CAPITAL COVERAGE NEWS SERVICE
media in the public interest
ESSAY - An Open Letter About a Silent Killer:
the Hepatitis C Enigma
Cheap Tricks Heat Up Spoiled Alphabet Soup
by John Zeh, copyright 1998
The person to whom this is addressed is a composite character of several young men whom the author has interviewed downtown in the past five months.
Downtown Cincinnati, early February 1998.
Yo, what's up?
I'm sorry I can't stop and talk, and that you missed the Ass Ponies and Deepwater Junction shows. Both all-ages concerts in safe spaces - Old St. George's uptown and Sycamore Gardens - in your old 'hood, and you went out trickin', didn't you? Yeah, I know, you gotta pay the rent.
Speaking of RENT -not your HO-tel's, but the Broadway play coming to town, check it out. For once you can be outside the Aronoff Center without Officer Speckface hassling you.
You should hustle tickets for the March 24 opening. RENT will show you part of the story told here. It's a retelling of an old opera by Puccini ("La Boheme"), but instead of starving 19th-century artists and low-lifes living in Paris risking poverty and TB, you'll meet struggling modern-day musicians, artists, and prostitutes. Sound familiar? It should, knowing who you hang out with.
The play is set in Manhattan's East Village, but AIDS is the plague. The play indeed's the thing, with phenomenal appeal because it's about contemporary life, with modern music and language. The actors even wear headsets, like rockers do at concerts. You'll recognize them as people from the sad hustlers' haven street life here now.
The script here, however, is not so much about AIDS, as it is about a new health threat that is as terrifying as HIV, Hepatitis C Virus, or HCV.
I can't believe you still hang out on this corner. The cops say they have undercover "johns" driving around this block and are checking the scene outside the Subway and Aronoff to document the need for more undercover dicks busting male hustlers. How fitting that it's happening near the Flynt brothers' shop. Phil Heimlich's supporters would say cheap tricks help make his point to a hip-hop beat: porn's bad scene, all that green, dark street, dirty books, dark looks, gone is MickeyD's, crime lights pre-Millennium tragedies.
Someone recycled one of the councilman's election signs into Righteous rhetoric, off-the-wall graffiti to say "Smash Heimlich Fascist Nazi" nearby on the block.
I hope you opened this note carefully so you didn't damage these jimmies; one size fits all. You use protection 100 percent, right? Even though some tricks offer more money if you ride 'em bare back? Don't go there.
Share this story, please; it's on a high you-do-need-to-know basis. It's something of an M.C. Escher maze, a mystery even for the sleuths working to solve this medical enigma -and they're scientists!
Take some of your trick money and go up Vine for a sandwich at Stenger's Cafe so you can consider this carefully. And punch up WNKU 89.7 FM on your Walkman to hear Roger Klug's "I'm a Porcupine" make my needle---point musically. Taste Stenger's stew while this STD alphabet soupcon cooks. It's based on a series of exclusive interviews and independent research.
And prick up your ears for the tune from David Mallet's "In the Falling" about "a sad parade from the cradle to the grave," where people are "hungry for love, they need some attention, they're tired of addiction, everywhere they go. Look around in any direction, there's a whole lot of people hungry for love. We need a connection, tired of rejection, everywhere you go."
Uncivil War on Drugs
Sex Panic Lets It All Hang Out
What worries me about boys like you, and the Sex Panic men who want unprotected sex in parks or alleys, as well as many gay barheads, is that some show the same traits that Ed Burns and David Simon cover in their new book, The Corner.
You crave the pleasure/risks inherent in hustling tricks, same as dopers out in Evanston selling/buying a bag. "The corner," one doper said on a National Public Radio interview, "blinds you through sex and drugs. It's just exciting. If you stop, what are you going to do?"
Stupidity, unlike most disease, is not necessarily contagious. Compulsively obsessed dependence on hurtful deep pleasure can be curtailed and must be rechanneled into rational, healthy choices on the path to recovery.
Scrabble Players Spell Disease
I'm hoping, too, that hustlers, hookers, and others seeking cheap thrills and "looking for love in all the wrong places," as another song goes, have not become complacent about unsafe sex after positive news and stats on sexually transmitted diseases (STDS). Medical science in 1997 did discover a vaccine for hepatitis A (HAV), which is caused by eating bad food. Streptococcal infections (Strep) have grabbed headlines after deaths in nearby Butler County and an Indian Hill virus recently, not STDs. And many STDs have declined in Greater Cincinnati since 1993. Word is out, as The Modulators' '80's hit is now "SAFER Sex on a Regular Basis."
