Now 52 and a grandmother, Stella Zuzé rummages through her old
photos. There she is in a Sophia Loren sunhat lounging in her garden in
Zimbabwe, circa 1976. “Let me tell you—I was a killer then! I could have any man I wanted.”
Three decades, four children and one near-death from AIDS later,
Zuzé lives in a single room in Cardiff, Wales, on the £38 ($68) a week
asylum seekers receive while U.K. immigration officials review their
cases, which can take years.
“Young Stella,” she says, as if telling a fairytale, “married an
artist. He designed the bird on the Zimbabwe flag. Stella had four
kids, and when independence came in 1981 and blacks were allowed to do
office work, she got a good job.
“But the marraige turned out to be far from the fairytale that Stell
had envisioned. So she left her husband and struggled as a single
mother. And she had a lot of boyfriends! Why not? My husband never so
much as paid my rent, but they did.” (Common in African cities, this
isn’t considered prostitution.)
“Eventually, in 2000, I got sick. I went to a doctor who took a test
and said, ‘Stella, your blood is dirty.’” She got blinding headaches.
With cryptococcal meningitis ravaging her brain, she flew to England
for the treatment she needed to save her life.
Four years later and stable on HIV meds, she can’t leave the U.K.
until her asylum application is settled. That means she can’t visit her
kids—whom she bore before getting HIV. But she’s determined not to
return to Zimbabwe. “The place is not fit to live in,” she says.
One in three Zimbabwean adults has HIV. “Every time you phone:
‘So-and-so died,’” Stella says, beginning to sob. “Last year, I was
begging for tablets for my nephew’s son, a teacher. He died at 28. Over
there, people think, ‘Well, if I use a condom, I’ll still die.’ ‘Death
is death,’ that’s what they say.”
Zuzé is the new face of HIV here in the U.K., which has largely
handled the disease admirably. One in 1,000 Brits is positive, compared
with one in 330 in the U.S. This is due in part to the government’s
early adoption of needle exchange. Only 7 percent of Brit HIVers got
the virus by injecting drugs, compared with 25 percent in the States.
The Brits’ bold, sexy and community-run info programs for gay men
remain models for tackling HIV non-moralistically. And the U.K. is
proud of its free, tax-funded National Health Service. This includes
sexual-health clinics where you can drop in, give your name as Elvis
Presley and get treated for STDs and HIV, no questions asked.
But the number of HIVers here has doubled in the past five years, to
60,000 in a country of 60 million. That’s the steepest climb in any
rich country. Two-thirds of those new infections are among
heterosexuals. Nine-tenths of those newly infected caught HIV outside
the U.K., 80 percent of them in sub-Saharan Africa. A health-care
system built in Victorian times to treat pox-ridden sailors returning
from the colonies is buckling as immigrants from those former
colonies—which have become the world’s HIV hot spots—turn up with AIDS.
This has panicked the government and enraged the conservative press,
which seems to mesmerize Britain’s politicians. Immigrants are “health
tourists bleeding the country dry,” to quote the Rupert Murdoch–owned
Sun. The London Times called them a “public health menace.” The Daily Telegraph got a doctor to say that paying for their treatment was “why your granny won’t get her hip replacement.”
Prime Minister Tony Blair considered a U.S.-style ban on letting
HIVers into the U.K. He dropped the idea when advisers told him it
would merely encourage false documentation. Since April, though,
roughly 1,500 to 4,000 “illegals” have been denied free HIV meds. That
includes those denied immigrant status even though authorities agree
it’s too dangerous to send them back to countries with civil unrest.
“We’ve had cases of people admitted to hospital unconscious and
getting a bill for £7,000 [$12,600] when they wake up,” says Lisa
Power, head of policy for the Terrence Higgins Trust (THT), the U.K.’s
largest HIV organization. “We’ve had people with active TB who, when
charged for their [HIV meds], discharged themselves halfway through
their TB treatment. The Immigration Department seems to think if we
don’t give them [HIV meds], they’ll go back home. But it’s still better
dying by inches in London than in Africa.”
THT chief executive Nick Partridge doesn’t think the U.K. will end up with people dying of AIDS in the streets. “The
human cost is just too high,” he says. “I can’t see
how clinicians would agree to refuse treatment.” A physician advisory
group, for example, refused last August to draft guidelines for
withholding free HIV meds.
Population: 293 million
People with HIV: Approx. 900,000
Who are they?: Among newly infected men: 60% via gay sex, 50% black; among newly infected women: 72% black
Hardest-hit places: Areas with highest AIDS rates in recent years have included Miami, New York City and Baltimore.
HIV reporting: HIV diagnoses are reported to the CDC by name in most states and by unique code in others.
