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again when he found out he had AIDS. Four other members of his group were in a similar situation. He wanted to use the time he had left to make peace with himself and feel good about himself. He didn’t look ill. Many recovering addicts turn to weight lifting and other sports to build their self-esteem and help them cope with withdrawal. Juan was barely five feet two inches tall, but had a physique resembling Arnold Schwarzenegger’s. His platelet count was low, and he had to take medicine to keep from bleeding or bruising spontaneously. It took five pages of forms and four visits to various social agencies to get him to qualify for zidovudine, under the newly funded Ryan White program. Politically astute legislators had named their ambitious program to provide treatment for everyone with AIDS after a well-publicized boy with AIDS and hemophilia—an “innocent” victim. Hemophiliacs need lots of concentrated blood products to stop them from bleeding, and before a blood test for HIV was developed, many received blood products that had been contaminated by the virus. I would later discover there was a bizarre Haiti connection to poor Ryan White. The Miami company that manufactured the concentrated product (called cryoprecipitate) needed lots of whole blood. Where better to harvest it but in Haiti, where there were plenty of people desperate enough to give until they passed out, at $10 per unit? Some of that blood was contaminated with HIV virus. The contamination of cryoprecipitate with HIV wiped out a generation of hemophiliacs.

A year of zidovudine cost about $3,000. Usually by April the program that funded zidovudine for poor people in Miami ran out of money, and we couldn’t enroll new patients until July. Juan found a job. He moved into his own apartment. He “adopted” one of our older patients with cancer, took him to the hospital for his radiation treatments, and translated for him there.

Far and away, our biggest success was Jackie. If ever there was a person who played to all the stereotypes of the AIDS epidemic, it was Jackie—a six-foot-two, 200-pound black gay transsexual. “Her breasts are bigger than mine,” said Ruth, somewhat jealously.



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