HIV: Too many positives
Springfield Urban League educates black teenagers about AIDS
African Americans have reason to be concerned about the AIDS virus. While black Americans currently make up 14 percent of the nation’s population, they represent 65 percent of the newly reported AIDS cases. It is the leading cause of death for African-American women between the ages of 25 and 34, and the second leading cause of death for African-American males between the ages of 35 and 44.
Though it’s unclear how many African Americans living in Springfield have HIV, what is certain is that the city’s black residents are at a high risk of infection. That’s why the Springfield Urban League is working to curb the spread of the virus in the capital city.
One of the Urban League’s biggest health initiatives involves educating youths about AIDS and other sexually transmitted diseases, teaching them the importance of changing behaviors that may put them more at risk for the virus and training young people to become peer educators.
Last November the Urban League gathered a group of young students from the University of Illinois Springfield for its first SISTA Project (Sisters Informing Sisters on Topics about AIDS), a peer-led HIV prevention program geared towards young African-American women. (Several other workshops have subsequently been held with various other young adults in the Springfield area.) Along with educating participants about HIV and other sexually transmitted diseases (STDs), the curriculum – made up of five, two-hour sessions – uses small group discussions, role playing, lectures and prevention videos to show participants how to use condoms effectively and consistently and to motivate participants to reduce their risks of contracting HIV or other STDs. The program also teaches young women how to identify and handle themselves in situations that may put them more at risk for contracting the virus and equips them with skills to effectively communicate with their partners.
A big part of the training is teaching women to think about themselves – and what they value – first. They are also trained to use the information they have about sex, HIV and STDs to determine if they should use condoms or remain abstinent. And, they are encouraged to think about various situations that they may find themselves in, and the trouble the situation may put them in. For example, being at a male’s house while under the influence of alcohol or drugs could result in poor decision making.
Among other things, the women were taught a 15-step approach to using condoms, which included discussing usage prior to engaging in sex; obtaining a condom; checking the expiration date; opening the package without damaging it; inspecting the device before using it; and inserting, removing and discarding it. They also discussed some of the societal and cultural factors that may reduce one’s ability to use condoms, such as gender roles and income barriers. “There are many assumptions when it comes to condom usage, particularly in terms of women having condoms and introducing using them,” says Anne Locke, director of the Springfield Urban League’s Minority Health Initiative. Women are often concerned that having condoms and requesting that their partners use them implies that they are promiscuous, Locke added. “But what we try to get the young people to see is that when they don’t step up, they in fact increase their risk of infection.”
Prior to attending the SISTA Project three months ago, 21-year-old Rashonda Williams says she was not aware of the high rate of HIV and STD infections among African Americans. “It’s just not something that is talked about much at home, or even on campus,” added Williams, who will be a senior majoring in social work at UIS in the fall. “Since SISTA, I’ve had the opportunity to pass the information on to others so that they can be more informed.” Though the participants spent a lot of time discussing sex and condoms, Williams says she also appreciated the fact that throughout the workshop, the curriculum also included abstinence as a choice.
One of the most beneficial aspects of the program, according to several participants, is the segment on communication styles, which outlines aggressive, assertive and non-assertive communication. Once distinguishing the difference between the three styles of communication, the women were presented with various scenarios and instructed to role-play ways to deal with them assertively.
For example, one scenario depicts college sweethearts who have been dating for four years. After volunteering at a community health fair and learning more about STDs and condoms, the young woman, who previously contracted an STD from her male partner, decides that she wants to begin using condoms when having sex. Using the assertive model, the young woman would express to her boyfriend her desire to use condoms and discuss how using them ensures that they both remain safe and healthy.
“Since SISTA, I constantly think about how I approach conversations,” states 21-year-old Ashley Harris, a junior majoring in psychology at UIS. “It has really helped me communicate with my partner. I now express myself differently and it has really decreased the number of arguments,” says Harris, who is straightforward and speaks her mind. While Harris was participating in the SISTA Project, her boyfriend, Tashawn Webber, participated in the Urban League’s NIA program – an HIV intervention program for young black males.
While the communication segment has helped Harris in her relationship, she is adamant that all women can learn from it. “As females, we are often passive. We tend to let things slide by without addressing them because we don’t know how to approach certain topics or situations. SISTA really helps with that,” she said.
“One of the best things about the communication section was that we were provided with information that can be used in all aspects of life, such as on the job and when dealing with family and friends,” Williams said.
In March, the agency offered its first NIA workshop, which is similar to SISTA but geared towards young, heterosexual black men ages 18 and over. NIA, (the Swahili word for “purpose”) is based on the idea that men with a purpose can take control of their personal risk-taking behaviors and help solve the problem of HIV infection in the community.