HIVer celebs: Hoops legend Magig Johnson; Olympic diver Greg Louganis
Diva advocate: Dame Liz Taylor
Slang for HIV: "The monster," "the package," "that shit" (prison); "the virus"
Population: 60 million
People with HIV: Approx. 64,000
Who are they?: 42% gay men; 50% heterosexual (62% women; 90% infected outside the U.K.)
Hardest-hit places: London, with 15% of the U.K. population, has 60% of the country's HIVers.
HIV reporting: The country's free clinics report HIV cases by unique code to the Health Protection Agency.
HIVer celebs: Queen frontman Freddy Mercury; director Derek Jarman (both dead)
Diva advocate: Sir Elton John
Slang for HIV: "The cat flu," "She's got snatch" (gay)
In recent years, Blair reorganized the National Health Service
(NHS), shifting spending power to Primary Care Trusts, which run all
local services. The Trusts have no problem spending 10 percent of the
NHS budget on obesity and diabetes. But they don’t like spending even
one percent on AIDS, a stigmatized disease increasingly suffered by
non-taxpaying immigrants. “It’s a challenge to make the local Trusts
understand that AIDS is more, not less, important than it was in the
1990s,” says Partridge.
The Trusts also don’t like spending on HIV prevention for “poofs”
(that’s British for “fags”). But infections in gay men have risen 40
percent from 1999—that’s three times the increase among American gay
London, where Victorian laws once punished any sex act other than
two-in-a-bed heterosexuality, has become the sex-party capital of
Europe for gays and straights. Take Hard On, successor to the
notorious, polysexual fetish club Fist, which made its promoter,
lesbian S&M diva Susie Krueger, a very rich woman. Or Pigpitmen, a
monthly bareback party at an East End pub. It’s for guys with HIV,
though proof of status isn’t required.
Meet Sam Cotton, 29. The hunky Scot represents yet another new face
of the U.K. epidemic: younger gays. He knows the bareback world well.
“After I was diagnosed, I had little safe sex,” he says. “I regarded it
as a perk of being positive. I’ve changed my mind due to STDs, but I do
think a lot of positive guys, like me, are thrill seekers. I’d never
had unsafe sex until six months before I was diagnosed at 25.”
In 2000, Cotton was having a bad year. “I thought I wanted to be an
actor but was doing it very half-heartedly. I was lost. It was that and
the GHB,” he says, referring to the party drug that can make one
vulnerable to rape or a fatal overdose. “That’s the only drug that’s
ever made me lose it. And yes, I have tried crystal.”
Crystal meth, or “tina,” has arrived on London’s gay scene but
hasn’t yet saturated the community as it has in the U.S. GHB is a
different matter. Positive guys on Norvir (ritonavir) are at particular
risk because it hikes GHB to lethal levels. Tired of ambulances carting
off comatose boys, sex clubs now frisk for GHB bottles.
After his diagnosis, Cotton was aimless. “In this country,” he says,
“if you’re positive, the government plies you with meds and money.”
It’s true that, if you’ve paid taxes, you can get generous benefits,
sometimes including a government-leased car. But benefits have become
more difficult to get—and many HIVers are being forced back to work.
After taking a life-coaching course, Cotton got a job working with
Derren Brown, the U.K.’s answer to the hip American magician David
Blaine. Now, Cotton rings up people and asks whether they’d like to be
“vanished” on TV. “I know so many boys who’ve had HIV for ages and are
just a mess on welfare,” he says. “I’ve learned I’m too important to be
a mess and that I can realize my goals. I’ve worked through a lot of
guilt about myself. You don’t ‘catch’ HIV, I think—you receive it. There’s something symbolic about that virus filling an empty hole.”
Yusuf Azad, policy director of the National AIDS Trust, worries
about people like Sam. Azad thinks prevention messages in the U.K.,
however nonjudgmental, are dangerously misdirected. “The U.K. has
brilliant information about how you catch HIV,” he says. “But I
challenge you to go into a gay bar and find a leaflet that issues a
clear statement about why you shouldn’t catch it.” Some HIV
workers think that CHAPS, the consortium of groups doing all that sexy
harm-reduction work, should augment their pamphlets on the relative
risks of, say, topping versus bottoming, with a blunt surgeon
general’s–type warning that unsafe sex with many partners greatly
increases one’s risk for HIV and other STDs.
“London is also an asylum center for men who can’t be gay in their
own country,” he adds. “How many of these new HIV cases in gay men are
also among immigrants?”
Welcome to Kudos, a gay bar just off London’s Trafalgar Square. The
designer decor and steep prices mark the opposite end of Pigpitmen.
Half the guys are Asian. And downstairs, in the louder disco bar, it’s
all African boys in beads and Muslim prayer hats.
