SisterLove, Inc.

SisterLove's Youth Leadership

2011-08-28T14:00:00.001-04:00

S. Jackson

Sisterlove, Inc Staff

Two of our young staff members are members of two separate programs. Shanebrae Price is a 2011 Black AIDS Institute African American HIV University Fellow. Shantrell Jackson is a 2011 Sierra Club Global Population and Environment (GPE) fellow. The Sierra Club GPE fellowship is a nationwide six-month fellowship program that equips outstanding working young/student activists leaders with continual training, resources and mentorship to implement self-designed campaigns that elevate population, sexual and reproductive health and rights, and environmental protection among youth audiences (www.sierraclub.org) .

This blog is for her Sierra Club GPE fellowship but its purpose is to celebrate Shanebrae Price (SisterLove’s HIV Outreach, Advocacy and Prevention Specialist) and a Black AIDS Institute African American HIV University (AAHU) fellow. In this blog you will be able to understand the role she plays at AAHU and her community mobilization project.

What is African American HIV University?

AAHU is a comprehensive training and internship fellowship program. The program is designed to decrease HIV stigma and misperception and increase the engagement of the Black community in HIV prevention and treatment services. See (www.blackaids.org) for more information on AAHU and visit the website.

Shanebrae what are you doing as a fellow in this program?

I am conducting a project that is focused on mobilizing the family planning and teen pregnancy prevention community. I am partnering with Lytani Wilson with the Center for Black Women’s Wellness to start the community mobilization project.

Where are you thus far in the community mobilization project?

As of right now we have accomplished two different phases of the AAHU program. The first quarter at AAHU we focused on a “needs assessment”. We conducted a gap analysis and assessed the needs of our target audience - Black adolescent females. The second quarter we returned to AAHU for a week to learn “coalition building”. Coalition building is when we established a core team and bring together a group of advocates and educators interested in family planning and teen pregnancy prevention to form the coalition. There are four different meetings in Los Angeles and each meeting is one week long. We learn the tools that it takes to successfully accomplish each phase of the training and internship.

What do you want as the desired outcome with this project?

I would like establish partnerships between organizations that provide health education to the youth population and family planning to prevent teen pregnancy in the Atlanta. Our ultimate goal is incorporate HIV and Sexually Transmitted Infections (STI) prevention into their curriculum.

Why did you choose to apply and participate in Black AIDS Institute AAHU?

I chose to apply and participate in AAHU for professional growth and leadership development; to establish relationships, network and to build programs from the ground up.

Do you have any other comments Shanebrae?

The AAHU helps me understand the intricate details required to develop and implement a program. Before you take action you have to have a plan. AAHU is also teaching us the core components of public health evaluation. This program enhances both personal and professional growth.

(Be the change you want to see in the world *Gandhi*)

The Global Pandemic of HIV

2011-08-03T14:22:00.000-04:00

N. Wright-Jegede
SisterLove, Inc Intern

Across many countries, the HIV/AIDS pandemic is an issue of major concern. Worldwide, the virus has become a human, social, political and economic misfortune for millions of individuals. While the nation-states of Sub-Saharan Africa have been hit the hardest by this devastating epidemic, the virus has increased at a staggering rate, across many parts of Central Asia, Eastern Europe, and Russia. The adversative impact of HIV/AIDS has caused the stability and security of populations, economies and governments to destabilize. As the virus continues to deter the quality and quantity of life, global policies and strategies which prevent HIV/AIDS remain a matter of vital interest and concern. No other illness has so vividly pointed-out the current inequalities in health-care access, economic stability, and the protection of human rights. Protecting one’s basic human right is extremely critical in the global fight against HIV. Sadly enough, the transgressions against individual rights can propel the spread of infection tenfold. Every day, HIV infected-individuals confront many obstacles, such as: achieving assured confidentiality or, overcoming social stigma and discrimination.

Therefore, responding assertively to these adversities must be global in its scope. Preventing the spread of HIV/AIDS requires effective comprehensive strategies and programs that work to safeguard and uphold individual human rights. However, these pivotal changes will not transpire if the information and skills needed to fight HIV/AIDS remains inside the sphere of public health experts; government officials and, researchers presently driving efforts to eradicate the pandemic. These endeavors can only emerge through the collective action of international partnerships, which can harvest positive results. In order to become effective in the global eradication against HIV, a comprehensive HIV prevention strategy requires strong political leadership. This means, policymakers and world-leaders in all localities must speak-out vocally about HIV/AIDS and, not back away from challenging issues like sex or reproductive health. A successful response requires strategic planning based upon high quality research, and careful consideration of local culture. We should all take action in the response, including non-governmental organizations, HIV-positive individuals, educators, employers and religious leaders. Around the world, efforts to reduce HIV, and mitigate its impact have been led by the affected communities themselves. The epidemic thrives upon prejudice, stigma, and discrimination related to those living with the virus. The spread of HIV is also driven by gender inequality, which limits what we can do as women to protect ourselves from infection. Protecting and promoting a worldwide respect for human rights should be an important part of any comprehensive HIV prevention program. Of course, this involves enacting laws against various forms of stigma and discrimination which impels vulnerability. Get active! It’s time to talk with our legislators. Policymakers need to be well-informed about the reality of HIV/AIDS, and the challenges it has created worldwide.

