At-Risk For Dying Prematurely

“They hack computers real easy. I will kill myself if I have to go back to them" (survivor commenting on members of a gang).

border patrol facilities are not a suitable environment for interviewing minors to uncover abuse and exploitation

Tristan's Moon art installation (detail from train carriage).

The most significant form of justice for a sexually abused and sexually exploited boy is being granted access to a place where he feels safe and to people he believes will ensure his best interests are served.

An abused, exploited and neglected boy is significantly-at-risk for contracting HIV/AIDS-defining infections & diseases and is chronically-at-risk for dying prematurely when he cannot access appropriate & consistent medical treatment. When a kid's medical treatment is interrupted (when he is being processed and detained), he is placed at-risk for developing drug resistance and new strains of HIV (a retrovirus).

It is immensely difficult for a young male survivor to access appropriate and consistent medical care, when he does not have safe stable housing or supportive and caring adults in his life.

I am sad about my life. A poem by Chito.

I wish no woman had born me.
She born me then she sold me then I did not know her no more.
I slept in streets. There was no food.
Sometimes I would carry the drugs from the boats to the dealers on my bike.
I was 8 years old.

They would fuck me and then beat me up.
I did things in movies they made.
I never saw no movie of me doing that stuff.
I got sick.
They would still fuck me.

I stole some of the drugs I carried around on my bike.
I was going to sell them.
I never want no more to get fucked again.
I been bout and sold so many times I do not know who owns me no more.

I still run from cops if I see one.
I was in detenshun 1 time.
They fucked me day and night in there.
I sad to them that I had the hiv but they did not care.
The hole land was fucking me now.
I did wanted to die a lot.

I am not sick no more but unless I do not have pills but now I have pills.
If I had to go back then men would fuck me again and I would have to do it to earn them men who bout me money.
But the drug ones will just shoot me like it was a lesson to the other boys.
Yo no soy ninguna lección para besar mi culo.

Shujaat's Bus. A poem by Shujaat.

the men who put us on the bus had guns

i did not want to go on that bus

but they will kill you so we all got

on the bus and some of them were

crying but not me cuz i knew i

would run away fast and i better

not rite about it to much cuz

those men are looking for me

and they will kill me

When the Department of Homeland Security (DHS) picks up children (unaccompanied by an adult), that child is put into detention. DHS claims it tries not to do this but the numbers suggest otherwise. They do not routinely test for HIV. Lack of testing has a lot to do with the reality that no one wants to PAY for treatment. Big Pharma keeps the price of HIV meds sky high in the US (they have money to lobby for laws and trade agreements and to pay for attorneys to fight for THEM). We have suggested that CIPLA could be utilized to provide affordable medications to acutely at risk kids. To not test and treat a fourteen-year-old child who has been living rough on the streets of places like West Hollywood doing survival sex is irresponsible and probably criminal. It certainly does not serve the child's best interests.

The children put on the bus “home” who appear to be sick, are given directions to the only hospice in, for instance, Tijuana, Mexico. A place manned by compassionate Mexican volunteers, who can offer little more than a cot to die on and barely able to provide food; most of the food comes from volunteers who live in San Diego, USA. That Americans would throw these children, many who have been trafficked, into such hopelessness makes us sick. Stigma is more than just some bully on the playground who terrorizes. Stigma can, too, have a fundamental economic origin. AIDS itself is an economic disease, and this culture has it.

Boys sex trafficked to US, jailed in US military bases with no healthcare whatsoever, are returned to face the traffickers who trafficked them to the streets of Los Angeles to be pimped to service men in cars. One such boy lives underground after eluding his traffickers/pimps: "I would rather die than be trafficked back to the streets of Los Angeles."  He has HIV and was fucked in the ass so many times, he has what appears to be anal gonorrhea. If he doesn’t connect to health care from a disease he contracted in America, he will, indeed, die. Sex work will kill you. So will punitive US Immigration facilities, procedures and actions.

Traffickers are low-level gang goons who are fundamentally fearful of US authority, but they are expert at knowing any cultures inherent weak spots, and they exploit anything and everything they can. They are not brave men, do not seek out confrontation and use a culture of silence to move the chess players around the board.

Risk of sexual HIV transmission in heterosexual relationships that involve HIV positive men who sexually abuse boys and their HIV negative female partners (wives, girlfriends & lovers).

Our findings suggest minimal risk of sexual HIV transmission for heterosexual serodiscordant couples when the HIV-positive partner has full viral suppression on cART with caveats regarding information on sexual intercourse type, STIs, and condom use. (see, Systematic review of HIV transmission between heterosexual serodiscordant couples where the HIV-positive partner is fully suppressed on antiretroviral therapy **full viral suppression is dependent on adherence to medications.

