Sales of HIV Meds Catch Lawmakers' Eyes

Washington Heights —

The pharmacist can then sell the pills back to drug dealers or ship them directly overseas.

When the spots become too "hot" –meaning the pharmacies are attracting too much attention—Cruz says the patient then moves on to less obvious buyers. "You don't even have to look for him, he's right there outside the pharmacy," she said about a dealer she often went to in the past and who stations himself opposite a small local pharmacy in the South Bronx.
      
The price fluctuates depending on location and dealers, she said, but it's always much below the pills' retail value. Cruz says she could get at least $250 for a bottle of 30 pills, when its real value amounted to more than $1,500.

"It's obviously worth more," says Loni Fernandez, a case manager for two years at Bronx AIDS, who notices that many of her patients did not take their medication. "But when you're dealing with poor people, that's what happens. They'll buy it cheap and sell it for more to people that really want it."

Drug users are well-known targets for street buyers, who sometimes approach them inside the pharmacy where they're buying their medication.

A financial struggle

Case managers and doctors are torn over whether the possible stricter punishments will discourage a dangerous practice or merely punish people who make a bad decision against challenging circumstances.

"They sometimes have to face a difficult choice," says case manager Antionettea Etienne about some of the people selling their HIV treatment. Etienne, also co-chair of the New York City Planning Council, says that often the dilemma boils down to this question: "Should I get my medication, or food for me and my kids?"

"I need my pills!" said two HIV patients at a Bronx AIDS group meeting for women. Roxanne and René, who declined to give their last names, were responding to questions about whether they ever sold their pills for cash. Both admitted that even with a job it's hard to cope financially.

Over the past two decades the cost of living has gone up, but benefits haven't kept pace. A person infected with HIV can get up to $115 a month in public benefits, depending on their occupation, financial situation and needs. If they have full-blown AIDS it's up to $300 plus a maximum of $940 for rent, although once again it varies. All are also eligible for up to $200 of food stamps each month.

These figures have remained about the same for years, says Fernandez. The financial support poor patients receive is often insufficient to cover everyday expenses such as transportation, food, rent and other bills, she explains.

"We know when something's wrong," says Julie Peña, who works at CitiWide, a needle exchange program based in the South Bronx. Peña carried out interviews for Bronx Works on the black-market of HIV drugs in 2004. According to her, the study was never published but she remembers that he black market for AIDS medication was already fairly common at the time.

Each month, case managers look at their patients' T-cells levels and viral load, which respectively indicate the state of the immune system and measure the spread of the infection. "So we see the participants and ask them why the numbers are changing," says Peña. "Most of the time they'll tell you the truth, that they're not taking their meds."

Selling HIV meds can be harmful to both seller and recipient. If a patient doesn't take his or her medications meticulously, the risks of becoming resistant to the treatment and developing colds and pneumonia become higher. Different cases of HIV have different biological characteristics, so the cocktails of drugs vary. And all treatments don't fit all viruses. <