Seen, But Not Heard: AIDS, Sexual Politics
and the Untold War Against Black Women
a documentary by Cyrille Phipps

As a follow up to the posting, “Is there such a thing of being too little, too late when it comes to AIDS.”  The Washington Post printed a story that raises some concerns about the study the National Institutes of Health plans to launch in the Bronx and Washington D.C. It is believed that the study, to test and treat every adult in two high risk communities, is a flawed model first created by the World’s Health Organization.  There are several questions and concerns regarding the plan, such as to whether testing every adult is possible and if you are able to test every adult, will they opt for treatment. Other concerns revolve around the consequences of encouraging bad sexual practices with the success of treatment and the chance of inducing drug resistance.

There is no doubt that there is need for a plan, much less a national strategy, to reduce the number of new HIV infections and decrease the death rates in these high risk communities. Beyond the success or failure of this inital plan, some aggressive moves needs to be made to slow the spread of this disease. The government and many national organizations have been slow to respond. There needs to be a cohesive plan and it need to happen now!

In a study of women’s health, the World Health Organization stated that AIDS is the leading cause of death among women between the ages of 15 and 44, worldwide. In addition, 1 out of 4 women in the United States is living with HIV/AIDS. AIDS is also leading cause of death among Black women between 25yrs and 34years. The majority of the death from AIDS happens in countries with low to middle incomes where unsafe sex is the biggest risk factor. Even in higher income countries like the United States, AIDS is still a major health concern for women. What adds to the high infection rates and ultimate death of these women is the devastation it causes to the entire family structure. In many of these families affected by HIV/AIDS, the woman is the only surviving parent or the head of a single parent household. More than likely, the woman is the primarily caregiver in the family and the death of that mother turns those children into orphans  or they are passed from one family member to another. In a report by Avert.org, “Worldwide, it is estimated that more than 15 million children under 18 have been orphaned as a result of AIDS. Around 11.6 million of these children live in sub-Saharan Africa. In countries badly affected by the epidemic such as Zambia and Botswana, it is estimated that 20 percent of children under 17 are orphans – most of whom have lost one or both parents to AIDS.”

The lack of information and resources, the social status of most women in many parts of the world and the social norms and values of certain cultures undermine the ability for these women to protect themselves. We will not see a change in these numbers until women are able to protect themselves and their children. Health services around the world need to be empowered to provide culturally specific information and educational materials to high risk communities. In addition, testing has to be the first step in prevention methods. A massive effort has to be directed at educating families, but women in particular, about safe sex practices and using treatment to prevent the spread of the virus.

These statistics can turn around, but first the status of women worldwide must improve,  changes must be made in the unequal healthcare of women and advancements to the treatment of patients with HIV/AIDS must continue.

As the AIDS virus spreads, infection rates increase and more die from AIDS related complication, federal officials create a strategy to tackle HIV. “Test and Treat” is a 3yr study of routine testing in two areas that have some of the highest infection rates in the country, the Bronx and Washington D.C. The plan is to test every adult in these two communities and treat those who test positive for the virus. In New York City, the infection rates have declined for most high risk groups except for youth, whose rates have increased. Despite the increase or decrease of rates among high risk groups, many still do not know they are carrying the virus. In a recent New York Times article, “Nationwide, 20% to 25% of people who are HIV positive do not know of their infection, according to the federal Centers for Disease Control and Prevention.” The CDC encourages routine voluntary HIV testing as a regular part of one’s medical care. But many hospitals, clinics and private practices don’t follow the CDC’s recommendation. And, even when doctors do offer the test, some patients refuse to take it. Those refusing to get tested don’t realize the severe consequences of a potential infection. Not knowing one’s status increases the chance of the virus spreading and it also increases the chance of someone developing AIDS by the time they receive their diagnosis.

The second obstacle to testing is getting those who test positive into treatment. This effort plans to address that problem by training community outreach workers along with other improvements.  Those who go straight into treatment can prevent extensive damage to their immune system and encourage a normal life expectancy.

So, with this extensive three year study and bold new strategy to stop the spread of AIDS, will this result in an effort that’s too little, too late! Or should we appreciate any effort to reduce the infection rate in the United States, especially in “hot spot’ areas like the Bronx and Washington D.C. Time will only tell.

In a series of studies recently conducted, it has been determined that bisexual men or men who secretly have sex with men (also know as “down low” men) are not the largest contributor to the increase of infection rates among Black women. On NPR, Dr. Kevin Fenton, the director of the National Center for HIV/AIDS at the Center for Disease Control (CDC) talks with Michele Martin, host of the show, Tell Me More. During the interview, Dr. Fenton talks about the myths and misinformation regarding how HIV is infected among Black women.

Since the infections rates for Black women began to increase in the late 90’s,  it was believed that heterosexual sex with “down low” men, along with drug use were the main causes for the high rates. Now with this new study, it is believed that the majority of infections are caused by heterosexual sex with straight men who have multiple partners (primarily believed to be women).  Although, this might be the case, if men are secretly having sex with other men, is there anyway to really know they are not skewing the results of the study by not admitting who they are having sex with. There is also the other issue of men of color who are entering prison HIV+ and returning home without any treatment. Or the men who enter prison HIV – and return home HIV+ to the same community and set of women they were intimate with before. Men, at least in the New York State prison system, are not allowed to receive condoms.

How is information being tracked and recorded and what preventive methods and/or treatment are we providing women and men who are not practicing safe sex, becoming infected and then spreading the virus. This is where the focus should be, the who and why of being infected becomes secondary once the disease starts to spread and becomes an epidemic.

