Hurting or Helping? My Story from IAC

By Rob Banaszak on August 8, 2012 in 2012 International AIDS Conference, GENERATIONS

by Dafina Ward, Project Manager, Beauty in Knowing
AIDS Alabama

On July 24,  I had the honor of attending the “AIDS in America” forum at The Washington Post.  Sponsored by the Ford Foundation, the event featured some of the nation’s leading experts and decision-makers in the areas of HIV/AIDS and health.  U.S. Surgeon General Regina Benjamin, Black AIDS Institute CEO Phill Wilson and acclaimed physician Dr. Anthony Fauci were among the speakers.  Also among them was my own CEO, Kathie Hiers, who also serves on President Obama’s Advisory Committee on HIV/AIDS (PACHA).  Following the panel discussions, Secretary of U.S. Department of Health and Human Services, Kathleen Sebelius, spoke on the topics during a one-on-one interview with Jonathan Capehart (one of my favorite MSNBC contributors).  Like I said, this event was a big deal.

With all of the acclaimed speakers and experts on hand, I expected to learn more about the future of AIDS in America, to leave reassured that we are moving in the right direction in addressing health disparities, to gain insight into the reality of an actual “cure”.  And I did gain all of those things—and more.  What did I not expect was to leave questioning the way I do my work.  But at the end of the day, I was left with a sense of guilt and a nagging feeling that maybe well-intentioned prevention workers are a part of the problem in communities at greatest risk.

That probably sounds really crazy.  I mean, how could that be?  We “target” populations at “highest risk” and equip them with the tools that should lead to less “risky” behavior.  But through our characterization of the people we serve as “troubled”, are we in essence part of the problem?  Unbeknownst to us, we sometimes approach our work as though there is something inherently wrong with the people we serve, as though they are “less than” and that they are in need of repair.

I came to this thinking as I reflected on my own experiences.  I facilitate an intervention, Beauty in Knowing, which services African-American women who are enrolled in cosmetology school.  The program provides five sessions addressing HIV/STI prevention, condom negotiation, assertiveness, and a host of other topics relevant to our participants.  Several months ago during class a participant posed an interesting question.  She asked why African-American women were always being discussed as though they were “THE” problem when it comes to HIV. Why weren’t the men they were sleeping with being made accountable through programs such as this?  Are prevention programs trying to say that African-American women are more promiscuous than other women?     Now of course I explained to her that our program was about empowering women.  That the HIV rates in our community reflected a need for targeted interventions that empower African-American women (In Alabama, African-American women are becoming HIV positive at a rate of 9.5 to 1 when compared to Caucasian women).  In that moment I thought that I had adequately reflected upon and responded to her question.  But perhaps not.

Dr. Vignetta Charles of AIDS United was also a speaker at the AIDS in America panel, and a point that she made gave me pause as it took me back to my participant’s barrage of questions months ago.  Dr. Charles made the point that African-American women are not becoming infected at higher rates than other women because they sleep around more or take more risks than others.  It is truly about who these women are sleeping with.  An African-American woman is more likely to become HIV positive during one unprotected sexual encounter with an African-American man, than a Caucasian woman who does the same with a Caucasian man.   Of course I haven’t done formal research to support that theory, but it makes complete sense.

In our program women often report being in sexual relationships with men in their communities who have multiple female partners.  They also express being uncomfortable discussing condom use with their partners—let alone making it a requirement.  Imagine if these women felt empowered to establish such a requirement with their partners.  Imagine if these women felt empowered to remove themselves from relationships where they know their partner is sleeping with other women.  Imagine these women being made to feel that they are part of the solution in the fight to end HIV/AIDS and not the problem.

So what I will take away from the International AIDS Conference is the necessity of true community engagement in fighting the spread of HIV in my community.  We often talk of community participatory research and program development.  But what if we truly empowered the communities we serve to see themselves as the key to stopping the virus—rather than problems that we desire to “fix”.   We can end the spread of HIV and turn the tide in our communities, but we must truly do it together.

Dafina works on AIDS Alabama’s “Beauty in Knowing” project as part of AIDS United’s GENERATIONS initiative supported by Johnson & Johnson.

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