and active. In spite of all this, the scene was not as chaotic and violent as might be expected:
HIV disease looms large in the life of the street community. About half of the participants are or have been IDUs, and about half of these are infected with HIV. As a result, people conspicuous with AIDS symptoms are constantly encountered, and some 3% or 4% of street community IDUs die of the disease each year. Thus, in important ways, this Bronx neighborhood is much like the Castro: AIDS is a tangible presence, lots of young people are dying, and yet the "scene" remains stable and vibrant, with indefatigable "survivors" living their lives and periodically slaking their cravings. People are still seroconverting, but perhaps (as in the Castro) at a slower rate, thanks to the disdain of younger users for the needle.
The Bronx, unlike San Francisco, has plenty of young women and babies going through the stages of HIV disease. The borough has recorded fewer than half as many men with AIDS as in San Francisco (9,000 v. 21,000) but six times as many women (3,700 v. 600) and eighteen times as many babies (440 v. 24) infected via their mothers. The disease therefore has a quite different social manifestation in the Bronx; sadly, "it's a family thing". This aspect is redoubled because of a phenomenon first noted by Don Des Jarlais: young male IDUs in New York, weakened by AIDS, give up on the autonomy so valued by young men of their class. They often return to their families of origin for care and shelter-- a return short in physical distance but long in existential distance.
(MidCity Numbers, July 1995)(printer friendly version)