Say you???

As part of our on-going campaign to get folks tested, especially women of color, Dr. Monica Sweeney explains why it’s important for all women to get tested but specifically married Black women.

There is only so much time in the day and there is no way you will always know where your partner/boyfriend/husband is. And you shouldn’t need to know and more than likely they are faithful and trust worthy.  But if you suspect differently, then you have to decide where your relationship goes from there. More women except sex outside their relationships, even if it’s not a mutually acted on situation, then you would believe. And they may or may not consider it an “Open Relationship,” but if you are in committed relationship and one or both are having sex outside the relationship, then it’s open.  Now, there are women who have no idea that their significant other is having sex outside the relationship.  Maybe, they suspect it or maybe they don’t. In either of these scenarios, you have to act. Having open and frank discussions about sex outside the relationship, is extremely difficult, but necessary. These discussions bring up a lot of anger, hurt and distrust but it’s the first step to changing your sexual behavior in this and future relationships. Both partners need to protect themselves; both partners need to get tested. If you can’t be guaranteed these two basic things then you need to reconsider the person you are sleeping with.

As Dr. Sweeney notes in her article, we need to start talking about how women are getting infected. You need to know your status and protect yourself!

In every major urban city, rural community and suburban town AIDS has a home. It doesn’t matter whether you are straight or gay, white, black, red, yellow or brown, AIDS is right around the corner. For folks who have the highest infection and death rates, primarily Black, Latino and/or gay, your care plays a significant role in your day-to-day life. The services you receive are vital to your survival. In DC as well as New York, a number of agencies and nonprofits have been caught squandering the resources used for housing, food, healthcare and other services needed in at-risk communities.

The organizations who have received hundreds of thousands dollars, even millions have victimized the very people they are suppose to serve. Misappropriation of funds, services promised but not provided, supervisors and specific staff helping themselves out to cash bonuses, gifts and trips while clients and patients lose out of access to services and/or necessary AIDS awareness and prevention information. And when the accused is caught, fingers point to everyone but themselves. Where are the checks and balances in government funding???? Hundreds of organizations have already suffered through funding loss during 8 years of the Bush administration and then more cuts due to the recession. Abusing an ill equipped system only further justifies the lack of trust and confirms the lack of accountability.

This is not to say that all AIDS organizations much less all non-profits misuse their funding. Many organizations are providing incredible services to individuals, groups and families around the country.  What hurts their good work is the selfish acts of a few who threaten the funding opportunities of other groups and the credibility of service based organizations. If any good can come out of this is the creation of a National AIDS Action Plan that has the input of several organizations, agencies, advocates, PWA’s (people living with AIDS), PWLHIV (people living with HIV), healthcare professionals and policy makers to develop a plan that recommends but not necessarily oversees funding, programming  and policy. A plan that can look at the overall system of AIDS services throughout the country, reduce redunancy in key areas, duplicate successful programs, track progress and eliminate or at least reduce waste. A plan that can look a the success and failures of prevention, awareness and care systems around the world and partner with other countries that have similar trends but with better outcomes. We have the resources, technology and research to do a better job. So, hopefully in 5 to 10 years, a HIV+ woman won’t die alone in a park only a few blocks from the HIV/AIDS administration or from resources that could have provided the help she not only needed but deserved.

HIV Awareness and the Congo:

Breaking the Silence

If previous trials of AIDS vaccines hadn’t been so disappointing, the results from the latest trial wouldn’t seem so promising.

Is this the end of HIV/AIDS as we know it. This new discovery is not a cure but it can make significant difference in slowing down the disease. Will this change the direction of AIDS activism and advocacy???

Will this vaccine change AIDS education and awareness. Will there be a push to put money towards a cure instead of prevention efforts. And will it give folks another excuse not to practice safe sex.  How will this change your sexual practices and behavior??? Do we now have a “get out of jail” card if infected!

Tony Wafford has taught his three daughters that when they go on a date, they need to be prepared: They carry a credit card, cash for a cab, a cell phone and a condom.

On the PBS program, World Focus, reporter Lisa Biagiotti, looks at homophobia in Jamaica tonight, in the two part series, “There are no gay parades in Jamaica.” The issue of homophobia in this West Indian Island has been a hotly debated topic since the Gay & Lesbian Alliance Against Defamation (GLAAD) criticized and boycotted events of Reggae/Dance Hall performers Shabba Ranks and Buju Banton in the early 90’s. This issue received further attention with the widely released report, Hated to Death: Homophobia, Violence, and Jamaica’s HIV/AIDS Epidemic by Rebecca Schleifer of the Human Rights Watch.

It is widely believed that the hatred and violence against gay men, in particular, has played a role in the increase of HIV. Some men who are gay in Jamaica, tend not to seek HIV/AIDS education, therefore don’t practice safe sex with their partner(s), much less seek treatment if infected with the virus. This level of stigma, encourages men who have sex with other men, to seek shelter through a heterosexual relationship. And more than likely not use condoms with either partner.

In the United States, it is also believed that homophobia, stigma and isolation has also helped fueled AIDS in the Black Community. Although, the level of violence is not the same as in Jamaica, the issues of shame, fear and stigma are very similar.

If homophobia does play a role in the rise of infection rates, how do we as a community fight against the stigma and fear that fuels the shame? How do we talk to each other about sex and sexuality? And how do we learn to negotiate safe sex, even with a long term partner (boyfriend/girlfriend/husband/wife/lover)???

Much to think about, much to discuss!

Please share your thoughts and comments.  Let’s talk amongst ourselves!!!