NEW YORK -- Rosemarie Velez sat on a sunny bench in a drug-infested Lower East Side neighborhood and stuffed a free, sterile hypodermic needle and bleach kit into her bag.
The 31-year-old homeless mother got the kit through an illegal program trying to protect those at greatest risk of catching and transmitting the deadly AIDS virus -- intravenous drug addicts.
'I hate this disease so much. The first person I knew it killed was my husband,' Velez said, pulling out a small photo album from another lifetime -- before AIDS -- with pictures of a striking, dark-haired young man and two smiling daughters.
'He helped me stand up to drugs and my manipulating mother,' she said, tears streaming down her youthful face.
Since her husband David, who years earlier kicked his habit, died in February, her daughters moved in with her mother, her Social Security benefits were cut and Velez tested positive for HIV, the human immunodeficiency virus that causes AIDS. And she returned to heroin.
Recalling her husband's lingering death in a hospital crowded with AIDS patients, Velez said, 'Maybe if I could get an apartment, I could help. That would feel better than any bag of dope.'
The AIDS epidemic is spreading faster among addicts like Velez than among any other group in the United States. Drug addicts represent the most women, most blacks and most Hispanics who get AIDS.
HIV is readily spread from one addict to another through shared needles tainted with infected blood. The virus is also spread from addicts to their sex partners and to children born to infected women.
'We see mothers and daughters on the stroll. We see a lot of nice cars from New Jersey,' with young men looking for a quick fix or sex, said Yolanda Serrano, executive director of the Association for Drug Abuse Prevention and Treatment, or ADAPT, which runs intensive outreach programs for prostitutes and drug users in New York.
'A lot of people are turning from crack to heroin' and sex is often traded for drugs, she said.
Intravenous drug users, including 7 percent who were homosexual, made up nearly one-third of more than 130,000 people reported with acquired immune deficiency syndrome to the federal Centers for Disease Control by last month.
Despite such sobering statistics, the federal goverment has eliminated the biggest AIDS prevention program for addicts.
The federal National Institute on Drug Abuse will begin closing 63 experimental counseling projects from Puerto Rico to Honolulu this September and cut funds to all the sites next fiscal year, officials said.
And with no agencies ready to take over the $45 million effort, the step 'is quite literally tantamount to consigning some people to a death watch,' said Barry Brown, NIDA's chief of community research in Washington.
To try to fill the gap, groups like the AIDS Coalition to Unleash Power go to neighboorhoods bustling with drug traffic to dispense free hypodermic needles.
On a recent Saturday, more than 1,000 needles were grabbed up, with some addicts exchanging bags of used ones.
'This is such a positive thing they're doing,' said a lean, 29-year-old who gave his name only as Billy and displayed an ulcer along the tracks on his left arm. He said he had been tested for the AIDS virus but feared getting the results.
'Maybe there's some kind of program they can get me into. I'm tired of chasing this goddam heroin,' he said.
One of half a dozen ACT UP activists stopped collecting used needles in a red plastic container and gave Billy a name and phone number for getting help to find treatment.
'You have to push the system,' said Jon Parker, a broad-shouldered graduate student helping ACT UP pass out needles along with kits of bleach, water, cotton and condoms. In cities along the East Coast, Parker has been arrested numerous times for his own similar initiatives.
In addition to the NIDA cut, the federal government's recently passed emergency AIDS funding measure strictly bans providing any money to states that allow needle-exchange programs.
Researchers insist NIDA's program was showing signs of success in convincing addicts to get treatment or curb dangerous needle-sharing practices.
The three-year effort contacted about 150,000 drug users, mostly on the streets or in shooting galleries, with advice on avoiding dirty needles and using condoms, Brown said.
In most cities, about 50 percent of the addicts counseled said they began to reduce their drug use, and 45 percent said they began using bleach to disinfect their needles, he said.
But top federal officals are skeptical about the usefulness of the programs.
'Addicts are very good at verbal behavior, at saying what they're going to do. They're all going to quit tomorrow, they're not going to share needles,' said Dr. Herbert Kleber, deputy director for demand reduction under William Bennett in the Office of National Drug Control Policy.
'Unfortunately, these are individuals who engage in high-risk behavior to begin with,' Kleber added.
Federal money instead has been provided to supplement the nearly $800 million now spent on drug addiction treatment, the only solution to controlling AIDS among drug users, according to Kleber.
But even Kleber admits there are hundreds of thousands more drug users than available treatment slots.
ADAPT recently almost lost a contract with New York for refusing to stop giving bleach to drug addicts. It now must find private funds for the project.
Across the country, scattered, small-scale efforts continue for drug addicts, from 'bleach and teach' programs to underground hypodermic needle distribution networks like ACT UP's.
But New York City, with the country's biggest concentration of intravenous drug users, half of them already HIV infected, canceled its small needle exchange program shortly after David Dinkins was sworn in as mayor.
Distrusting research reports to the contrary, Dinkins and his supporters argued that such programs encourage drug abuse.
Some cities, such as Portland, Ore., Tacoma and Seattle, Wash., Boulder, Colo., and most recently, New Haven, Conn., fearing an AIDS epidemic like New York's have set up their own needle give-aways.
'Our intent is to keep from what happened in New York from happening here,' said Kathleen Oliver, executive director of Outside-In, a non-profit social service group that has run a needle exchange program in Portland since November.
'The program was remarkably non-controversial here compared with the rest of the country,' Oliver said.
Clyde McCoy, director of the University of Miami's Comprehensive Drug Research Center, argues, 'Highly charged political issues beg the question.' He continued, 'All of us, if we had sufficient funds, agree our primary goal would be drug cessation. Without funds, we have to use intermediate strategies available to us.'
Rep. Charles Rangel, D-N.Y., a powerful opponent of needle exchange or bleach programs, maintains that even methadone treatments fuel addictions and are prone to abuses.
The chairman of the House Oversight Committee on Narcotics Abuse and Control, Rangel refuses to estimate the cost of providing non-methadone addiction treatment to all drug users, but he has introduced a bill to make addiction treatment reimbursable through state Medicaid programs.
However, committee sources say the bill is not likely to pass soon.