HIV Criminalization

2011-07-29T14:53:00.000-04:00

A. Watanabe
SisterLove, Inc Intern

As a summer intern for SisterLove, I’m helping with policy research on HIV criminalization in Georgia and the South – criminal laws that specifically target HIV transmission, or actions that pose the risk of transmission, without disclosure of one’s HIV status. The specifics of the laws vary from state to state; some of them don’t even require the intent to transmit, or for actual transmission of HIV to happen. Many states consider these “crimes” to be felonies, with prison sentences as long as twenty or thirty years. At first, for many people, the policy seems just: most would agree that intentional or reckless transmission of HIV is wrong.

But when you look at how these laws actually play out on the ground, you’ll find that HIV-specific criminal statues violate the human rights of HIV-positive people, are ineffective public health policy, and promote unscientific, stigma-based ideas about how HIV is transmitted. The Positive Justice Project found that 25% of HIV-related prosecutions between 1986 and 2001 involved biting, spitting or scratching, which carry virtually no risk of HIV transmission. Even so, Georgia and many other states continue to include these acts in their criminal statutes. These laws undermine efforts to promote accurate information about HIV, which is crucial to prevention.

Anti-criminalization advocates also argue that these laws, by placing the responsibility of prevention solely with people who know that they are HIV-positive, undermine the important message that everyone is responsible for protecting themselves from STDs. And these laws can discourage people from getting tested because not knowing your status can protect you from being prosecuted. This is especially dangerous when research has shown that HIV is generally transmitted by people who are unaware of their own status, not by people who knowingly or intentionally transmit it. In cases of sexual assault, or other exceptional situations in which transmission was clearly intentional, general criminal laws are sufficient to prosecute individuals, and HIV-specific laws are unnecessary.

The issue goes deeper than ineffective policy, though – it is well known that the United States leads the world in incarceration, having just 5% of the world’s population but 25% of the world’s prisoners, the vast majority for non-violent offenses. And the rates of incarceration are grossly disproportionate for people of color, especially African-Americans and Latinos. Though many racial justice advocates have called for alternatives to mass incarceration, the prison population has continued to grow for the last few decades. And so it’s not surprising that the United States would again turn to criminalization as a “solution” to HIV, instead of pursuing desperately needed public health and human rights-centered policies. A health issue is quickly turned into a moral issue through these dramatic and harsh criminal laws – reminiscent of the way that abstinence-only education rather than comprehensive sex education was used to respond to the spread of HIV, despite its proven ineffectiveness.

The laws especially target communities that are already stigmatized– for example, clause 3 and 4 of Georgia’s law specifically mentions sex work and “sodomy”, even though these acts would already be covered in clause 1, which specifies “any sexual act involving the sex organs of one person and the mouth or anus of another” and “sexual intercourse.” These laws are sending a clear message: that HIV is spread by “criminal” and marginalized communities – sex workers, intravenous drug users, and men who have sex with men – rather than placing the responsibility where it really lies. The United States has such a high HIV rate (the highest in the industrialized world) because policymakers continue to ignore the real causes of HIV: poor sex education, poverty, stigma, homelessness, lack of rehabilitative services for substance users, lack of adequate healthcare, gender inequity, sexual assault, and so on. Turning to criminal law as a “preventative” measure ignores the bigger issues that are actually at the root of HIV.

The fact that women of color are among the hardest hit by HIV/AIDS is not accidental: HIV/AIDS is deeply tied to social inequality. And because many of the communities at the greatest risk of HIV are also at the greatest risk of being criminalized in general, we can easily imagine who will pay the price. For women of color, who disproportionately face risks of gender violence, poverty, and lack of access to medical care – these women, even if they are not personally prosecuted by HIV transmission laws, will undoubtedly be impacted by the stigma and fear that these laws promote. Every time someone chooses not to get tested for fear of being prosecuted; every time someone is misinformed about how HIV is spread; every time the stigma and discrimination that HIV-positive people already face is made worse by these criminal laws; every time policymakers vote in favor of criminalization while ignoring the real issues that cause the spread of HIV– women of color, who are already vulnerable to so many of the social issues connected to HIV/AIDS, will be affected in some way, as will their families and communities.

I think that when the topic of criminalization of HIV comes up, people often struggle with the most notorious examples of intentional or reckless HIV transmission and how these cases should be handled. But I think that the questions we ask have to be deeper than, “is punishing people in this worst-case scenario the right thing to do?” The bigger picture questions we need to ask are: What does criminalization accomplish? How and when are the laws applied? What message do these laws send? Do these policies actually help stop the spread of HIV? And, who do these laws hurt?

As citizens and community members, we have to keep educating ourselves and others about what real solutions to HIV look like. We can support prevention strategies instead of criminalization – by spreading accurate information about HIV, encouraging people to get tested, and promoting safer sex practices such as condom use, among many others. We can support HIV-positive people in our communities facing stigma and fear of criminalization, and when organizations like SisterLove or the Center for HIV Law & Policy advocate for policy changes, they will need people to stand behind them.

More resources about HIV criminalization policies, who they impact, and how to advocate against them:

Positive Justice Project: A New Strategy to End Civil and Criminal Punishment and Discrimination on the Basis of HIV Status (2010). http://www.hivlawandpolicy.org/resources/view/563

Positive Justice Project: HIV Criminalization Fact Sheet (2010). http://www.hivlawandpolicy.org/resources/view/560

Open Society Institute: 10 Reasons To Oppose the Criminalization of HIV Exposure or Transmission (2008). http://www.hivlawandpolicy.org/resources/view/318

Positive Justice Project: What HIV Criminalization Means to Women in the U.S. (2011). http://www.hivlawandpolicy.org/resources/view/584

Positive Justice Project: Ending and Defending Against HIV Criminalization: State and Federal Laws and Prosecutions, A Manual for Advocates (2010). http://www.hivlawandpolicy.org/resources/view/564

Positive Justice Project: Guidance for People Living with HIV Who Are At Risk of, or Are Facing, Criminal Prosecution for HIV Nondisclosure or Exposure (2011). http://www.hivlawandpolicy.org/resources/view/580

Domestic Violence: A Risk Factor for HIV/AIDS?

