Diagnosis put brother on mission

David L. Neale, a prominent bankruptcy attorney and major donor to AIDS Project Los Angeles (APLA), was stunned when the call came from Brazil in late 1999: His younger brother, John (not his real name), then in his mid-30s and previously robust, was gravely ill in Rio de Janeiro.

John had been producing a concert at the famed opera house in the jungle city of Manaus when he collapsed in the throes of a virulent fever and had to be airlifted to the hospital. By the time Neale, his mother and sister flew down to Rio, John was in a coma, the result of a severe case of meningococcal meningitis.

His doctors promptly dropped a bombshell: John was suffering from AIDS and had apparently been in denial about the mysterious fevers that had landed him in bed for weeks at a time over the past year. “I was shocked,” said Neale, who hadn’t previously known that his brother was HIV positive.

Even after John’s condition was stabilized, he refused to return to the United States for treatment until several months later, when Neale received another emergency call from Brazil. “They had had doctors coming to John’s apartment, to do spinal taps for him in his bed,” recalled Neale, who has been consistently named by Los Angeles magazine as one of its 100 “super lawyers” in the bankruptcy field. “They had given him all these steroids, and his skin was waxy and yellow — he really looked awful.”

Neale hustled his brother onto a plane for Los Angeles, “which was in itself an ordeal because he couldn’t walk,” the attorney recalled. After landing in L.A., “I immediately drove him to the emergency room at Cedars-Sinai [Medical Center], where they told me that they hadn’t seen someone this ill with AIDS for years, given the advances in medications, and that I should be prepared for my brother to die.”

John survived, after 12 weeks in the hospital, yet he was weak and debilitated, and the family panicked. “I had no clue about what to do in a situation like this,” Neale said. “And because my brother had lived out of the country for so long, he had no health insurance, no place to live, nothing.”

The situation remained grim until, through Neale’s then-wife, the family was introduced to an official at APLA, which currently helps care for some 11,000 people with HIV in Los Angeles. It was the family’s first stop once John was out of the hospital: “He was literally lying on the floor in an office there,” Neale said.  “But APLA was a very comforting influence; it was like we were frantic, but they weren’t. They made things very manageable; otherwise it would have been overwhelming.”

APLA workers calmly helped to set John up on disability and Medi-Cal, so that he could receive the AIDS drug cocktails that cost around $5,000 per month, Neale said; they sent him to the right doctors, arranged for a hospital bed and IVs to be set up in Neale’s living room, and even for John to procure a driver’s license and other documents to get him re-established in the United States.  “I was so grateful,” Neale said.  

Thus, he immediately agreed when APLA officials asked him to serve on the group’s board for a full six-year term limit; since that ended three years ago, Neale has continued to fund the group, having donated sums in the six figures over the years. John, he said, has now regained his health and is back in Brazil producing concerts and other events.

“Thousands of low-income Los Angeles County residents with HIV/AIDS have benefited and continue to benefit from the vision, leadership and continuing support of David,” said Craig E. Thompson, APLA’s executive director.  “Admirably, he built on his personal connection with HIV disease to become a key board leader in the fight against HIV/AIDS.”

Neale, a graduate of Princeton University and Columbia University law school, has also been involved in Jewish causes, such as donating to campus Hillels and serving on the board of the American Friends of Hebrew University — he studied at Hebrew University for a time as a youth. He traces his philanthropy, in part, to the influence of his parents: His late father had been active on the board of the family’s synagogue in Cedarhurst, N.Y., while his mother has run the Head Start program in Williamsburg, N.Y., for the past 40 years, where she encourages low-income children to stay in school. “She’s always been very conscious of people who have less,” Neale said.

The health crisis of HIV/AIDS has also shifted to those who are underprivileged, he added.  “It’s no longer a fashionable cause, as people think everyone’s fine now, with the new medications,” he said. “But they don’t think about lower-income people, African-Americans or the Latino community — all these places where AIDS is still a huge problem. It’s like it’s not a white person’s problem anymore.

“In the Jewish community, people often give to Jewish charities, and I’ve done some of that, but I feel like AIDS is a cause that doesn’t have all the support it could use. It’s not like people are fixed and the disease is eradicated. It’s still a continuing and vital issue that we should pay attention to.”

HIV/AIDS impacts the vulnerable across the city, up the state, over America and around the globe

Los Angeles resident Darryl Hendrix often struggles to get by. Like many of his neighbors, Hendrix’s costs for housing and personal necessities sometimes exceed his modest monthly income. But Hendrix, an African American gay man and a client at AIDS Project Los Angeles (APLA), is also living with HIV.

