The New World of AIDS: On the Front Line

Poverty Entangles Promise of Powerful Treatment

By David Brown
Washington Post Staff Writer
Monday, September 1, 1997

BALTIMORE -- We're back from the front lines now, away from the places where patients know their viral loads and CD4 counts by heart, and ask, by name, for drugs that aren't yet on the market.

Or could it be that this is the front line in America's war on AIDS?

Barbara Worrell leans forward in the chair of the examining room. In a while, when the methadone kicks in, she will lean back and put her head against the wall. The doctor knows he has to work fast. But not too fast.

The woman looks all of her 56 years. She carries a black, knobby walking stick. Her ankles, visible at the end of pink sweat pants, are slightly swollen. Human immunodeficiency virus (HIV) infection is just one of her medical problems.

The doctor, Chukwuemeka Ufomadu, begins with her medicines. She's on 10. He goes over them with her, making sure that what's in her inch-thick medical chart on his desk reflects what she's actually putting in her body every few hours, every day of the week. Of the three drugs intended to quell the virus in her blood, she can identify only one. This doesn't bother the doctor, who knows plenty of people who take a medicine for years without once being able to pronounce it correctly.

But the names, at this point, don't matter anyway. Ufomadu's seen the most recent lab test results. The three antiviral drugs aren't working. Soon, she'll be on three new ones.

"Today you are complaining of what?" Ufomadu asks her, the words short and musical in his Nigerian accent.

"I just feel chills all the time. And diarrhea."

"How long have you been having this new diarrhea?"

"It comes and goes. This time three weeks."

And so they proceed.

As much as anyone, Worrell represents the typical AIDS patient in the United States. Her problems are rapidly becoming the mainstream -- not the marginal -- problems of AIDS medical care, as well.

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