Many Washington Heights residents are choosing money over their own health. What once were the miracle drugs that changed an HIV-positive diagnosis from a death sentence into a treatable problem are now among the most desirable medications on the black market.
The trade resembles the usual illegal deals that take place across New York City, but the drugs flow upstream: people with desirable prescriptions sell their medications to buyers, who then either ship the drugs directly to family members abroad or sell it to pharmacists for resales overseas.
Street sales have been particularly noticeable near uptown subway stations for more than six years, according to Dr. Michael Mowatt-Wynn, the president of Precinct 33’s Community Council. Prescription painkillers are prevalent, but the most popular drugs aren’t addictive and don’t produce any kind of high: HIV antiretroviral medications.
Mowatt-Wynn remembers the first time he saw a deal take place.
“I was exiting the subway on the 1 train line, and I always noticed there were young gentlemen just wandering around, scoping out the passengers who were walking up the stairs,” he says. “Others would stop at the first level of the subway, stand with bags in their hands, pull out bottles of drugs, and the young gentlemen would inspect the bottles.”
Drug treatments for HIV dates to the 1990s, and although they remainl expensive, many health clinics and AIDS advocacy groups offer medications at no cost or at sharply reduced prices.
“HIV is no longer a death note,” Mowatt-Wynn says. “It’s a controllable disease someone can live with, like diabetes.”
But that doesn’t mean everyone has access to the medication. The waiting lists for treatment are lengthy. More than 107,000 New Yorkers are living with HIV, and thousands more are unaware they’ve been infected, according to the New York City Department of Health and Mental Hygiene. New York City’s AIDS rate is almost three times the U.S. average, and the infection continues to spread.
And those who do have access to the medication don’t always make healthy choices. Pablo Colón* is the senior HIV counseling and treatment specialist at East Harlem’s Iris House, a service and advocacy program for women, families and communities affected by HIV/AIDS. Colón himself received an HIV diagnosis in 1990, and has witnessed the poorest recipients of HIV medication make the harrowing decision to forgo their physical health in the name of their families’ financial well-being.
“A lot of us are tired, a lot of us are poor,” Colón says. “There are a lot of us who are homeless, a lot of us who have children who are hungry. A lot of us live on the edge. The same reasons that you go out and sell your body is the same reason they sell their medication.”
Although the price depends on the strength of the black market, some HIV medications can fetch around $500 a bottle, Mowatt-Wynn says, an alluring sum to those who are infected but also desperately need money.
“I saw a mother with children in tow, no more than 5 or 6 years old,” Mowatt-Wynn says. “She was selling her HIV medicine, saying she needed to get food for her children. So she was basically selling herself. It’s a form of medical prostitution — that’s what we call it.”
In other countries, HIV medication is expensive and uncommon, making it a lucrative product for the black market. Buyers stand around the more popular uptown subway stations as if it’s a full-time job. From 9 to 5 Monday through Friday, they’re buying prescription medication from people who will use the proceeds to buy food, pay bills or fuel an addiction. Pharmacists then buy and repackage the drugs so they’ll sell for higher prices and ship them to countries with high demand, like the Dominican Republic and Mexico, Colon says.
He also knows people on the other side of the deal — the buyers — who purchase medication in order to send it directly to infected family members abroad. But people overseas who use medication without a prescription are taking huge risks, he says.
“It’s not only dangerous to buy someone else’s prescription, but you don’t know the effects you’re going to have from those prescriptions,” he says. “Because you and I are on the same medication doesn’t mean we take the same dose.”
Colón remembers when an acquaintance purchased and sent medication to a pregnant HIV-positive family member in the Dominican Republic. She took the medication regularly, but her infected baby only lived a few days. Colón believes the medication actually harmed the woman and baby, and says only a personalized prescription is safe.
The people who stop taking their medication in order to sell it risk even more. Colón says people who do not follow the prescribed regimen can grow resistant to medication and develop serious infections.
As with most black market items, some scam their way into a sale. HIV-negative men and women can obtain medications from corrupt doctors or pharmacists simply to sell on the streets. Many people abuse the system, Colón says.
“It’s unfortunate for those people who really need the medication, who can’t get medication because there’s a waiting list longer than their arms,” he says.
Precinct 33 Commander Brian Mullen told Mowatt-Wynn and the rest of the council during a public safety meeting that the trend of everyday people selling their prescription medications represents one of the precinct’s longest ongoing investigations. The council and precinct have instituted new policies to try to reduce the drug trade, placing cameras on lampposts at the most popular subway stations and stationing patrol officers nearby. It’s a start, Mowatt-Wynn says, but many sales continue right in front of the cameras, and enforcement has been challenging given the precinct’s limited resources.
Colón hasn’t seen much of an improvement from where he’s sitting, either. “What’s out there is real, and it’s a mess,” he says. “And that’s the reason the numbers continue to rise.”
*Pablo Colón died a few days following this interview.