An account of working on an HIV-aids helpline in San Francisco.

Submitted by ludd on March 11, 2010

Working at the AIDS Hotline

"How many cases of AIDS have been reported in Kentucky?"

"Can you hold while I look that up?" I turn to the printout at the front of the AIDS Hotline Encyclopedia. "OK, looking at the Center for Disease Control list here, it shows Kentucky as the 39th highest state at 56 reported cases. "Really? Well, how about Georgia?" "Georgia is 9th with 148 reported cases. "Can you look up Oregon?" "25th with 101 cases." "Delaware, what's Delaware?.. The woman asks for at least 5 more states before I finally ask why she wants to know. "Are you writing an article?" "No, uh, I just want to know." Perhaps she is just idly curious. But I suspect she wants to know where to move to be "safe. But I'11 never know for sure. All I can do is give out the information. It's up to the receiver to determine how she wants to use it.

I've been volunteering at the San Francisco AIDS Foundation hotline for a few months now. I do it because it is a good way to keep up on AIDS research, treatment, education and politics. I do it because I think education is the best way to stop the spread of the disease. Hotline workers go through an intensive 16-hour training that covers the gamut of the epidemic: the biology of the AIDS virus, immunology, safe sex, safe needles, talking comfortably about sex, community resources. At the start of each shift, each hotline worker reads through the "This Week" section to find out what's new in the "Encyclopedia," a looseleaf compendium of articles, memos, brochures arranged by subject. The subjects include things like: oral sex, opportunistic infections, alternative treatments, women and AIDS.

The calls are a steady test of how much I've absorbed. At least once very fifteen minutes, sometimes three or four times in a row, someone calls up wanting to know where to get the AIDS antibody test. Quick, easy, boring. I have the San Francisco number memorized, and I'm a person who barely knows his own phone number. California has set up anonymous testing sites in most regions. Instead of using names, the patient is assigned a number that is used through the whole process of counseling, testing, disclosing results. The test is conclusive and can alleviate fears. It's especially useful in cases like where the caller guiltily obsesses about a one night stand they had three years ago. When the test was first announced, some feared it would be used for work and insurance screening. Some people stupidly and callously use it for selecting lovers. The test is a good thing, but open for abuse.

I like the sex calls best. Not that they're titillating; they're mostly matter of fact, humorless even. People take their sex lives very seriously. I'm touched by the way people pursue pleasure in a repressive period: the guy in Georgia who likes to go to strip joints, the married woman in Sacramento who has a lover in San Francisco who she understands 'lives quite the wild life, the straight guy in Walnut Creek who likes to go home with men "now and then, when I'm in the mood." I talk with them about what they do, and how they can do it with less risk. Condoms, condoms, condoms. It's probably safe to kiss, here's why. Please, go right ahead and use that dildo, as long as you don't share it.

The hotline is getting more and more calls about using drug needles. These callers are not incoherent, crazed freaks. And while frequent bouts of safe sex are probably healthier than frequent bouts of intravenous methadrine, like with the sex calls, these people have found something that gives them pleasure and they want to know how to do it safely. We tell the callers to plunge the needle in a bleach and water solution, as little as 1 part bleach to 10 parts water works. Afterwards, draw water up and out at least twice to clean the works out; bleach can be very caustic to veins. I had a caller protest that the bleach also breaks down the needle's rubber stopper, which must be true. The best solution would be to legalize over the counter sale of needles, or even free needle distribution. But the drug moralists would rather see long painful deaths from AIDS than allow the easy obtaining of "paraphanalia."

Some things I hate. I hate when the TV cameras come to film. The reporters are very distracting. I remember talking to a man who thought he had caught AIDS from his girlfriend. He wanted to beat her up--a touchy emotional scene. All the while cameras were filming my "live drama." I was trying to focus on this caller,each word was being excruciatingly judged. I couldn't concentrate; the call ended badly. Television may be the ultimate means of mass communication; but mass media is mass voyeurism, using other people's trauma to titillate a population of couch potatoes.

The AIDS Foundation's Media Director is the worst sort of self-important boss. She orders volunteers around in a way that no one else would dare, or perhaps care to. When she's not being a bruiser, pie book. The chapter she forgot to read is "How Not To Be Obvious." The Foundation is a bureaucracy. It may be "politically progressive, gay sympathetic, equal opp. [sic], maybe even self-critical. But it's still bureaucracy with all the impulses toward self-preservation and self-importance. The slavishness to mass media and the consequent distortion of the Media Director's personality is one expression of this. Another expression is a survey released earlier this year. The survey inflated the AIDS carrier base among the Bay Area heterosexual population. It supported an argument that the Bay Area needed a larger educational campaign. Of course the Foundation would be the contractor for a huge portion of this campaign-institutional preservation overrides the real truth.

Despite these problems, I'm drawn back week after week. I like the busy days best, the days when the calls come in at a manageable pace--not too fast, not too many long gaps. If it's too busy, I leave feeling on edge. At my last shift, I fielded more than 20 calls during a three hour shift. By the end, I felt like an overworked Bell operator, checking myself from being too snappy, not always succeeding. Slow days can be pleasant, if the other hotline workers are amiable. It's odd though. I guess because the calls set such a strong emotional tone, I develop strong feelings about other workers, even though I see them maybe once for three hours every three weeks and hardly talk to them even then. If I run into a coworker I like on the street, it's instant ease and friendliness. If I run into one I dislike, I skirt around, avoiding them like an old boyfriend from whom I parted awkwardly.

My life was a lot less busy when I started working at the hotline. I should stop. But I'm still answering calls.

-- by Mark Leger