2011-07-26T13:25:00.000-04:00

T.Kimbrough
SisterLove, Inc Intern

It is quite alarming to note that black women are 15 times more likely to be diagnosed with HIV than our white counterparts (CDC, 2011). The question is why? With the amount of knowledge and free HIV testing available today, you would expect for our numbers to decrease. But for some strange reason, our numbers are increasing.

It is estimated that nearly half (45%) of new HIV infections are in the black population (CDC,2011). Researchers attributed this rise to specific sexual risk factors that seem to be prevalent within our community. Risk patterns such as unprotected sex, injection drug use, multiple sex partners and even domestic violence? Domestic violence is now being associated as a risk factor for HIV (Wingood et al, 1997; Raiford et al, 2009).

Women, who are in physically abusive relationships, are less likely to negotiate for the use of condoms with their partner (Wingood et al, 1997; Raiford et al, 2009). They are also more likely to reason that their chance of acquiring HIV is not as likely as their fear of being physically abused for refusing sexual advances. Even though they are knowledgeable about HIV/STD transmission, they would rather take a chance with acquiring HIV by engaging in unprotected sex than to advocate for condom use and risk the threat of their partner leaving them or even abusing them.

Where do you draw the line? Ask yourself which is more important to you; your sex life or your health? The choice is yours. Choose health. Ask yourself what can I do to protect my health? Seek solutions to commonly asked questions like: How can I better negotiate with my partner for condom use?; What proactive measures I can take to prevent the transmission of HIV/STDs?; How can I build better communication between my partner and I so that I can openly and freely discuss issues that I am concerned about?; Where can I go to get advice and counseling that can help me advocate for the things I feel are best for?

SisterLove, Inc is an organization that can help you with many of these concerns. SisterLove, Inc offers a free “Healthy Love session” that discusses HIV/STD transmission and prevention. The Healthy Love parties offer information about safe sex practices with emphasis upon condom negotiation and proper condom use. Once you learn how to feel comfortable discussing your sexual health needs and gain confidence in proper condom use, you will be more confident in your sexual health practices.

Contact SisterLove, Inc and find out when and where the next Healthy Love party. Come and have fun! Learn how to have better sex and safer sex. Visit us online: www.sisterlove.org.

References

Centers of Disease Control and Prevention (CDC,2011), HIV/AIDS and African Americans, Retrieved July 11, 2011 from http://www.cdc.gov/hiv/topics/aa/index.htm

Raiford, J., DiClemente, R., & Wingood, G. (2009). Effects of fear of abuse and possible STI acquisition on the sexual behavior of young African American women. American Journal of Public Health, 99(6), 1067-1071. doi:10.2105/AJPH.2007.131482

Wingood, G., & DiClemente, R. (1997). The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women. American Journal Of Public Health, 87(6), 1016-1018. Retrieved from EBSCOhost

Domestic Violence and Risk for HIV

2009-05-03T14:49:00.010-04:00

Lailaa Yasmeen Bartley SisterLove, Inc. MPH Intern

I am a 23 year old native of Savannah, GA, currently living in Atlanta. This year has been full of great events for me. I traveled abroad for the first time to Costa Rica in March, I graduated from Columbus State University in May, and I got engaged to the love of my life in July.

Currently, I am a first year Master of Public Health student at Morehouse School of Medicine (MSM). My degree concentration is health education/health promotion, and my specific research interests are women’s and teenage sexual health, childhood obesity, infectious diseases, the health of the homeless. It has always been my goal to serve others in whatever career I chose, especially those whose voices are rarely heard. This motivated me to apply to Morehouse School of Medicine. I love the fact that their primary goal is to aid the underserved and minority populations.

Outside of public health, my hobbies are reading, trying new things, shopping (especially at thrift stores), and constantly trying to maintain a close relationship with God. Following the attainment of my Master of Public Health (M.P.H) degree, I plan to work for a community health organization. I also plan to obtain a Doctor of Medicine degree in the future. That degree coupled with my M.P.H. will truly allow me to be an agent of change in a society where health disparities run rampant. Ultimately, my goal in life is to improve the lives of others. I am a firm believer in the mantra “be the change you want to see in the world,” and my plan is to do just that.

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Hello, my name is Lailaa. I am a 23 year old graduate student studying public health at Morehouse School of Medicine in Atlanta. I am working with SisterLove to increase awareness of HIV/AIDS and reproductive justice. As you may have seen in the news over the past couple of years, the number of those living with HIV/AIDS has decreased worldwide; but not for black people, and especially not for black women. In the US, African American women account for 49% of new cases of HIV (http://www.diversityinc.com/public/2790.cfm). In 2004, the last year such data is available from the Centers for Disease Control (CDC), HIV infection was:

the leading cause of death for black women aged 25–34 years;
the 3rd leading cause of death for black women aged 35–44 years; and
the 4th leading cause of death for black women aged 45–54 years.

