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By the time Eddie Rudd started developing symptoms in 1999, he was serving time in the Missoula Pre-Release Center for his fourth DUI, a felony. His body ached and he slept more hours than he spent awake. When the doctor told him he had HCV, Rudd thought he was about to die.
"I closed up right then and there. That's all I heard—that I was positive," he recalls.
He says the doctor didn't even look at him.
"I think it is because of the stigma," he says. "He probably thought that I was a junkie. I had tattoos all over me. And you know that's the first thing that comes in their mind, that you're a junkie."
Eddie Rudd was a junkie. But that's not the case anymore. In the '90s, he began a transformation. Rudd's diagnosis motivated him and his wife—also a former drug addict—to become certified hepatitis C prevention specialists. When the CDC started funding MTAP in 2000, the Rudds eagerly hopped aboard. The couple's Bozeman-based nonprofit, which Casey Rudd founded in 1998, also helps rehabilitate felony offenders and assists newly released inmates in finding jobs and homes. The Rudds' background puts them in an ideal position to combine MTAP outreach with their nonprofit's goal: helping disenfranchised individuals who have drifted to the fringe become productive members of the community.
"Eddie and I, we make no bones, we speak their language," says Casey Rudd. "We come from the same place."
A world away from the Rudds' office in Bozeman, MTAP outreach workers Bill and Martha Spotted Eagle tell a similar story. Situated on the 1.5-million acre Blackfeet Reservation in northern Montana, the Spotted Eagles worry about how to proceed with their work knowing a primary funding source has dried up. The condom supply MTAP provided is already dwindling. HIV tests are also a scarce commodity. Bill Spotted Eagle says when the tests are gone, that's it—he won't be able to test on the reservation anymore.
"[The lost grant money] really hurts us, because of that simple fact," he says.
As a child, Bill Spotted Eagle learned how to dance in traditional Blackfeet style. He loved the sound of songs and prayers passed on by his elders, and the lessons those songs and prayers taught him. But he says he drifted away from those native customs as a young man, and he began to drink. He's sober today and aims to reconnect others in his community to the strength provided by Blackfeet tradition.
"They told me that one day, this is going to be an important tool for me," he says, referring to his parents' teachings.
Bill Spotted Eagle believes that addiction—and many of the unhealthy behaviors that go along with it—is symptomatic of a society losing sight of its roots. When one drifts between two cultures, he says, it's easy to get lost. That's why he teaches indigenous people how to reconnect through Native spirituality. As an MTAP subcontractor, he incorporated those teachings into his HIV and HCV prevention outreach.
"It's really important that they see it from an individual who is the same nationality they are," Bill Spotted Eagle says.
Even so, persuading Browning residents to get an AIDS test isn't always easy. As in much of rural Montana, gay members of the community face possible discrimination and ridicule, and, in turn, often keep their sexuality under wraps.
"There's a real homophobia," says Martha Spotted Eagle, Bill's wife and a registered nurse who oversaw MTAP outreach efforts on the Blackfeet and Fort Peck reservations.
That fear makes the back door to the Spotted Eagles' Browning office all the more vital; it's a convenient way for patients to surreptitiously slip in for a free AIDS test. The $5 gas card provided by MTAP also lured clients. Every little bit helps to get tribal members tested for what is often referred to as simply "the gay disease."
"A large portion of our pull to get these people to come in for testing was the incentives that were provided," Martha Spotted Eagle says. "So, of course, with the cut in the program, we are already seeing a major decline in people coming in for testing and/or follow-up."
What's most frustrating, Martha Spotted Eagle says, is the couple's long-term investment in the program, and how their strong standing in the community may suffer.
"It has taken so long for us to build that trust relationship," Martha Spotted Eagle says. "And then it just stopped."
Rick Holman, 63, remembers when HIV was called GRID, or "gay related immune disease." He recalls doctors who, unsure of how the disease was transmitted, wore protective gear that looked like moon suits to prevent from becoming infected. In the early 1980s, as a wave of sick and dying men flooded inner city hospitals, Holman lived in Houston and watched as the epidemic took hold.
"I was going to as many as three funerals a week," Holman recalls. "I just saw death after death."
Holman returned from Houston to his hometown of Butte in 1992. But even in Montana, he couldn't escape the virus. His partner of 14 years, Tony Montgomery, died in 1997 from AIDS-related pneumonia at 37.