It took two weeks of steady phone calls for Tracy Jackson to establish a rapport with a Howard County mother with AIDS.
"Each time, I would keep talking," said Ms. Jackson, a volunteer in the county health department's Buddy Program for AIDS and HIV patients.
"I would say, 'Tell me about your kids, tell me what you like to do.' "
After seven months, the two women now call each other regularly. Ms. Jackson has even taken the 29-year-old woman and her two children to the circus.
"She'll call me and say, let's do this, let's do that," Ms. Jackson said. "I check on her and she checks on me."
Ms. Jackson is involved in a network of Howard County programs and services for AIDS and HIV patients that is financed under the Ryan White Care Act, which provides federal assistance for AIDS and HIV victims.
Ryan White funds support medical and dental care, mental health services, counseling and support groups, buddy programs, rental assistance, utilities, food, transportation and home health services. Some services are provided directly to patients by county health departments, while others are given by agencies that contract to provide them.
In Howard County, the money has been used to start the Buddy Program, provide emergency funds for patients and start a medical clinic for HIV-infected residents.
"There's a pretty wide range of services considering the relatively small number of people with HIV [in the county]," said county Health Officer Joyce Boyd.
78 AIDS cases in Howard
Since the first cases of AIDS were reported in 1981, there have been 78 reported cases in Howard County. Of those, 48 have resulted in death. Since January, nine new AIDS cases have been reported in the county.
The county health department has received about $81,000 in Ryan White grants. Of that money, about $17,000 was used to start the Buddy Program, which pairs patients with county volunteers who provide companionship, meals or simply a shoulder on which to lean; it is up to the buddies to define their relationships.
Since its start this spring, the Buddy Program has attracted three to four patients and eight to 10 volunteers, county health officials said.
A 34-year-old mother of three was one of those helped by a companion.
Before she acquired a buddy two months ago, the woman, a resident of Savage, said she felt alone.
"I used to cry a lot because there was no one around," she said.
Although the woman said she enjoys the support of her family and talks to a therapist twice a week, they were not enough.
"It's helpful to talk to someone outside your family," she said. "Family members are too close. They don't understand the difference between your depression and the disease."
The woman said she and her buddy go for rides together, or sit at home and talk. She calls her buddy every other day.
"It's just like having a friend," the woman said. "You can talk to her about your disease. You can tell her what's on your mind. There's no judgment."
AIDS Alliance of Howard County, a nonprofit group that provides emergency funds for residents with HIV or AIDS, has received about $11,000 in Ryan White funds since 1991.
AIDS Alliance has used the money to help patients pay for such critical expenses as rent, utilities, food or medical bills. The organization has helped about 35 people since its start five years ago.
"Those emergency funds either fill in when no other funds are available or while the person is waiting [for money]," said Ann Wicke, chairwoman of AIDS Alliance. "We've paid for people's rent, mortgage, transportation and child care."
Words of praise
"These are very effective services," said a 37-year-old Columbia man who has the AIDS virus and wants to remain anonymous.
He said a social worker from the county health department quickly helped him qualify for medical benefits, and directed him to AIDS Alliance of Howard County.
"It would have been disastrous" had he not received help. "The case management people get all the documentation together," he said. "It's a very fast program."
Ryan White funds also have been used to finance the Seropositive Evaluation Clinic, which provides medical evaluations and referrals for HIV-infected patients who have had difficulty finding medical care.
The clinic, which operates on alternate months in Howard and Carroll counties, has enabled patients to receive quicker treatment at Hopkins' Moore outpatient clinic for AIDS patients.
Before the Seropositive Evaluation Clinic, "we would have tried to scramble around locally or find them an appointment at the Moore Clinic, but they would have faced a three- to four-month wait," said Cynthia Lipsitz, former director of the county's Personal Health Bureau.
Now, because the Moore Clinic reserves a specific number of slots for Howard County residents, patients can see a doctor in less than a week.
Despite the variety of services offered to people with HIV and AIDS, county health officials said they do not know if they are reaching everyone who needs help.
"There's not any way to tell because we're reaching different people with different services," said Dr. Lipsitz. "I'm sure we're not providing all the people with the services they need."
In coming years, the county health department wants to use Ryan White funds for transportation, home health care, and to expand case management services and the seropositive evaluation clinic, Dr. Boyd said.
For right now, the Ryan White funds seem to be reaching the people that need them the most. Ms. Jackson, the Buddy Program volunteer, said she has noticed her friend's health improve since they met in November.
"She's better holistically," Ms. Jackson said. "Her cell count had increased and that's proof right there."
The mother of two said Ms. Jackson is partially responsible for that improvement.
"She's so full of life and energy, it rubs off on you."