I don’t know about you, but when I learned this, I was appalled! Our aunts, our sisters, our mothers….are dying. To truly make a difference, to keep more Black women from being affected by HIV/AIDS, we have to educate ourselves about behaviors that contribute to the spread of this disease. I am contributing to this blog to educate others about a behavior that increases women’s risk of contracting HIV. There are many behaviors which contribute to the spread of HIV/AIDS. The most common of these are having unprotected sex and intravenous drug use. Safer sex, or always using condoms, and other latex or plastic barriers, is the best way to prevent the transmission of HIV when engaging in vaginal, anal or oral sex. By using new needles (clean works), intravenous drug users can reduce their exposure to the virus that causes AIDS. Today I chose to write about a situation that most people probably do not associate with the spread of HIV. That situation is domestic violence.

Research has shown that women who are physically and sexually abused are more likely to contract HIV. Women in relationships with violent men rarely have the power to resist when their mate initiates sex. A woman who depends on her partner economically cannot afford to jeopardize her relationship even when she suspects that her mate may be living with HIV or another sexually transmitted infection or has multiple sexual partners.¹ Women in relationships with violent men are also rarely in a position to insist that their mate use a condom. This imbalance of power prevents women from reducing their risk and results in them being more likely to contract HIV.

So what can women in situations like these do to get help? There are many organizations that provide resources for women experiencing domestic violence. Two of these are The National Domestic Violence Hotline (1-800-799-SAFE and http://www.ndvh.org/), and the National Coalition Against Domestic Violence (http://www.ncadv.org/). Both organization’s website includes information for women in violent relationships.

Women who are living with HIV/AIDS are actually at a greater risk for domestic violence because of their HIV status. More than one in five women with HIV are physically harmed after being diagnosed. Of these women, almost half said that they felt that the physical aggression they suffered resulted directly from another’s anger about their HIV status².

It is really a shame that a woman cannot tell a partner her HIV status without being afraid that she will be physically hurt by him or her. While most domestic violence involves men assaulting women, it can also involve men assaulting their male partners, or women assaulting their male or female partners. Domestic violence is more common in the lesbian community than was formerly believed².

I did, however, find some great tips, provided by The Well Project: Domestic Violence and HIV, for women about disclosing their HIV status:

Avoid exposing others to HIV without telling them, ahead of time, of your HIV status. The risk of violence may be greater if a person feels you knowingly put them at risk or lied to them.

Disclose your HIV status in a semi-public place, like a public park with many people around. Pick a location that is private enough to have a conversation, but public enough to get help if you need it.

Consider disclosing your HIV status with a third person present, like a friend or a health professional.

If you feel at all threatened by a person’s reaction to knowing your HIV status, keep meetings with this person public for a few weeks.

Well, I hope the information I have provided will spark your interest and inspire you to start a dialogue with a friend, a co-worker, or even someone you may be sitting next to at the hair dresser. Tell that woman what you have learned. Every conversation about how to prevent HIV/AIDS counts. You never know, you may be saving a life.

I will leave you with a few websites as resources on AIDS and domestic violence.

¹The Women’s Human Rights Program at The Advocates for Human Rights: Stop Violence Against Women - Domestic Violence, HIV/AIDS and Other Sexually Transmitted Infections:
http://www.stopvaw.org/Domestic_Violence_HIV_AIDS_and_Other_STIs.html
Pan American Health Organization: Gender Based Violence and HIV/AIDS
http://www.paho.org/English/ad/ge/Viol-HIV_FS0705.pdf

²The Well Project: Article titled “Domestic Violence and HIV” by Sandra K. Trisdale, Ph.D.
http://www.thewellproject.org/en_US/Womens_Center/Domestic_Violence_and_HIV.jsp
Harvard School of Public Health: Literature Review on the subject of HIV/AIDS and Gender Based Violence:
http://www.hsph.harvard.edu/pihhr/files/Final_Literature_Review.pdf
The Body: Article titled “Women, Healthcare and Violence” by Carmen Retzlaff, MPH
http://www.thebody.com/content/treat/art12224.html
HIV/AIDS Among Women

http://www.cdc.gov/hiv/topics/women/resources/factsheets/women.htm

HIV and Ethnicity-Based Health Disparities

2009-05-03T14:18:00.008-04:00

Mina Rasheed | SisterLove, Inc. MPH Intern
Born and Raised in Atlanta, GA (briefly lived in New Orleans, LA). Graduated from North Atlanta High School.

Undergraduate School Experience: Graduated from Georgia State University in December of 2007 with a Bachelor’s of Science Degree in Exercise Science

Graduate School Experience: Master of Public Health Candidate 2010 at Morehouse School of Medicine; Concentration/Track- Health Education and Health Promotion

General Public Health Interests: Underserved populations; Physical activity in adolescents; Nutrition; Cardiovascular disease in older populations

Hobbies: Reading; Enjoying time with family and friends; Sports; Volunteering

Favorite quote: “Education is the passport to the future, for tomorrow belongs to those who prepare for it today.” Malcolm X

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This whole blogging thing is new for me and honestly I was a little intimidated by the thought of writing about HIIV/AIDS and reproductive justice. As far as I’m concerned, who would want to read my thoughts on these issues? Who am I? What insight can I provide? I’m just a graduate student, certainly not an expert in the field -- yet. But then I thought about it. It’s not always the expert who has the most impact in a community. Often it’s the person with a real connection to a community who has the most impact. With this in mind, I warmed to the blogging idea.

My blog is in no way meant to provide expert advice. It is just a way for me to share my thoughts and passion about the health of minorities and other underserved communities. I intend to share what I have learned, and am learning, and provide insights that may be new with others.

