By Rosalyn Plotzker | Just before my freshman year at Penn, my friend Lynn and I got together over coffee to compare our separate summers. It was the first time in years that we had not spent the months off from school together at camp. As we sat in the plush chairs of the Jenkintown Starbucks with our mochas, our conversation wandered from my four weeks touring art museums and cathedrals in Western Europe to her work for a needle-exchange program in North Philadelphia.

“It’s so sad, and the people there are intense,” she said.

The issues surrounding public health were never raised at our socially aware Jewish summer camp. While I had a firm idea of why gay marriage should be legalized and why everyone should compost, I had no knowledge of how to help fight HIV/AIDS as a suburban teenager, except for buying the “Until there’s a cure” bracelet from the Body Shop and participating in the Philadelphia AIDS Walk. I had never heard of a needle exchange. Yet through an inexplicable cascade of events, I ended up at Prevention Point in October of my freshman year.

The Philadelphia Prevention Point office at 333 Girard Avenue is not a place where people come to trade syringes. The actual exchanging goes on for two scheduled hours at a different location each day of the week. Still, most clients have been to the office at some point for activities or the Saturday medical clinic.

Most of the activities take place on the second floor, which has a small kitchen, a meeting room, and a lounge with a computer and coffeemaker tucked in one corner. By the time I arrive each week, the Internet is down and the coffeemaker is spitting caffeinated mud.

When I first volunteered, I began with Prevention Point’s women’s support group. I prepared food for them, then sat and listened as they talked with each other; I was reticent. My class schedule wouldn’t allow me to work at an exchange site, and I was thankful for that—for the chance to ease my way into the world of drug-harm reduction that I found intriguing but alienating. As an Ivy League student, I did not feel comfortable there, because I would go home to a lavish lifestyle—an environment where I also felt out of place. I felt frustrated by the materialistic concerns of some of my classmates as well as their pre-professional outlook towards education. These two worlds, which I had hoped would balance each other out, at first pulled me in opposite directions.

Gradually, I eased into the role of a site volunteer. My job included counting needles as they were dropped into biohazard bins, then doling out the same amount of packaged syringes in return (plus-seven if they exchanged less than 20).

As time passed I took medical histories from patients at the clinic—an experience that solidified my decision to be a pre-med student. I started to recognize regulars. We smiled at each other, saying, “How’s your week been?” Through my growing knowledge of exchange clients, along with the simple passage of time, my personal relationship with them deepened. I felt a responsibility to use the power I had as a Penn student to make a bigger contribution to the needle exchange. At the end of the year, I received a grant to research child-abuse histories among the female clients.

I was forced to exchange intimacy for objectivity, ironically, to better understand the women with whom I had developed the odd friendships that motivated my study. For six months I spent my time at Prevention Point surveying women about child abuse, demographics, depression, Post Traumatic Stress Disorder, and HIV risk, in exchange for $5—a bargain or rip-off, depending on your point of view.

Most of the women filled out the questionnaires on their own with no problems. However, sometimes a client needed help, and I would conduct the survey out loud. When this happened, the conversation would deviate, and often women would need to talk about issues brought up by the questions.

The following interview was conducted in January 2003, with Sandra* (*real names aren’t used), the 87th woman I surveyed:

 

“These questions are about your HIV risk. I know you’re already positive, but that comes up later, so don’t worry about it.”

“Mhmm.”

“Okay. For these questions the answers are never, a few times, a few times a week, or every day, okay?

“Okay.”

“Okay. How often in the past month have you injected cocaine?”

“Every day.”

“How often have you injected heroin?”

“I don’t do that stuff.”

“Have you snorted cocaine?”

“Yeah, every day.”

“Do you drink?”

“Like beer? Yeah.”

“How often?”

“Every day, something’s gotta get me through the day, ya know?”

“Mmhmm.”

“I mean, it’s hard. I got AIDS, an’ I’m only 36 years old. Dying. I got three months left to live.” Her voice started to get cut off by a mucusy sound from her throat. I put down the clipboard and rubbed one of her shoulders to calm her. She started to cry. “Shit. Thirty-six years old—I can’t see, ’cause the virus messed up my eyes. Look at my hands, they’re all scaly an’ scarred up. An’ my eyebrows’re fallin’ out.” I stood next to her, not knowing what to say other than, “Shhhhh, it’s okay sweetie. Shhhhh.”

“Shit, everybody knows I got AIDS. Fuckin’ Nina told everybody. They all treat me like shit now … And what if I told them about her Hep C? But I don’t, ’cause I’m a decent person …”

As Sandra cried I kept rubbing her shoulder. I felt awkward and helpless to do or say anything that would alleviate the tension, or Sandra’s breakdown.

“I’m a good person and I believe in God, and He knows that I’m a good person, so I know it ain’t up to me to tell no one about her. She don’t get that, but that’s HER problem, and if she ain’t a good person she ain’t gonna last that long. ’Cause that’s how I’m here. That’s how I made it BECAUSE OF GOD!”

She banged her fist on the table. I stayed there with my hand trapped on her shoulder as she fervently delivered her sermon, her face channeled with lines from her eyes to the corners of her wide mouth. “That’s how I made it to 36! It don’t matter if people know that I got AIDS ’cause God knows I’m good and that’s why I’m here!”

“Shhhh, it’s all right.”

Now, a year later, I find myself returning to the women’s group where I started, but today I am a group participant as well as a volunteer. Sometimes women whom I have interviewed come to group, and I recognize them from their surveys: The escort who makes about $600 a month. Another who hasn’t had a sexual partner since 2002. The former nutritionist. The woman who has the same birthday as my mother. Most of the women don’t identify me as the girl who asked for the fragile information. Some of those who took the survey don’t even remember filling it out.

The women who remember me, and those who don’t, all greet me warmly. Every Wednesday afternoon the women’s support group gets together in the meeting room. The windows face west, and the walls were recently painted lavender. The result is golden afternoon light that illuminates the dozen women’s faces, most of which are much darker than mine and stand out against the walls. The entire room feels welcoming. At three o’clock the food is brought in. For the next hour we talk over tuna sandwiches. It’s a safe space, and mostly we know each other, but we go around the table, introduce ourselves anyway, and check on how the week has been. We tease each other a lot, and joke around. If I am stressed about midterms or moving out of an apartment, then we’ll talk about that for a little while.

Sometimes Amanda* talks about how she’s dealing with being HIV positive. When she first found out, she was devastated. “ … An’ people at the emergency room all thought it was ’cause of the drugs, but I tell ’em it was because I wasn’t using a condom, and they didn’t believe me.” Her voice fluctuated between angry and sad as she talked, while everyone listened, chiming in: “We’re here for you baby, we got you.”

I am no longer restrained at meetings, nor am I labeled a researcher. I am entering my senior year at Penn, where my involvement in Prevention Point has led me to the University Scholars program, as well as my current job at Penn’s Center for the Study of Addiction. It has piqued my interest in many areas: behavioral research, HIV prevention, public health, drug-harm reduction, writing, and women’s health.

But on Wednesdays, when I arrive at 333 Girard, I am looking forward to the hugs and jokes from the women’s group members. It is just as much a social activity for me as a civic one, a true and even exchange.

Rosalyn Plotzker C’05 is a senior biological basis of behavior major from Wilmington, Delaware. She would like to thank Prevention Point, the Center for the Study of Addictions, and University Scholars.