Indeed, in 1996 new AIDS cases in Hamilton County dropped 45 percent from 1995 and 76 percent from 1993. Gonorrhea was down 47 percent from 1995, 67 percent from '93. Same for syphilis: 58 and 75 percent, respectively. And chlamydia: 47 and 37 percent then.
But data for 1997 is not available yet, and officials count dramatic outbreaks of herpes, chlamydia, and gonorrhea in the past six months. Surely, smart hustlers and their clients are not always so lonely, horny, poor, or desperate that they see only dollars and no dangers.
A syphilis epidemic warn that peaked in 1994 at 832 cases here, health experts warn, could have an "echo" effect reverberating into more AIDS cases, or the disease at hand, Hepatitis C virus, or HCV.
"It's a huge problem, says Dr. Kenneth Sherman, MD, who directs liver clinics at University and Veterans hospitals here. Nearly four million Americans and about 190,000 Ohioans may be infected with HCV, according to the Ohio Department of Health. Estimates suggest that there may be up to 2000 new infections a year in Ohio. About one out of five may get liver cancer and die, especially if they overdrink alcohol. Those Hurricanes at the MainStrasse Mardi Gras could be real killers. Add booze to HCV and "one plus one equals four or five times the damage and progression of HCV disease," cautions Dr. Sherman.
"Liver diseases," adds Dr. Robert Donovan, MD, of the City Health Department "can't be taken lightly by anyone who is sexually active." Booze, he warned on WAIF FM's "Alternating Currents" last month, is an extra "insult" to the liver and people's common sense. Those who "get drunk get stupid," and don't take precautions necessary for less-risky "safer" sex, a term he uses because, anymore, there is no "safe" sex.
Another caution he's learned from his work in clinics and among the homeless: Folks who smoke crack cocaine tend to be sexually promiscuous, often trading sex for drugs. Indeed, one teen I met reports seeing a young white man on his knees doing a black man in a public bathroom. "I know it was for crack," he said.
Roll the Dice
HCV is four times more frequent than HIV, Human Immunodeficiency Virus, which is thought to cause AIDS, Acquired Immune Deficiency Syndrome. And HCV is feared to become more lethal than AIDS in less than two decades, according to an Ohio Public Radio last November. "Hepatitis is not something you want," says Jim Sherwood, AIDS counselor and instructor of pediatrics and infectious disease at Children's Hospital."
There's no preventative vaccine, no cure for HCV. People who have had hepatitis A or B can still acquire HCV. The test is expensive ($100-$150) and those testing positive must be re-tested. Proving positive require costly counseling. HCV patients may never fully recover. Liver transplants are unlikely. Liver failure causes death. "It's the most silent infection," Sherwood says. "At least half those with HCV will become chronically infected for the rest of their life."
That's why this is such a serious public health problem for party animals, lovers, and even housemate - especially those without health insurance or a primary care physician.
It's now especially terrifying when "Sex Panic" people demand promiscuous, anonymous sex without condoms and in public places. "Anyone sexually active is potentially at risk if they have more than one partner," says Sherwood, who serves on the federal Community Advisory Board for the AIDS Clinical Trial Unit in southwestern Ohio and teaches through the University of Cincinnati (UC) College of Medicine.
But don't despair, dudes. There is hope, if people learn how to get assistance.
Hard for the Easy
Finding help can be difficult. Public health officials say they do not have funds for HCV testing. Veteran Cincinnati health director Dr. Malcolm Adcock pledges to find the funds to include HCV testing in routine blood work at the city's Burnet Avenue STD clinic. Until he scores, people with limited incomes can get the test now by paying on a sliding scale at neighborhood health clinics coordinated by Dr. Ronn Rucker, Ed., who counseled people with AIDS here over 20 years ago.
Poor Bluegrass State residents are out of luck, a Northern Kentucky Independent Health Department official said. Other Ohioans can check city or suburban county health departments or move to Dayton, which has more liberal policies, said one worker from the U.S. Centers for Disease Control (CDC).
Ohio Department of Health (ODH) epidemiology specialist Robert French laments that there are few resources to prevent HCV's spread. Most victims are IV drug users who are difficult to reach. Why? Some are dead already. The living move a lot, can't afford phones. Finding them is not "cost/time effective" for number crunchers.
Users Are Stuck
But many of those at highest risk to HCV, HIV, and other blood-borne illnesses will die and infect others because Clinton, Congress, and Cincinnati City Council will not finance free needle exchange programs. Leaders stubbornly refuse to keep drug shooters safer despite a U.S. Presidential Council on HIV and AIDS report December 7 saying that needle exchanges are a significant solution.