My specific interests in public health stem from my family history of chronic diseases; these have included chronic obstructive pulmonary disease (COPD) and diabetes. I’ve watched as those debilitating diseases have affected not only my family members but also friends and others in my community. After learning that African Americans are disproportionately affected by many devastating disorders, I was compelled to find out why. Why are African Americans more susceptible to certain diseases than other populations? Why don’t we have adequate access to health information and care? Why are we less likely to get diagnosed with certain diseases yet more likely to die from them when we are diagnosed? Why us? So many questions plagued me.

The medical community has long reported that African Americans are more likely to be diagnosed with many unhealthy conditions and diseases. This list includes high blood pressure, obesity, diabetes, certain cancers, stroke and, for over a decade now, HIV. The statistics are frightening. The Black AIDS Institute, the first Black HIV/AIDS policy center dedicated to reducing HIV/AIDS health disparities, reported that in 2006:

AIDS remained the leading cause of death among Black women between 25-34 years of age and was the second leading cause of death among Black men between 35-44 years of age;

In the 33 states with mature HIV reporting systems, Black women represented 65% of new HIV/AIDS diagnoses among women in 2006; and

Black women are 23 times more likely to be diagnosed with AIDS than white women.

Is it too much to ask for a healthcare system that provides equal care to all regardless of race, gender, class, socioeconomic status, or health status? Is it too much to ask for a healthcare system that responds to the frightening health statistics shared above? Are we so focused on protecting the profits of health insurance and pharmaceutical companies that we neglect to provide adequate care? I could continue with this laundry list of questions.

The sometimes daunting, yet exciting, task for me and other health professionals is figuring out new ways to remedy these problems. Increasing awareness of the ethnicity based disparities that characterize the AIDS epidemic is a step in toward addressing and reversing these disparities.

It is imperative that health care delivery be restructured to deal with sexual and reproductive justice issues that affect African-American women. According to the article, Can Cultural Competency Reduce Racial And Ethnic Health Disparities? A Review And Conceptual Model, the authors suggest that racial and ethnic minorities have been linked to a lower likelihood of having a regular source of care, fewer physician visits, and lower total health-care expenditures. There are also studies that illustrate that along with improvements in economic and social conditions, and physical environments, appropriate implementation of sound cultural competency techniques in delivering health services could go a long way toward reducing these health disparities. Having health care professionals that are culturally competent can lead to a better understanding between the patient and the provider which, in turn, can cause the patient to be less apprehensive to medical advice and procedures. I also encourage including more lay health workers from the community who are properly trained by health care professionals to address sexual and reproductive justice issues. Most people will be more receptive to someone they know or who at least looks like them in comparison to a physician or other provider. For example, a woman may be more encouraged to get tested for HIV if someone they know expresses his or her concern about the issue.

Many interdisciplinary health care strategies can be used to address sexual and reproductive justice issues. Religion is a major part of the African-American community and I think it’s important for it to be tapped into as a resource for disseminating health information. More hospitals and health care organizations need to begin partnerships with places of worship in order to make women aware of sexual and reproductive justice issues. Places of worship are great venues to the message across to many women and men of different ages and backgrounds. Partnerships between places of employment and health care providers are also great strategies. Providing free counseling to women who are being abused or workshops on prenatal care in places of employment can be a channel to educating more women.

Not only are the aforementioned suggestions useful for helping to decrease health disparities in our minority and underserved communities, but this blog itself is also a step in the right direction. The media, including television, radio, and internet, can join with the health care systems as advocates for sexual and reproductive justice. By bringing these issues to the forefront and making it accessible to countless numbers of people, I hope that I have contributed to increasing awareness about health disparities and provided some useful information about ways to reverse their effects.

References
Brach, C., & Fraserirector, I. (2000). Can Cultural Competency Reduce Racial And Ethnic Health Disparities? A Review And Conceptual Model. Medical Care Research and Review , 57 (1), 181-217.
Fiscella, K., Franks, P., Doescher, M., & Saver, B. G. (2002). Disparities in Health Care by Race, Ethnicity, and Language Among the Insured. Medical Care , 40 (1), 52-59.

Reproductive Justice and HIV: They are Not Going Away

2009-02-23T21:06:00.009-05:00

Dahlia Bell | SisterLove, Inc. MPH Intern
Dahlia Bell has been on the front lines of advocacy and activism for HIV/AIDS and the community well before relocating to the Atlanta area in early 2004. Originally from the state of New York, Dahlia was born in Poughkeepsie and raised in Middletown, about an hour from the heart of New York City. Dahlia graduated from Vassar College with a degree in Psychology and a Correlate Sequence in Africana Studies. She recently worked for AID Atlanta, Inc., providing comprehensive case management and educational services to women affected by, and living with, HIV/AIDS. She is currently contracted with The Children and Teenager's Foundation, Inc. to provide in-home behavioral counseling and therapy to at-risk youth and their families. Dahlia presently holds the position of Project Manager and Coordinator with Faith Christian Center, Inc. and Andre Butler Ministries headquartered in Atlanta. She is also pursuing her Masters of Public Health Degree from the Morehouse School of Medicine in Atlanta, Georgia, where she resides.

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When I agreed to blog for SisterLove, I was both excited and frustrated. I was excited because I would finally have a place to share information and express my thoughts and feelings about HIV/AIDS and women’s health — two topics I am very passionate about. I was frustrated because I knew that I had so much to say but didn’t know where to begin. How would I find my voice? If, or when I did, who would want to listen? Would my words make a difference? Despite my anxiety, my passion for these topics forced me to move beyond my fear.