Glossary of Acronyms and Terms Within the United States

DHS The Department of Homeland Security. Within DHS:

CBP Customs and Border Protection has primary responsibility for protecting the borders and ports of the U.S. Within CBP:

OBP The Office of Border Patrol (Border Patrol or BP) guards the borders of the U.S. to prevent undocumented aliens, smugglers and drugs and other contraband from entering the U.S.; and

OFO The Office of Field Operations processes the people, goods and conveyances entering and leaving the U.S. at U.S. ports along the land borders and seaports of the U.S.

ICE Immigration and Customs Enforcement has primary responsibility for immigration enforcement within the interior of the U.S., and for the removal of deportable or excludable adults and minors from the U.S.

USCIS U.S. Citizenship and Immigration Services has primary responsibility for processing immigrant visa petitions, naturalization petitions and asylum applications.

HHS The Department of Health and Human Services. HHS takes custody of unaccompanied alien minors who are provisionally admitted into the U.S. Within HHS:

ORR The Office of Refugee Resettlement provides people in need with critical resources to aid in integration into the United States. Within ORR:

DUCS The Division of Unaccompanied Children’s Services supervises privately run shelters that provide for the care and least restrictive placement of unaccompanied alien children.

DOJ The Department of Justice. Within DOJ:

EOIR The Executive Office of Immigration Review is responsible for adjudicating immigration cases and interpreting U.S. immigration laws by conducting immigration court proceedings, appellate reviews and administrative hearings.

DOS The Department of State is responsible for entering into agreements with foreign countries to establish repatriation and reintegration processes.

TVPRA The William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008, among other things, mandates screening of Mexican children before they are repatriated to identify victims or potential victims of trafficking or persecution, and children who do not consent to be returned to Mexico.

UAC Unaccompanied Alien Child, also referred to as a UAM (Unaccompanied Alien Minor): a non-citizen who has no lawful immigration status in the United States, has not attained 18 years of age, and with respect to whom there is no parent or legal guardian in the United States available to provide care and legal custody.


DeMarion is attempting to tell his story with music and images. He does not know how to write.

By the age of nine, DeMarion was running drugs for a Los Angeles-based gang. By the age of ten, he was stopped, beaten up, and robbed of the drugs he was carrying by a competing gang. DeMarion’s mother, an addict-prostitute, was twenty-one. Her response to the news that DeMarion had been beaten up was to beat him up. DeMarion’s first suicide attempt was at age eleven. By age twelve, he was diagnosed with HIV. By age twelve, his mother was dead. The gang that had beaten him up three years earlier was now his new family. A juvenile court slated DeMarion for foster care. But there was no foster care. Los Angeles had run out of it. And even when it had foster care families, none of them wanted DeMarion.

"I can’t even understand his medication schedule," one prospective foster care mother says. "He’s on a dozen separate medications, and even if I could understand it all, I don’t have time if I am going to be able to tend to the other children."

DeMarion was put into a holding facility for older boys where he was raped. The twelve-year-old hit the streets. Sex work was his only option. Think what you want, it kept him alive if you can call his existence living.

Los Angeles is in foster care crisis mode.

State officials have threatened to impose fines because too many children are languishing in sometimes chaotic holding rooms during traumatic separations from their families.

Officials say the problem intensified in recent weeks after the widely publicized torture death of 8-year-old Gabriel Fernandez, for which his mother and her boyfriend have been charged. The Palmdale boy’s case triggered a jump in child abuse hotline calls and the number of children entering county protective care.

Between May 28 and July 5, nearly 600 children were diverted to holding rooms as social workers scrambled unsuccessfully to find them homes, according to data obtained under the California Public Records Act.

That’s 600 children in one county with no access to parenting, and nowhere to live.

And nowhere to receive medication (ARVs) if they are infected with HIV. No one knows those numbers because children are not tested.

No one wants to pay for it. Pediatric scripts are just as expensive as adult ones.

One social worker called DeMarion’s plight as: “He’s less likely to be raped living on the street.”

Stays in holding rooms exceeded a state-imposed 24-hour legal limit in 117 cases, and dozens of children spent multiple nights in the holding centers before being placed in foster homes. By comparison, last August only one child remained in a holding room longer than 24 hours, and overall about a third fewer children were diverted to the centers. Sequestration has hit social services hard.

Typically, children who become stuck in the government-run way stations are the hardest to place: infants, large groups of siblings, children returning from failed placements and the mentally ill or those afflicted with lice, ringworm, chickenpox, respiratory problems and other infectious diseases such as HIV. Placing a child often requires more than 100 calls by social workers, records showed.

California regulators have given the county until Wednesday to fix the problem or face possible daily financial penalties they can ill afford.

And a prominent nonprofit law firm is warning it may bring legal action to force a resolution of the problems it says state and county officials have failed to address in the past.

The San Francisco-based Youth Law Center maintains that potential state penalties of $200 a day have been ineffective and don’t apply to a serious shortcoming of the system: instances in which children have multiple holding room stays of less than 24 hours because they are shuffled between child welfare facilities.