The Health Protection Agency, the U.K. equivalent of the CDC,
documents the probable country of infection for every heterosexual
diagnosed with HIV but not for gay men. In a recent newsletter, the
agency estimated that one in six new gay infections comes from abroad.
The 2002 Padare Project, which studied HIV positive African Londoners,
found that one in five was exclusively gay. So far, however, remarkably
little HIV prevention targets them.
Mohamud Yasin, 29, is from the one African country that beats
Zimbabwe in U.K. immigrant numbers: Somalia. It’s a failed state torn
between rival warlords. But that’s not why Yasin’s family bundled the
newly married 16-year-old to neighboring Kenya shortly before civil war
broke out in 1991.
One evening, Yasin’s brother caught him kissing another man. “It
wasn’t my brother who tried to kill me,” recounts Yasin. “He just said,
‘You are qanes.’” (Pronounced kanesh, the word means “gay” in Somalian.) “But my sister leaped on me and started biting me! I was in fear of my life.”
Somalia is homicidally homophobic. “This guy in London,” Yasin
reports, “came out to his mother. She pretended to accept it but rang
his father in Somalia. He said, ‘You must kill him.’ And she did! She
invited him ’round and stabbed him.”
Islam dictates, however, that if your family accepts you, no one
else can touch you. “The night I was ‘outed,’ my father gathered us,”
continues Yasin. “My brothers wanted to kill me. But my father said, ‘I
am the one who can kill him or let him go.’”
In Kenya, Yasin found a Somalian boyfriend, Abdi, also an exile. But
Abdi returned to Somalia to die of AIDS in 1997. “That was my dark
year,” says Yasin. “I got letters from him every week. Then, they
Mohamud applied to the U.K. for refugee status and arrived here in
1999, almost as sick as Zuzé. He soon tested HIV positive. Thanks to
meds, he’s healthy and works at the Naz Project, a West London group
that supports positive Latinos, Asians and East Africans. Working with
Somalian HIVers, he decided to set up a support group for gay ones.
“Their lives are still in danger,” he says. “I get them running to my
door saying, ‘Mohamud, they’ve found out—you have to rehouse me now!’”
He was expecting around 30 guys at the first meeting. Eighty-five
showed. “A lot are nice-looking and have good hearts but are forced to
marry,” he says. “They have no English; they have no self-worth; and if
a white man wants sex without a condom, they are easy meat. If I don’t
work with them, who will?”
Britain finds itself at a crucial point with HIV—the numbers aren’t
yet dire but the political will to ramp up funding for prevention and
treatment for gay men and immigrants, who need it most, is feeble.
Without it, experts say, the situation could worsen. “At the moment,”
says Partridge, “prevention for HIV and sexual health is simply not one
of the NHS priorities—something I think will turn out to be a huge
mistake.” And with right-wing groups like the British National Party
weighing in, no one wants to trigger more anti-immigrant backlash by
screaming for immigrant AIDS services.
At a recent major PWA conference, an angry caucus of Africans
protested that groups serving them weren’t doing enough to counter the
media’s scare stories. “It’s time for us as Africans to take the lead
on these issues,” says Thandi Haruperi, 42, who came here from Zambia
in 1990 with ambitions to start her own chain of fashion boutiques only
to learn she had HIV in 1998. Today, the divorced mother of two runs a
health-education agency for black youth and HIVers—and serves on the
board of the U.K. Coalition, the nation’s largest PWA group. “We need
to challenge the government,” she insists. “Why press for more Africans
to test for HIV if there is no treatment?”
For all the press hubbub over HIVer immigrants, the issue likely
won’t play a major role in the upcoming elections, which, experts
believe, will favor Prime Minister Tony Blair’s Labour Party, which has
been relatively progressive on HIV and AIDS. Even if Blair’s own party
evicts him as party leader and PM—a possibility, due to his unpopular
support for the U.S.-led Iraq war—his likely replacement would be his
own finance minister, Gordon Brown. Brace for the worst, however, if
the Conservatives get in. Their leader, Michael Howard, supports
immigration quotas and deportations—even though his own Jewish parents
fled the holocaust.
Also troubling? The increasing criminalization of people who
transmit HIV. Last year, three men, all African asylum seekers, got
heavy sentences for passing HIV to women. “African men are demonized as
ghastly sexual predators,” says Azad. “HIV is becoming fetishized as a
criminal activity by the government and the conservative media. We are
losing the argument for a public-health approach to HIV. Would we get
needle exchange through today? I doubt it.”
Meanwhile, back in Cardiff, Zuzé thinks about her family in
Zimbabwe—about her daughter, a jazz singer, and her teen son, who’s
failing his school exams. But she’s determined to prove her worth to
her new home, proudly displaying the paper on European Union law she
wrote in night school. And she’s determined to stay in the mother
country for the drugs she needs to live. Says she: “I’m not going