After an interesting conversation with two guys, both about my age, I suddenly knew where to begin. I talked with them about my work with women living with, and affected by, HIV/AIDS. One of them asked a question that I often get whenever I tell people that I have worked in an AIDS clinic. He wanted to know if the women with whom I worked still had sex, got married, and had children. When I told them that my clients led normal lives that often included sexual relationships, marriage, and healthy children, they both seemed amazed. The one who had asked the question openly expressed his disgust at the thought of women with HIV/AIDS having sex with people who were not infected. My other friend was also disgusted. And then it happened. One of the guys said that he wished there was a way to force HIV-positive women to tell everyone about their HIV status so that people who were not infected could avoid them. Even though I have heard this before, I couldn’t believe that I was hearing it again. Hearing it again in 2009 when so much progress has been made since HIV first appeared on the scene 26 years ago. He actually suggested that women with HIV/AIDS didn’t have a right to keep their status confidential. As I said, I have heard such things before, mainly from those who are not infected, and mainly from men. It’s as if women with HIV/AIDS are no longer human beings, no longer capable of loving, no longer worthy of being loved. It’s as if they’re damaged goods who serve no place in society except as objects of public humiliation. Injustice always follows this type of ignorance.

Should women living with HIV/AIDS be allowed to maintain healthy sexual relationships (regardless of their partner’s HIV status), birth children, and have the right to control their reproduction? Just imagine a male legislator, or even a female one, feeling as my male friends. Such beliefs and prejudices could lead to legislation that forces people to reveal their HIV status or takes funding away from organizations that work with people with HIV/AIDS. We can’t afford to take this kind of ignorance and prejudice lightly. This type of blatant discrimination would seriously affect women who are already facing major health challenges and hinder organizations dedicated to serving them.

My conversation with the men led me to think more about women, HIV/AIDS, and reproductive rights. The rate of HIV and AIDS among women, particularly African American women, is rising steadily and does not seem to be slowing down. We have to accept that we can’t consider how AIDS affects women without also considering that AIDS is an issue of reproductive justice. The term, reproductive justice, is relatively new, having appeared in the past few years. It was coined by a group of Black female activists to acknowledge the many issues that are related to women ’s sexual and reproductive health and rights. It was important to these activists that we all understand and acknowledge that achieving reproductive justice must involve challenging racism, sexism, gender and ethnicity based health disparities, economic injustice, and human rights violations that affect the lives of women all over the world. In looking at reproductive justice it is obvious that HIV/AIDS is most definitely included.

Reproductive injustice, particularly in regard to women infected with, and affected by, HIV/AIDS, is not going away any time soon. To bring about positive change we need more opportunities to talk openly about the rights of women, especially as it pertains to their positive or negative HIV status. I am not angry with my friends for how they feel. I know that too many in our society already feel the same way and will continue to feel this way. I hope that the information I shared with my friends caused them to reconsider their attitudes and beliefs, and maybe even left them with a different impression of HIV-positive women. I hope they now understand that an AIDS diagnosis is not a mark of shame and that being diagnosed does not change your status as a human being. I hope that others in our society engage in similar conversations. I hope that those living with HIV/AIDS are no longer isolated and ostracized and feel safe to manage their diagnosis without fear of injustice. We can’t leave it up to organizations like SisterLove and AID Atlanta to shoulder the responsibility to change our world and fight for justice. We each have to do our part. Every conversation and every action contributes to change. The recent 2008 presidential election reminded us of the power one person can have to change a social condition. I took the time to educate my male friends. It didn’t seem like a big action at the time but now I see that it was a step, a positive step, toward the change that we need.

The Miseducation of HIV/AIDS and Breastfeeding: What is the Risk?

2009-02-23T20:15:00.008-05:00

Ayanna Robinson | SisterLove, Inc. - MPH Intern

Ayanna Robinson was born and raised in Cincinnati, Ohio. She moved to Atlanta in 2003 to attend Spelman College. As a Biology major, she enjoyed learning about the different systems in the body, including the reproductive system. She combined her passion for biomedical research with her desire to serve her community and decided to attend Morehouse School of Medicine. At Morehouse School of Medicine, Ayanna is enrolled as a first year Master of Public Health (MPH) student with a concentration in Health Education and Health Promotion. A vegetarian for twelve years, her public health interests revolve around chronic disease and diet/nutrition. With an upbeat outlook on life, her motto is “All that we are is the result of what we have thought. The mind is everything. What we think is what we become.”

While I am open to embarking on all new, positive, and enlightening experiences, in this lifetime I can honestly say that I never imagined myself blogging for reproductive justice. And actually, before coming on board with SisterLove, I wasn’t exactly sure what reproductive justice was or even all the topics that it includes. So this will be an interesting journey. I will forewarn that as a mother of a beautiful baby girl, barely past her first year of life, and as a graduate student in the field of Public Health, 86% of my thoughts naturally turn to motherhood or school. It work likes this -- someone says “blog about reproductive justice”. I immediately think “breastfeeding”. Then from a public health stand point I think of promoting breastfeeding because of its benefits to mommies and babies. And because of my work with SisterLove I realize it is important to recognize the tie between “breastfeeding” and “HIV/AIDS”. And so, the plot, along with my mission, thickens.

Considering the many benefits of breastfeeding, I’ve always wondered why many minority women, especially African American women, opt not to breastfeed. With the proper information and a strong support network, I’m sure more women would choose to breastfeed. That’s my public health side coming out. But then I remember another group of women who, despite their personal preferences, would never get the chance to -- or have a reasonable option to -- breastfeed at all.

