Inside the HIV/AIDS nonprofit the Women’s Collective, Sabrina Heard walked a 37-year-old client with HIV into a private room for a serious talk at the end of a long day.

Would she, Heard asked, be able to keep an upcoming doctor’s appointment?

“I’m struggling to see if I can go. If I don’t, I won’t get medicine,” said the woman, an unemployed mother of four who knew the risks of going without. “I want a vacation.”

Heard, a community health worker who also has HIV, gave her an exasperated look, then stretched out her arms and palms.

“Put your hands on the table. I want to touch your hands now,” Heard said. She clasped the woman’s hands tightly. “This may be new for you. I remember when it was new for me.”

At the Women’s Collective, a one-floor clinic in a Northeast Washington strip mall with a liquor store and pawnshop, a single day spent with Heard can illuminate the battles of HIV/AIDS patients in granular, raw detail.

Each step of her day, Heard, 55, juggles the complexities of her own diagnosis, complicated now by a nettlesome change in her Medicaid status. But she soldiers on, dispensing cheerful, tough therapy to her clients with HIV and walk-ins who need to be tested.

Here, people stricken with HIV or AIDS talk to case managers for help navigating hospitals, medical appointments, obtaining the right medicines or gathering the strength to talk honestly with doctors about their symptoms. With 18 employees, the organization operates on a $1.6 million budget and gets about $300,000 from the city, half as much as the city’s allocation a few years ago, according to its founder, Patricia Nalls.

The Women’s Collective largely looks like any other office. But there are signs of its sensitive nature — a room with free children’s clothes, another with free food. Way in the back, there is a makeshift altar with candles and funeral programs adorned with the faces of former clients who have died of the disease.

Heard, dressed in purple jean leggings and an orange dashiki, began her day at 9 a.m., reviewing four patients’ CD4 blood counts, which represent the number of cells attacked by the AIDS virus in a microliter of blood. One was just below 200, the point at which the disease is considered advanced. Another was 85. Another was 535. The fourth’s count was missing from the file.

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Heard said she rarely regrets her life choices, even though she admits they were reckless.

A Chicago native, Heard moved here in the late 1970s to attend Howard University. Her mom worked in a lamp factory, her dad worked at a paint plant, but Heard wanted to be a theater costumer designer.

She got sidetracked. She ended up having two children with two separate men; by 1984, she had dropped out to care for her children.

Heard fell into the District’s crack scene and became a regular at the city’s open-air Hanover Street drug market, buying $50 bags of powder and weed laced with a hallucinogen.

She enjoyed men, she said. By the late 1980s, she had a third child with a third man.

Living mostly off city subsidies for low-income parents, Heard worked odd jobs at day-care centers or as a seamstress. One of her boyfriends was abusive, she said.

The drugs dulled her to the accumulating stress in her life. “I didn’t want to deal with the disappointment of not being able to return to school. I smoked drugs as a means of not feeling exactly what was going on at the time. I would do it away from children. They were in the other room.”

In 1990, Heard had twins with another man, the fourth father of her five children. When she gave birth at Howard University Hospital, she remembered some doctors and nurses wearing three gloves each. A sign on the door of her hospital room warning visitors about “hazardous body fluids.”

“That’s when I was given an HIV diagnosis,” she said. “I was pretty numb. I don’t remember crying.”

She is not certain which man gave her HIV; she suspects it was her third child’s father, whose death certificate said he died of AIDS, she said. (Her children do not have HIV.)

“But I am not one to point fingers, because of my lifestyle then,” she said. “I didn’t practice safe sex. And I didn’t discuss it with him.”

Over the next decade, Heard “fantasized” that her “bug” was something else. She never got a prognosis, or any death sentence.

In 2000, she enrolled herself in a local drug treatment center, and her children were moved into city foster care. But once Heard completed her detoxification, she got them back. Soon, she was referred to the Women’s Collective, where she began volunteering and working part time.

In 2004, she grew extremely sick. She had never taken any HIV medication, and her body was deteriorating. Her feet tingled. She developed mouth infections. She suffered bouts of AIDS-related pneumonia. Her T-cells had plummeted so much that she was formally diagnosed with AIDS. Once, she got so sick that she was laid up for days in bed. Her daughter, Zataunia, remembers her asking: “What would you do if I died?”

She finally began taking medication to stave off the disease. Bactrim at first, then Zerit, Reyataz and Atripla. Added to the mix: a monthly supply of whole-leaf aloe vera liquid for drinking.

Slowly, the crisis passed and her health improved.

* * *

Shortly after lunch, Heard introduced herself to Darnell Burley, a 24-year-old man wearing loose jeans and a Hugo Boss jacket, who said he had just been released from prison after serving time for destroying property. He wanted an HIV test.

Heard ushered him to a back room, where she had him sign some papers, pricked his pinky finger and waited 20 minutes to see if had HIV.

While the digital clocked ticked on, she interrogated him. “Tell me, what brought you in?”

“Just walked past,” he said.

“What was your highest level of education?”

“Twelfth,” he said.

“Your last HIV test?”

“February,” he said.

“Why did you come in?” she asked.

“You have to know your status; anything less is uncivilized.”

The clocked reached 20:00. The test results were negative. Thrilled, Burley pulled out his cellphone and called the mother of his 8-year-old to celebrate.

Late afternoon came.

Heard was with the 37-year-old who wasn’t sure she could keep her doctor’s appointment, tightly clasping her hands, hoping to connect with her physically and emotionally.

Heard smiled to calm the woman and asked, “Where are you right now?”

“I know I got to take it,” the woman said. “I don’t want to be faking it, getting a prescription and letting it sit there.”

Heard offered to travel with her to the doctor’s office. She looked down and realized their hands were still joined.

“I am holding your hands so you can feel what I am saying,” she told the woman.

“I don’t know no one in here like you,” the woman said back.