Editor’s Note: I am a certified HIV counselor and tester.

It’s been over three decades since the first known case of HIV was discovered in America and although we’ve made great strides and discoveries when it comes to prevention, testing, and treatment, HIV continues to disproportionately impact marginalized populations. I have worn many hats in this field. I’ve been an HIV counselor and tester, a case manager and even a disease surveillance investigator. And no matter what capacity I’ve worked in, I’ve noticed the same trend—HIV rates in the black community continue to skyrocket. Although black people are less than fourteen percent of the population, we account for more than forty percent of new HIV infections. And if those statistics aren’t frightening enough, let’s look at rates among black women. Black women account for over sixty percent of new HIV infections among women. Traditionally black women have always put everyone’s needs before their own and I think it’s time we discuss how we can mark World AIDS Day by starting a conversation about our health.

Let’s start with the basics. We’ve all heard about HIV, but do we really understand what it is and how it impacts our health? HIV is an acronym that stands for Human Immunodeficiency Virus, which can lead to AIDS (Acquired Immunodeficiency Syndrome) A person cannot ‘catch AIDS’, even if the person who infected them has been diagnosed with AIDS. HIV is transmitted through blood, semen, pre-cum, vaginal secretions, rectal fluids and breast milk. Engaging in any activity that could lead to exposure to these fluids WITH an HIV-infected individual could put you at risk for HIV infection. Those activities include unprotected sex (oral, anal and vaginal), needle sharing and a mother passing on the virus to an infant through breastfeeding. You cannot contract HIV through hugging, kissing, sharing toilets or utensils. It’s also important to remember that barriers such as condoms and dental dams are not one hundred percent effective in preventing the spread of HIV during sexual activity. The only way to avoid infection is through abstinence and avoiding sharing needles with other drug users. But, let’s be real. People enjoy having sex. IV (intravenous) drug use will continue. So, we’re not going to shame black women for having sex and we’re not going to judge black women who use drugs. Those aren’t solutions. We need concrete ways to lower infection rates.

It’s been proven that black women do not engage in riskier behaviors than white women, so how do we account for the rocketing HIV rates in the black community? Simple—funding and accessibility to resources. There is an absolute relationship between HIV infection rates and poverty. And those who live in poverty don’t have access to resources such as harm reduction education, or access to resources such as condoms and dental dams, which reduce the spread of HIV. There are other barriers such as mental health, substance abuse, and at times intimate partner abuse that prevent many from seeking testing and other services. And most importantly, many don’t have access to proper health care which includes annual STI screenings, assuming those women have trust in medical providers to seek such services. And then there’s the obvious stigma that comes along with HIV testing because there are so many myths and misconceptions around HIV/AIDS.

In 2016 I still hear the same myths about HIV such as “I can tell if a person is infected” or ”It only happens to gay men”. HIV has never and will never discriminate, and anyone who is sexual active or shares needles is at risk of contracting HIV. It’s that simple. There’s no look. There’s no particular sexual orientation. The ‘down low’ is a myth rooted in homophobia. And our community is rife with homophobia. Many assume and HIV positive woman must have had sex with a man who had sex with another man. This is wholly damaging and only perpetuates homophobia while doing nothing to address HIV infection rates. There’s risk involved each time you have sex. It does not matter who your sexual partners have been with. It matters that you’ve had sex. Again, there’s always a risk when you have sex. And even if you’re in a monogamous relationship, it’s still recommended that you get annual HIV screenings. Monogamy isn’t a barrier and not a guarantee of your health and well-being. And for those of us in relationships, we can’t assume that just because our partners test negative it covers us–it doesn’t.

But, let’s be real, not everyone is in a place where they are ready to be open and engage in these conversations. Conversations about STIs, specifically HIV, are difficult to have, and many women, especially those in relationships where they are experiencing emotional and/or physical abuse, will never feel safe having conversations about HIV testing. And we have to work around that. My training in harm reduction allows me to help black women find ways to protect themselves, regardless of their readiness or ability to have conversations with sexual partners. So, these harm reduction methods are helpful in lowering your risk:

USE CONDOMS

There are many non-porous latex and non-latex condoms that are effective at lowering your risk for contracting HIV. “Male” and “female” condoms have high rates of success in lowering risk. A male condom covers the penis, while a female condom is inserted into the vagina or rectum. Both are often free or low cost at local testing sites and clinics such as Planned Parenthood.

UNDERSTAND HOW PREP AND PEP WORKS

There are also two medications that may lower your risk, and they are PrEP (Pre-exposure prophylaxis) and PEP (Post-exposure prophylaxis). PrEP is medication prescribed by a doctor for people who are considered high risk for HIV infection. The once a day pill is taken at least seven days in advance of any risky sexual behavior. It’s recommended to be used WITH “male” or “female” condoms. And PEP is medication prescribed by a doctor to be used AFTER you’ve been exposed to HIV. Both have high rates of success.

USE CLEAN SYRINGES

Many cities participate in needle syringe exchanges, where you are able to exchange used syringes for new syringes. They have proven effective at lowering HIV infections among IV drug users. Even if you aren’t an IV drug user, but with your partner is, the needle exchange will lower their risk, which lowers yours. Here’s a link to find a needle syringe exchange program near you: North American Syringe Exchange Network

Prevention and testing are key when it comes to reducing HIV infection rates. And we can no longer afford to look at individual behavior. It has to be a community effort. As a collective, we need to do our parts to make sure there are programs and resources available to black women. AND we need to make sure they have access to those programs and resources. There are too many personal and structural barriers that are aiding in the rise of HIV infections, and it ends now. Black women are worth our efforts. We wear red for them.

If you or someone you know is looking for free/low-cost HIV testing, please visit: Get Tested

If you’re looking for organizations that work to help black women and girls impacted by HIV, please visit:
The Red Pump Project
Black Women’s Health Project
Black Women’s Health Imperative

– Creighton Leigh