Until now, I never questioned or gave a second thought to the CDC, World Health Organization, and other medical experts’ advice that mothers living with HIV or AIDS should not breastfeed and should seek alternative/”safer” methods for feeding their babies. So for me and the rest of American society, women living with HIV and AIDS do not have the choice, or right, to breastfeed. Some recent studies, however, question the risk of mother to child transmission of HIV through nursing.

In many developing countries, infant formula is not readily available. Formula can’t be found ‘within the walking distance’ like it is in the U.S.. Or, better yet, formula isn’t affordable or culturally acceptable. And even when infant formula is available, it may not be a safe alternative because of the lack of water, or the lack of an uncontaminated water source. For these reasons there are many mothers with HIV and AIDS living in less industrialized nations who breastfeed their babies, despite medical warnings regarding HIV transmission. So the question remains, how risky is it for HIV-positive women to breastfeed?

Early research showed that breastfeeding increases the risk of mother-to-child transmission of HIV. The most often cited source for this conclusion, which is used to drive home the recommendation against breastfeeding for mothers with HIV or AIDS, is a study published by Dunn in 1992. However, in this study “breastfeeding” was not clearly defined. Other researchers have distinguished “exclusive breastfeeding” (defined as a diet consisting solely of breast milk) from a “mixed feedings” diet which is one that consists of breast milk and formula. Recent studies actually show that there is no additional risk of mother to child transmission of HIV if the baby is exclusively breastfed in comparison to not being breastfed at all (Coutsoudis et al, 1999). A study done in South Africa showed that by 6 months, babies who had been exclusively breastfed for 3 months still had lower rates of infection (18%) than never breastfed (19%) or mixed fed babies (26%) (Coutsoudis et al, 1999).

Some breastfeeding advocates now argue that exclusive breastfeeding should continue to be promoted for the first six months of life, despite the mothers’ HIV status. Breastfeeding gives the babies all necessary nutrients, builds a healthy immune system, and decreases the risk of developing certain disorders. But from a public health standpoint, prevention is definitely important when confronting HIV/AIDS and there is still a risk of transmitting HIV when breastfeeding. While I don’t believe that this newer research should cause HIV positive mothers to completely disregard warnings given by medical experts, I do believe that mothers should be properly educated on the risks and benefits of breastfeeding so that they can make the best decision for themselves and their babies. The inconsistencies in research, especially when it comes to clearly defining methods of “breastfeeding”, and the lack of available and accessible feeding options when alternative feeding methods are recommended, limit women’s right to make an informed choice.

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Sources:

Coutsoudis, et al, (1999) Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa: a prospective cohort study, The Lancet 354: 471-6. See also correspondence in The Lancet 354: 1901–4.

Dunn, et al (1992) Risk of human immunodeficiency virus type 1 transmission through breastfeeding The Lancet 340: 585-8.

Pamela Morrison, IBCLC. Mothers and Babies and HIV: What is the Risk of Breastfeeding? AnotherLook. http://www.anotherlook.org/papers/e/index.php

STANDing Against AIDS

2008-10-05T14:11:00.021-04:00

Shayla Pierce
SisterLove, Inc.
Bridge Leadership Program Assistant
September, 2008

The STAND Against AIDS rallies in Oxford, Mississippi were conducted by the Campaign to End AIDS organization in September, 2008. The Campaign to End AIDS, better known by its acronym, C2EA, is a coalition of HIV advocates who are dedicated to informing their political leaders about HIV and demanding action to end the epidemic. C2EA held the STAND Against AIDS rallies in conjunction with the first presidential debates that took place at the University of Mississippi. The intent of the organizers and the participants was to demand from the nation’s next president, whomever he may be, that a national AIDS strategy be formulated within his first one hundred days in office.

During the first day of the Atlanta caravan, the participants traveled to Oxford, Mississippi by way of Birmingham, Alabama, where they took part in a church organized rally led by Kathy Heirs of AID Alabama. Here, everyone expressed their individual concerns about the HIV/AIDS pandemic, in an activity called “Message in a Bottle”. Each participant was given a slip of paper where they were asked to write their name, as well as, three key points that they would like to be added to the national AIDS strategy. Each slip was then placed inside bottles bearing the C2EA logo, to be reviewed later. Some participants chose to vocally express the things that they would like to be added to the AIDS strategy. More affordable housing and more accessible health care, two of the main concerns throughout the rallies, were noted. Most remarkably, however, was a comment from 22 year old “Queen”, infected since birth, who remarked that see wanted, most simply, “a cure”. The caravan then left Birmingham, Alabama for Oxford, Mississippi where each group retired for the evening.

The next day, Wednesday the 24th, eight different caravans from cities that included Dallas, Texas; Memphis, Tennessee, and even a walking caravan that traveled 172 miles from Jackson, Mississippi by foot, gathered together in the town square of Oxford for a rally to promote their cause of a national AIDS plan and to garner media attention and attention from the public. It was here that participants took part in a brief media training session. If asked a question by a journalist, participants were encouraged to emphasize the intent of the demonstration: to demand from the next president that a national strategy to end AIDS be put into action within his first one hundred days of office. If they were to be asked a question that they did not feel comfortable answering, demonstrators were instructed to direct the interviewer to consult either the Campaign to End AIDS or the Center of Disease Control websites.

