The house on First Avenue is like all the others along this quiet, narrow street. With its white paneling, green roof and yard choked by tall grass and weeds, there's a sense of bored isolation that permeates not only this house, but most of those along a block that overlooks the hulking remains of an abandoned textile factory.
It's what's happening inside this house that's making a difference.
One Monday each month, a small team of doctors, nurses, therapists and case managers from the Health Services Center (known as "The Clinic") drive 79 miles of back roads and state highways from their main office in Hobson City to Lanett in Chambers County, transforming this plain, empty house into a satellite clinic for HIV patients.
At 9:28, the white "AIDS Van" pulls up to the curb. A caravan spills out and begins unloading cases of Ensure nutritional supplements, armloads of medical supplies, and patient charts packed in four-wheeled coolers.
With the van emptied, staff members scatter to various rooms of the house. Nurses set up in the kitchen, case managers huddle behind small desks and the two mental health therapists set up folding tables and open laptops.
"We're open for business," says Bobby Malone. "Who's first?"
Malone, a mental health therapist who's been with the clinic for eight years, slides a sign-up sheet to the center of a table where two women and a man have quietly gathered.
"What's he so happy about?" says 42-year-old Willie Anne, slouching against her plastic chair.
"Guess he gets to keep all his blood," answers 48-year-old Carl, with a burst of laughter.
Since 1992, clinic staff have been coming to Chambers County to provide full-scale health care for HIV-infected patients, as well as administering HIV tests to those worried they might be infected.
"We provide all the things they'd get in a regular medical center here it just doesn't look like it," says Dr. Barbara Hanna, medical director for the clinic. "We do it all very quickly and intensely and then we go away."
Besides the main office in Hobson City, there are five satellite clinics — Lanett, Alex City, Gadsden, Fort Payne and Sylacauga. As the only HIV clinic in East Alabama, the clinic serves 14 counties, from Dekalb to Tallapoosa, and Blount to Randolph, as well as Chambers and Calhoun counties.
The clinic currently serves 425 active HIV patients. Another 1,400 people are served through various education and outreach programs.
The 142 cases in Chambers County, as well as the 278 known cases in Calhoun County, are especially sobering considering that the numbers don't include those who have never been tested or who tested positive in another state. The Centers for Disease Control and Prevention estimates that 25 percent of all HIV-positive people do not know they are living with the disease.
This means many infected with HIV are unknowingly spreading it to others.
"A lot of people are hiding, scared to let people know they got it," says 53-year-old Kenneth, who's been HIV positive for nine years. "It's so bad that some of their friends don't know. Sure, there're rumors, but still nobody knows for sure. It's only when they die that the truth comes out, and even then it's kept a secret."
In a time when more people seem worried about swine flu than AIDS, such intentional ignorance and complacency can be lethal, says Tom Robertson, HIV coordinator for the Alabama Department of Public Health's area VI, which includes Chambers County.
"We're doing a really good job in treating HIV patients because of the clinic, but the awareness isn't there," Robertson says. "We've become complacent about HIV. It's not on the front burner, so we don't talk about it a lot, especially in rural areas."
There is a certain small-town mentality when it comes to addressing societal ills — drugs, crime, HIV — that are often viewed as big city issues.
"We're the people nobody else really cares about," says 30-year-old Eric, sitting in back of the waiting room. "Some folks are still so ignorant about what's out there and what's really goin' on. Some people don't wanna believe that this thing is here, that gay people are here, that drugs are here but they are and they ain't goin' nowhere anytime soon."
Hanna believes the HIV infections in Chambers County were initially brought home by those who "partied" in Atlanta.
"HIV infections were already well established in the community before we even got here," she says. "And now it continues to feed upon itself."
Though it's a small, rural area, Chambers County has a surprisingly high number of HIV infections. It's the population and at-risk behaviors, such as prostitution, unprotected sex, and drug and alcohol abuse, that have allowed this disease to fester in the shadows.
"This population appears far more disenfranchised than what we see virtually anywhere else," Hanna says. "Many just don't have very much else to do. Drugs are a problem, poverty is a problem, lack of education and available community resources is a problem. So it's difficult to stop that type of behavior, which often starts at a young age."
Once they've completed the blood work, patients sit down with their various case managers, therapists and dietitians who have made the trip this month. The clinic's onsite services include substance abuse treatment and counseling, mental health therapy, medication prescription, dietary counseling, medical referrals, housing and food referrals and laboratory services.
"It's a one-stop shop," says nurse practitioner Sonja Preston, over the rattling hum of a centrifuge set on the kitchen counter.
As a psychiatrist, Dr. Glenn Archibald has witnessed firsthand the quiet desperation that influences many HIV patients both in Chambers County and beyond.
"Because of the poverty and the lack of opportunity, they go to drugs for escape," he says. "The drugs increase at-risk behavior now they're HIV positive, depressed and have no real support system — other than us and that's only once a month."
And yet many patients, once they learn of their status, want to survive. With a proper diet and a regimen of medications, HIV is no longer a death sentence. Some patients can live 20 years or more.
Willie Anne was 20 years old when she was infected, though she can't say exactly how. She was among the first patients to visit the clinic when it first set up in Chambers County 17 years ago. Now, at 42, she's a veteran in the war on AIDS.
"When I first heard 'AIDS' or 'HIV,' it meant that was that I was gonna die," she says, sitting at a large folding table in the waiting room while scattered patients nod in agreement. "But I'm still here, I'm still alive, and it's all because of this place and these people."
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Information from: The Anniston Star, http://www.annistonstar.com/