How do you get HCV? A big part of the mystery is that it's unclear exactly how people catch it. If you screw someone who got HCV from shooting drugs with shared needles, or by using someone else's toothbrush or razor, you could get infected too.
Alcohol and Pills
Your partner does not have to have been a junkie to pass HCV to you. Someone innocently experimenting with heroin, or shooting crushed opiate pills, which is much more common here, may be infected, Dr. Don Nelson, University of Cincinnati professor of clinical pharmacology, said on WNKU's "Speaking Frankly" in January.
Or maybe your lover got a blood transfusion before testing of donors was upgraded for HCV in 1992. An estimated 290,000 people got HCV via blood transfusions, says Thomas F. Zuck, MD, head of UC's prestigious Hoxworth Blood Center. Anyone who got blood before then, and ONLY those early transfusion recipients, can be tested free at Hoxworth (558-1317). "Don't ever give blood just to get tested for any disease," begs Hoxworth spokesperson Marsha Terry.
Call to (Pierced) Arms
So, HCV could be considered the newest STD, new because despite a National Institutes of Health study in March 1997 and a major USA Today article then, it's just now becoming more widely known, through a national mobilization this month and next. On March 21-23, Hepatitis Foundation International has mobilized a March on Washington to encourage research and treatment and visits to Capitol Hill legislators, said board chair/CEO Thelma King Thiel, who herself answered HFI's hotline one Saturday (800-891-0707).
But HCV is really an old infection because it can have lingered for a long time without any signs of internal body damage. It can take until middle age, to rear its ugly head.
Okay, you ask, are head jobs safe? Anal or even ordinary vaginal sex and rough play can cause blood to be exchanged. You know that, because you're hip to HIV and AIDS, right? And you know that the other serious liver illness, hepatitis B, can be transmitted through semen during oral sex. Fortunately, HBV can be prevented by vaccination. AIDS Volunteers groups here or in Northern Kentucky have details. Maybe you've met one of their outreach workers on the street or the parks if the cops didn't catch you first. How to tell the difference? Plain-clothes cops, presumably, don't distribute free condoms.
Heads Up
Here's what definitely puts you or someone you know at risk to hepatitis C, warns the U.S. CDC:
- injecting drugs
- employment that exposes you to human blood
- undergoing dialysis
- having gotten a blood transfusion before about 1990.
You may possibly be at risk, health experts warn, if you have multiple sex partners or live or sleep over with one who has HCV. For instance, you, or someone you have been close to, may have experimented with shared needles, used somebody else's personal grooming items tainted with blood.
There is no scientific proof that getting tattoos or body-piercings have transmitted HCV, but those skin punctures are risks that keep whole-blood banks from accepting blood donations and for-profit labs from buying plasma for one year.
When symptoms are visible - sometimes surfacing years later - they include yellowing of the skin and eyes, loss of appetite, nausea and vomiting, fever, extreme fatigue, or stomach pain.
You're too young to have heard it on "Hill Street Blues" but it's on safer sex literature: Be careful out there.
Federal officials and gay health activists say:
- Use latex condoms and dental dams to prevent exchange of bodily fluids.
- Having multiple sex partners increases risk.
- If you have, or think you have HCV, reduce the number of sex partners and inform them about yourself and HCV. Protect your liver from alcohol and other threats such as acetaminophen products like Tylenol.
The role of sexual contact is still unclear in HCV, but getting rid of condoms just doesn't make sense," says Sherman. Please give your 17-year-old buddy this hepatitis health alert. Is he still working the flood wall in Newport? Despite the cold, the heat's on there too. The KY cops are as steamed as Dixie Chili wiener buns, snapping photos of guys in Gen. James Taylor Park, especially after a robbery last month at gunpoint and hustlers went home with a trick and robbed him. Are their any strip clubs left where his girl can go to shake her butt dancing, or is she tempted to join the girls outside hookin' it. Tell her too; this AIDS rival is a color-blind, equal-opportunity infector that does not discriminate.
So heed this lesson, and spread the word. It could be a lifesaver.
Journalist John Zeh covered HBV, STDs, and blood donations here starting in 1978 on the radio and for the Queen City's first gay paper, The Yellow Page, published by the Greater Cincinnati Gay Coalition, which he co-founded in 1978. Send any back issues and audiotapes you have, please, to the Ohio Lesbian Archives at Crazy Ladies Bookstore in Northside.