Next, a passionate rally, lead by the dynamic Dazon Dixon Diallo, of SisterLove, Inc was conducted. Participants stood on the town hall steps, holding the state flags of their hometowns. This was representative of the nationwide presence of the epidemic, and how the disease has permeated throughout every corner of the United States; visual testimony to the necessity of the immediate development of a national AIDS plan. The demonstrators enjoyed the speeches of several different emphatic speakers. Most notably were a poem about the HIV epidemic by Brandon Plain entitled, “Reflections” and a riveting civil rights narrative from “Larry” who compared the Campaign to End AIDS rally to James Meredith’s triumph infiltration of the notoriously segregated “Ole Miss” in the 1960s. The crowd was most moved, however, by the testimony of “Lisa” who stood heroically in front of the podium and spoke of her experience with HIV, despite being diagnosed only thirty days before. Throughout the rally, demonstrators fervently cried out chants of “End AIDS Now!”, “Ring the alarm! It is and emergency!”, and the organizations acronym “C2EA!” The rally was covered by local FOX and CBS news.

Later in the day, about 20 or so women gathered for the southern women’s caucus, also facilitated by Dazon Dixon Diallo. Here, participants were asked to briefly give a summary of their experiences with HIV/AIDS and to talk about some of the problems that face southern women in regards to HIV/AIDS. Five common problems arose. They included the stigma of the disease, lack of sex education in schools due to conservative southern attitudes, problems within romantic relationships like violence and dependence, a lack of attention to lesbian and elderly women’s issues in regards to HIV and a wealth of economic problems, like health care and housing.

The following day, the participants convened at a local camp to further discuss, more intimately, the problems that they face with the disease, with society, and with the government. To do so, participants dispersed into different affinity groups. The affinity groups divided into two sessions, one morning and one afternoon, and each was given its own facilitator. Here, participants were encouraged to talk about the problems that were unique to their own social group. The affinity groups included women and girls, heterosexual men, men who have sex with men, youth, African American, risk reduction, post-incarcerated, discordant couples, and fifty plus. Afterwards, the affinity groups dispersed and gathered collectively to talk about the problems they discussed. While each group listed several problems that were inherently theirs, most of the problems were universal. Most, if not all of the groups sited stigma, lack of education, feelings of being ignored, discrimination, and lack of funding as problems within the HIV/AIDS community that need to be addressed immediately. There was one common theme throughout the week that continued to arise, however, and that was health care. At every event and activity, everyone expressed a dramatic concern about the lack of health care, clinics, and treatments for HIV/AIDS patients. People sited that either health care was not affordable, inaccessible, not efficient, or nonexistent. Most devastatingly, however, was learning that in Mississippi, the very state that we were demonstrating in, fifty percent of those infected with HIV or AIDS were not receiving any type of treatment.

On Friday the 26th, the last day of the rallies, participants gathered on the quad of the University of Mississippi, at the heart of the debate. It was here that demonstrators, donning bright yellow STAND Against AIDS t-shirts, stood in the background of a live news broadcast of MSNBC and chanted their demand to “End AIDS Now!” Other activists taking part in the event included volunteers from the Save Darfur campaign, the Rock the Vote Campaign, the American Constitution Society for Law and Policy and a host of others.

My time spent with positive women in our caravan was extremely enlightening. Just meeting them made me self-aware of my own unrealized tendencies toward stereotyping in regards to HIV/AIDS and those that have the disease. I have to admit that, foolishly, despite my years of doing work involving HIV/AIDS advocacy, and my familiarity with certain aspects of the disease, that I was extremely surprised to learn that the women were HIV positive. Even despite having seen some of them previously at other HIV/AIDS events, it never even occurred to me that these elderly women were in fact HIV positive. Their delicate demeanor and sweet disposition were more reminiscent of my grandmother, not someone suffering from AIDS or HIV. Even when told that I would be spending the weekend with “positive” women, I interpreted “positive” as meaning optimistic, cheerful, and constructive, not HIV positive. This was obviously extremely insightful, allowing me to deviate into an unnerving point of self-actualization, making me fretfully aware of my own ignorance. Despite understanding that AIDS does not have a face and that anyone and everyone was susceptible to the disease, I, unfortunately had a misguided template of what I thought someone who had HIV/AIDS should look like. It also made me realize that while book knowledge is fundamental, experience is and all ways will be, the best teacher.

But outside of my own self-examination, I learned many other things by being amongst those that are HIV positive. Prior to this I wasn’t aware of the variety of problems that exist among those that are positive, as well as the unique problems that exist among the scores of socially communities within the HIV epidemic. I was just under the assumption that people simply faced the problem of having the disease and wanting a cure. However, I learned that there are many other intricately devastating problems that people who are HIV positive have to battle on a daily basis. Issues with inadequate health care, medicine, stigma and feelings of being disenfranchised are ones that chronically plague those that are HIV positive. Many of the same problems that occur among those of a lower socioeconomic status are then magnified by the ongoing reality of living with HIV.

Aside from addressing seemingly endless problems there was a sense of hope when trying to develop the solutions. While people shared stories about the ordeals they encounter and how they were infected, they also talked of where their kids go to school, laughed at each other jokes, and discussed their plans for next summer’s vacations. Conversations like this gave the weekend a more humane element. In a field such as this, while being bombarded with statics, facts, and figures, it is easy to sometimes forget that HIV is more than just a clinical virus whose effects can be measured with graphs and pie charts. It is a disease that affects people, people who are not dying from it, but living with it. There was an overall sense of love, pride, and above all, unity, that resonated that weekend. Unity existed in the sense that whether you were positive, loved someone that was positive, or was simply there just because you cared, HIV/AIDS is a universal problem that puts every individual at risk and will continue to be a problem until the epidemic is ended.

::: Websites for More Information :::

Campaign to End AIDS

SisterLove, Inc.