"This crisis has been building for several years," said Maria Ramiu, a Youth Law Center lawyer. "The state just hasn’t been able to fix the problem."

Children younger than 12 typically go to the Children’s Welcome Center on the campus of the Los Angeles County-USC Medical Center. A large open space with cribs for infants and cots for other children, it can have as many as 30 children sleeping over on some nights.

Officials acknowledged they don’t always have enough personnel to promptly feed children or change diapers.

The smell of shit pervades the place.

The department recently issued an emergency plea for community volunteers to help in the holding rooms. What public health officials call “patient compliance” has been applied to a child who cannot take his own antiretrovirals (he’s not allowed to take his own meds) and one more label has been slapped on a child who has never had a chance. He is now red-flagged as HIV noncompliant. Even though the real problem is that there is no one to bring him his drugs. The system rarely indicts itself.

Older children who can’t be quickly placed in foster homes typically are sent to a conference room in a high-rise building south of downtown Los Angeles, where they sleep on the floor.

A volatile mix involving teenagers can land in the facility. At times, objects have been thrown and police have been called to restore order, claims a recently retired county social worker who worked at the center.

In addition to lingering in holding centers, hard-to-place children often endure a bureaucratic gantlet, records and interviews show. Each day, social workers take them to various regional offices across the county as the search for foster homes continues.

DeMarion was left in a car while his social worker went to lunch. That is when the kid took off.

If nothing is found, if there is no place to put the kid, they are driven back to the holding rooms in the evening. During the placement hunt, they are not enrolled in school, have no rooms of their own and have virtually no privacy. Medication schedules are not a priority. But it becomes recorded as the child’s fault.

"I wouldn’t say this problem is under control, but we are making progress," said Philip Browning, director of the Department of Children and Family Services.

A number of factors has exacerbated the foster bed shortage. For one, the county lacks an accurate, real-time database of foster home vacancies. The system, updated just once a month, lists the licensed capacity of a home but not the number of beds a foster parent now is willing to fill.

Social workers are left largely to their own contacts, experience and word of mouth to find vacancies. Records show offices with more experienced workers, such as the West San Fernando Valley, rarely use holding rooms. Offices with some of the newest social workers — in Hawthorne, Compton, South Los Angeles and Palmdale — resort to holding rooms more frequently.

Efforts to improve tracking of vacancies are under way, Browning said. But he added that it would not compensate for the fundamental problem: too few foster homes.

There are half a million children in the US who have been placed in foster care.

Over the last decade, the number of foster parents has been declining faster than a reduction in children entering the foster system. In 2007, the county had 7,800 children in 6,380 foster family homes; there now are 6,300 children in 3,440 foster homes.

The bed shortage is especially acute for infants, partly because the gap between the cost of caring for the children and what the state pays families is the greatest. California’s reimbursement rate for very young children would have to be increased 61% to match foster parents’ costs, according to a recent study by Children’s Rights, a national foster care advocacy group.

The rate for children younger than 4 was recently boosted to about $680 a month, which is still hundreds of dollars below the estimated costs for foster parents. No one is doing it for the money.

"We need more homes and we need to pay them more," Browning said. "But the rates are set by the state, not the county, and that constrains us." The department is exploring ways to ease the financial burden of young children, such as providing free child care, diapers and transportation.

None of which apply to a child like DeMarion no foster care family wants walking in the door. “I’m afraid the other children could get AIDS,” one foster care mother from Oakland says.

How can you plan for these kids when you don’t know what’s really wrong with them?

What’s immediately wrong with DeMarion is called HIV.

DeMarion is now living in a safe house whose focus is to get the kid off the street.

Unfortunately, getting him back on ARVs means he has to provide identification and an address.

The clinic where he would receive his medication is also the same exact clinic where the members of the gang that beat him up in the first place get their medication from as well.

Not one part of the way the system operates has gone in DeMarion’s favor and he will tell you that.

The state blames the city and the city blames the state and everyone blames the mother who is dead. She cannot tell her story or defend herself.

The blame game crosses state lines, city lines, and simply does not recognize jurisdictional boundaries. DeMarion is living far away from Los Angeles in another state. Yet the state he lives in has the same gang activity in organized crime that he left in Los Angeles. The players might have different names but organized crime doesn’t really care what your name is. “They hack computers real easy,” DeMarion claims. “I will kill myself if I have to go back to them.”

The gang that he used to run drugs for wants very much to know where he is.

Bugs in my Hair. A poem by DeMarian (as dictated)

They said I had bugs crawling in my hair.

Daddy shaved my head that time.

Then he poured kerosene on me.

Stinging my candle eyes.

With burn.

Then when I got the virus.

He could not make it better.

Or cut the thing out of me.

And he kicked me out and I could feel the cold wind around my head.

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