This is true for all marginalized populations, everywhere. Take the formerly incarcerated, for instance. They are among the most marginalized populations in the United States. And the formerly incarcerated who are HIV-positive are even further marginalized.
In New York, after an HIV-positive prisoner finishes his sentence, he’s whisked away from an upstate detention facility and dropped off at the Port Authority bus station in Manhattan. He’s usually given no more than $50, three days of medication, and a list of social service organizations that might be able to help.
Imagine: You are standing all alone by the bus or the subway. You haven’t been outside the walls of prison, let alone in the middle of Midtown, in years. You have nowhere to go, maybe no one to call. And the clock has started ticking—you have seventy-two hours until your medication runs out.
For Carl, after twenty-four years in prison, that experience made him feel like he was Rip van Winkle, waking up to a whole new world. Everybody around him was talking into a mobile phone. He had used a token the last time he rode the subway; what on earth was a MetroCard?
The world had changed, and so had Carl. He was infected with HIV in prison, and he left with AIDS.
Carl was luckier than many; someone he “ran with” picked him up from the Port Authority. They spent the next three days driving around to every single organization on the list he was given when he was released from prison. At all of these places, places that were supposed to help him, he heard the same thing: “Where’s your Medicaid card? ”
Carl had been released without any documentation of his HIV status, and since he didn't have Medicaid, there were few places he could go to be tested. He waited hours at a city agency to apply for public assistance in order to get the funds he needed to buy medication, but there was a 45-day waiting period to determine if he was eligible for benefits.
Carl’s story is all too common. The United States imprisons a higher percentage of its population than any other nation in the world: more than 2.3 million people, or 1 in every 104 adults. Almost a quarter of the world’s prisoners are in America. And as of December 2008, about 1.5 percent of all prisoners in the nation were HIV-positive. When these HIV-positive prisoners reenter society, very few are connected with services to give them stability and support while they figure out how to handle their health and their new lives.
That was the case for Carl. He was overwhelmed, exhausted, and almost totally defeated when he showed up late in the afternoon at Bailey House, a halfway house in East Harlem for people living with HIV/AIDS. By the time he walked through the front door, he was out of medication and he was a ball of anxiety. That’s when Carl met Chris Olin, a caseworker for Project FIRST at Bailey House—another real-life hero. Chris is one of those exceptional people. You know, those people who just immediately put you at ease. Chris said to Carl, “I've got this for you.”
It can be paralyzing to be in the throes of your own crisis. I remember that feeling when I walked into rehab, like I had no control over anything that was happening to me, like I didn't know where to begin. When I was told not to worry, when I was told that people were going to help me, it was like an enormous weight lifted off my chest. Suddenly I had a chance to get better, because I wasn't alone anymore.
I imagine that’s how Carl felt when he met Chris. It was the first moment in a long time, maybe ever, that Carl had been treated with such dignity. That his anxiety, the trauma in his life, had been acknowledged. That somebody had his back and said, “I’m with you.” That’s when everything changed for Carl.
Project FIRST stands for Formerly Incarcerated Rental Support and Training, and it’s a program run by Bailey House to support HIV-positive ex-offenders who are homeless or in danger of becoming homeless. It helps people like Carl with whatever they need to get back on their feet, to stay healthy, and to stay out of trouble. Within the first few weeks, Project FIRST connects their clients with a rental assistance program run by the City of New York. Because of the flexible funding that EJAF and others provide, Bailey House is able to cover necessities such as security deposits and first month’s rent, so that clients can get into safe housing immediately. After all, if you don’t have anywhere to lay your head at night, how are you going to get the rest of your life together?
My foundation has been supporting this project at Bailey House since 2007, and we couldn’t be happier with how far they’ve come. Since Project FIRST got off the ground in 2003, they have successfully placed more than 200 people in permanent housing, and they have also connected them to the care they need to ensure their health and well-being. Many are still in the same apartments.
To me, Project FIRST is a tremendously efficient weapon against the AIDS crisis in New York City. We know that ex-offenders leave prison with disproportionately high rates of HIV. We know that they often don’t have a way to get the medical care they need, let alone a place to live. We know that their lack of job opportunities makes it all the more likely that they could slip back into risky sex, drug abuse, and other behavior that would put them in danger of spreading the disease or land them back in detention. Common sense says, let’s address all of these problems quickly—let’s not be afraid to help the very people who need the most help. Let’s not let stigma get in the way.
One of the things I love most about Project FIRST is that the program does more than fight AIDS; it helps people in the most basic ways. Caseworkers like Chris walk clients through the system and show them how to do everyday things such as open a bank account and figure out where they can go grocery shopping. They help clients get back into the community, find a doctor, take their medications regularly, get vocational training, and start taking care of themselves. For instance, Chris connected Carl with a clinic where he could go for medical tests, treatment, and medications, and Chris also got the necessary documentation of Carl’s AIDS status and income level to qualify him for housing assistance.
People who go through Bailey House’s program have much better health outcomes. And they are far less likely to end up back in the penal system. Typically, more than 40 percent of U.S. prisoners wind up returning to state prison within the first three years of being released. Fewer than 10 percent of Bailey House beneficiaries are reincarcerated.