AIDS IN A 'SECOND-TIER' CITY

"The single greatest need is for the structuring of a powerful leadership group.'

aging negative ones. It may also allow for more Cleveland visibility on the state level and, somewhere in the future, suggests Interrante, might lead to more visibility nationally, a real need for non-coastal areas like the Midwest.

It is heartening to hear a veteran like Interrante say, "larger cities don't have the amount of cooperation evident in Cleveland. In fact, we're significantly ahead in terms of cooperation.”

While Cleveland may be ahead of the game in this area, and helped by it, it is ironic that it is also helped by being further behind larger cities in terms of infrastructure. Without a lot of" baggage" says Stewart, "our slate is clean, we can build from here."

Stewart also notes that fears about program eliminations should be allayed. "I see it as fine-tuning rather than elimination. All the players that are here are needed. More will have to be recruited. Everything is needed. There are gaps still." What about streamlining? "If streamlining means agreement on issues and policies, then yes. But if it means elimination, then no." There is a general agreement that avoiding unnecessary duplication is needed and that "too much diversity in an agency can diminish its focus."

There should also be no worry that one single agency will pull total control. As director of the Health Issues Taskforce, the area's largest AIDS services provider, Interrante is familiar with such fears. He stresses that "we can't do it all. We don't want to do it all. We have our hands full now."

As for the bottom line ...

And of course there is that nagging question of money. Everyone agrees that government needs to ante up. Columbus and Cincinnati both give money to communitybased organizations; Cleveland does not.

Private money, like the Cleveland Foundation and the Gund Foundation, await

Committee results to aid them in effective decision making. Major benefits like the AIDS Walk and "Dancin' in the Streets" are beneficial and produce results. How to make more use of them and allow for wider partnership? "We don't need another organization that's going to become an AIDS fundraiser. We already have organizations that raise money for AIDS. Clearly we need to facilitate among them," says Interrante.

Some issues are so knotty that even the most thorough surveys may not make them go away. There is still a great need for wider public acceptance, and there is much competition from other social issues facing Cleveland. But expectations are generally positive.

Ron Stewart is "hoping to get something running long before my tenure is up next summer. 1993 is the year for Cleveland. We are prepared for this now. Let's set the ground work and be ready for the wave ahead."

John Nolan feels it too. "I was at a recent meeting of the Ryan White Consortium and I just had to stop and look around at everyone there. These are great people who genuinely want to make things happen, who are really working at solutions. It's so good to work with people like that." As executive director of the still-extant AIDS Commission he is eager for Committee results and sees his role in a state of metamorphosis, adapting to identified needs.

Things are happening, says Interrante. "The community has learned to collectively deal with this issue. There is more public visibility. Mayor White's participation in the AIDS Walk shows that. Now we just have to translate that into concrete programs."

Next issue will take a look at some of the current "concrete programs." Who are the key players? How are they meeting needs? What future roles will they play? And, if there are more than 60 care providers in the Greater Cleveland area, just who are they?

Rural AIDS: a tough fight

Pittsburgh-One irony of AIDS is that the disease can be hardest to handle in places where the fewest people have it.

In rural America, the roadblocks are plenty. The general public often refuses to face the disease openly and still fights attempts at education. Some elected officials behave and speak ignorantly. while even health care professionals themselves fight treating AIDS patients.

Kristine Gebbie, President Clinton's top adviser on AIDS, heard August 10 about the many hurdles and frustrations facing seven AIDS advocates in West Virginia, two rural Ohio counties and the city of Youngstown.

"I'm still educating people that you can't get AIDS from a mosquito bite or off a plate," said Chris Morrison, executive director of the Mountain State AIDS Network in West Virginia.

Morrison said West Virginians still talk about officials in Williamson who drained and cleaned a pool after a man with the AIDS virus swam there. The 1987 incident brought Oprah to town.

Most rural residents, even some doctors, mistakenly believe AIDS is only a big-city problem, Gebbie said. "But there is nothing about this disease that says it's not rural."

The Ohio counties of Columbiana, Trumbull and Mahoning, which includes Youngstown, have combined their AIDS counseling. Health records show 141 people in those counties have contracted AIDS, and 101 of them have died.

The Ohio delegation said if AIDS patients seek treatment in their hometowns rather than nearby cities like Pittsburgh or Cleveland, they often shuffle among as many as a dozen government agencies and charities to get help.

Gebbie referred the Ohio advocates, who

want to build an AIDS center, to federal grants restricted to construction of AIDS hospices. She said pharmacists are important allies in rural areas, and a national group of druggists is starting an AIDS education program.

The meeting followed Gebbie's speech to a convention of public health officials.

Gp160 vaccine trial set for '94

Washington-A controversial AIDS vaccine trial set for next year will be the largest test of a new concept of therapy: using a vaccine to bolster the immune system against an infection that has already taken hold.

The vaccine trial will test gp160, a genetically engineered protein, in 5,000 to 10,000 HIV-positive people.

MicroGenesys Inc., a Meriden, Conn., company that lobbied Congress for $20 million to conduct the trial, said that the test will start early next year under the guidance of the Walter Reed Army Institute.

AIDS experts said the trial will be the first major test of the idea of treating HIV infection with what is called a therapeutic vaccine. Vaccines generally are given to uninfected people to prevent infection.

Genentech Inc., a California drug company, also is testing gp120, another therapeutic vaccine, based on a sub-unit of the gp160 protein in the coat of the AIDS virus. The Genentech product already has been shown to protect chimpanzees against infection by HIV. Now the company is testing the drug in some 500 HIV-positive people to see if it helps them fight the infection.

SEPTEMBER 3, 1993 GAY PEOPLE'S CHRONICLE

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