U.S. 90 runs alongside the swamps and bayous of southern Louisiana. The old highway makes a picture-perfect Sunday drive. I love to travel this scenic route, especially during the sugarcane harvest, when traffic slows to a snail’s pace as drivers yield to allow access to tractors from the mills.

But more and more my HIV ministry work calls me to the fast track of the interstate. On several occasions this past year I’ve received Saturday phone calls at 3 a.m.—here we call this “’fo-day in the morning,” slang for “before day”—asking, “Is this Raymond? I was told you might be able to bring me to the emergency room in New Orleans.” I’m unsure of what an epidemiologist would make of this, but four such calls in one year from towns like Bayou Vista and Chacopee—each with a population of less than a few New York City blocks—ring “epidemic” in my mind.

These makeshift ambulance rides have a silence more difficult to navigate than the dark roadway. The quiet offers a refuge, yet I know well what poet Audre Lorde meant when she wrote, “Your silence will not protect you.” It’s her voice that compels me to share details of my health with my passengers. When I tell them what they have likely already heard from whoever referred them to me—that I tested positive 10 years ago—I am sometimes met with tears, questions or a smile of recognition. More often it is a simple nod and a whispered plea for reassurance that I not tell anyone of bringing them to the hospital.

The ER doctor is the first to tell them they have HIV. My passengers are usually hospitalized—some with CD4 cell counts as low as 20—for treatment of AIDS, but they go home with a variety of diagnoses. Cancer or diabetes—common among African Americans—is what they tell their families.

Sunday mornings afford me the opportunity to travel U.S. 90 in the opposite direction. As I go down the highway’s access road to make 8 a.m. church services, I often pass the car of the director of the local AIDS organization, South Louisiana Human Resources, on his way to work. This agency’s commitment—in concert with similar efforts from the office of public health—shows me that I’m not alone. The regional consumer advisory council provides support, often acting as an underground railroad to those needing care. A local priest provides space for “a circle of friends” where PWAs can gather. Also, a consortium of organizations is spearheading prevention activities in the Bayou community.

This is a difficult task, as there are no models for work in rural areas. The Internet age supposedly means that we’re all connected, but I do not own a computer—and neither does our target audience. Besides, I can’t imagine receiving an e-mail at 3 a.m. asking for safe transport. I like the personal contact of my Wal-Mart telephone. In any case, my tin-roofed, shotgun home is hardly wired for this new millennium.