His diagnosis has complicated daily living. To stay healthy, he must maintain a nutritious, balanced diet in the face of rising food prices. He must confront HIV-related dental problems as health care costs climb. He must travel to medical appointments as gas prices and transportation fares skyrocket. And he must live with a disease that still carries tremendous stigma.

Hendrix’s story repeats itself locally, nationally and globally, among the most vulnerable populations: communities of color; the poor and disenfranchised; people struggling with addiction, mental illness and histories of abuse; and gay and bisexual men. More than 25 years into the epidemic, HIV/AIDS is the greatest public health crisis we’ve known.

A Global Crisis

Worldwide, there are more than 33 million people living with HIV/AIDS, and the epidemic continues to expand. In 2007, there were more than 6,800 new HIV infections globally each day. And while new treatment options make longer, better life with HIV possible, more than 5,700 die from AIDS-related complications daily.

Internationally, Sub-Saharan Africa remains the hardest hit. The region, which accounts for only 11 percent of the world’s population, is home to 68 percent of people living with HIV/AIDS. In response, APLA has partnered with several agencies on the ground in South Africa to develop sustainable food programs that support the nutritional needs of people living with HIV/AIDS.

APLA has also formed key collaborations with local organizations in India, which has the highest HIV prevalence rate in the world; in Latin America, where 100,000 new cases of HIV were reported in 2007; and in China, where high levels of stigma surrounding homosexuality complicate intervention efforts.

A Growing Epidemic in the U.S.

Since the first cases of AIDS were reported in the United States in 1981, more than 1.7 million Americans have been infected. More than 550,000 have died, and approximately 1.2 million are living with HIV/AIDS today. More than 25 percent of those who are infected do not know it.

The national epidemic is also growing. While previous estimates indicate 40,000 new HIV infections occur each year in the United States, the Centers for Disease Control and Prevention (CDC) is soon expected to raise that estimate to as many as 60,000.

The disease disproportionately affects communities of color and other minorities in the United States. African Americans, who comprise 12 percent of the U.S. population, accounted for nearly 50 percent of 2006 AIDS diagnoses. Latinos and Native American/Alaska Natives have the second- and third-highest rates of AIDS cases, respectively. Gay, bisexual and other men who have sex with men account for nearly 60 percent of AIDS cases among men annually. And more than one-quarter of all new AIDS cases are among women.

Responding to these trends, APLA formed the Sexual Health Exchange (SHX) in 2007, a nationwide partnership with other AIDS service organizations to address these disparities in HIV infection rates among communities of color.

The Face of AIDS in Los Angeles

Los Angeles is the second-most HIV/AIDS-impacted community in the United States. Today, more than 60,000 Angelenos are living with HIV/AIDS — more than ever before — and Los Angeles sees 1,500 to 2,000 new infections each year.

As nationally, HIV/AIDS continues to impact communities of color and gay and bisexual men. Where these communities intersect, the statistics are even more striking: an estimated one in three African American gay men in Los Angeles is living with HIV.

APLA’s client profile offers a snapshot of the Los Angeles epidemic. APLA clients are diverse, with 37 percent Latino, 36 percent white and 23 percent African American. They are poor. Nine out of 10 live on less than $20,000 per year. Too many are uninsured. And while they are living longer thanks to treatment advances, their need for food, dental care, mental health services and other programs is also increasing.

Challenges Ahead

Darryl Hendrix’s story is a common one among APLA clients. For many, the cost of daily living is rising, while income is not. Necessities like food, housing and medical care are too quickly becoming expensive luxuries.

Government funding for HIV/AIDS services is also shrinking. Last month, Gov. Schwarzenegger announced plans to slash nearly $10 million from the state’s HIV/AIDS programs, along with proposed cuts to Medi-Cal dental benefits for adults that could leave millions of low-income beneficiaries (including people living with HIV/AIDS) without dental coverage.

Still, in the face of these challenges, APLA is doing more to support the hardest hit. Last year, more than 9,600 people living with HIV/AIDS accessed APLA’s direct services and education programs, including our countywide network of food pantries, our state-of-the-art dental clinics and a wide array of supportive services.

We reached nearly 600,000 through our publications and Web sites, working to prevent HIV infection through comprehensive HIV risk reduction and health education programs that target those at highest risk.

And we’re in Sacramento and Washington, D.C., responding to budget cuts by bringing our clients face-to-face with lawmakers to find solutions and shape the future of HIV/AIDS-related policy.

But our work would not be possible without our generous supporters. Two-thirds of our operating budget comes from private donors. We are particularly inspired by the generous contributions of the diverse communities of faith in Los Angeles. It is these gifts that allow us to fight an epidemic that still outpaces our most aggressive efforts to control it.