The NIA curriculum uses interactive exercises and activities, as well as movie and music video clips, to educate participants about HIV/AIDS and its effects on the black community. It also gets participants to examine their own sexual behaviors and beliefs; increase their motivation to reduce their risks of contacting the virus; develop skills needed to identify and manage situations that may put them at risk of becoming infected; and increase their intentions to use condoms.
The NIA program begins with facts and statistics about HIV and other STDs. Participants then watch a video featuring five African-American men who have the virus. The HIV-positive men detail how the virus has affected them, as well as their families. The purpose behind showing the video is to get the young men to think about their own sexual behaviors and motivate them to use condoms. Following the video, a post-discussion focuses on community responsibility and the protective role the men can play to lessen the impact that AIDS has on the community.
In getting the participants to challenge any negative attitudes they may have about sex, the participants view a number of movie clips. For example, a scene in the movie Boomerang shows a man preparing for a first date. The character wants to have sex with his date but he doesn’t want her to know. His plan is to pretend that he is not interested in sex in hopes that this will prompt her to initiate sex. Following the clip, participants discuss how the male is playing mind games as opposed to having an open and honest discussion about sex.
When dealing with their sexual risks and triggers, the men learned that lack of knowledge, perceived risks, their intentions, negative attitudes towards condom use, cultural and gender norms, low self-esteem, sexual arousal, substance use, self-efficacy and lack of communication with a partner are all negative behaviors that can lead to poor decision making.
During the NIA workshop, participants view a video of a heterosexual couple handling various condoms and discussing condom usage. Participants also examine their attitudes towards condom usage and identify safer-sex alternatives when condoms may not be available. For example, without a condom oral sex is safer than vaginal sex. Afterwards, they are shown a variety of condoms and they practice using them correctly.
NIA’s final component involves building sexual communication skills. During this segment, participants view a variety of movie scenes which depict “preludes of sexual encounters” that are used to provide situations and scenarios for the young men to generate verbal responses to risky situations. The men also discuss their individual plans for reducing their risks of becoming infected with the virus.
UIS students Tashawn Webber and Justin Rose recently attended a NIA workshop. While each maintain that that they had some knowledge of the virus, they also stated that they learned a great deal.
“Not only did NIA help me further my knowledge of HIV and STDs, it also taught me a lot about myself,” said 22-year-old Webber. He added that he received a great deal of information during a segment on facts and myths. “I didn’t know that you can get HIV from oral sex,” stated Webber.
For Rose, the most beneficial segments involved communicating effectively with his partner and identifying risky situations. “We don’t often think about situations until they happen, which often results in poor choices. They really stressed that our safety, as well as that of our partners, is very important.” He added that all men could benefit from the NIA program. “We play a part in keeping our community safe.”
“The wonderful thing about the SISTA and NIA models is that they meet the young people where they are,” Locke said. “We know that students get the facts about HIV and sexual activity in high school. But unfortunately they are not taught the skills needed to negotiate and communicate with their partners when it comes to sex. Both the models are about empowering oneself, being safe and learning ways to work yourself out of situations that may not be safe.”
The goal of both the SISTA and NIA training is for participants to go back to their communities and college campuses to create programs to educate their peers. Many end up working through the Sangamon County Youth Wellness Bureau – a joint effort between the Urban League, Sangamon County and Illinois public health departments – that began two years ago. The Bureau uses youths to educate peers on various health issues, such as HIV and nutrition. Since its inception nearly three years ago, youths from the Bureau have participated in health fairs in areas such as Springfield, Peoria, Cahokia and Jacksonville. “The more we can educate people, the better off we will be,” Locke said. “Our hope is that the participants, and those young people who participants reach out to, will be impacted enough to change themselves and their communities.”
The Springfield Urban League is not just relying on education to decrease the rate of infection in the black community. The agency has teamed with Fifth Street Renaissance/SARA Center in conducting a night outreach via “Wellness Wheels,” a motor vehicle offering HIV testing and several other health screenings during the weekend at sites highly populated by African Americans, such as Mac’s Lounge, American Legion and high-traffic gas stations. In addition to covering various community events in the area, once a month Wellness Wheels travels to locations across the state, providing HIV testing and other health screenings. “This works out very well for people who are simply not going to go to a center or agency for testing,” says Locke.
Getting African Americans tested for HIV has been one of the biggest obstacles. And lack of testing is directly related to access to health care. While many African-American neighborhoods have numerous liquor stores in walking distance, health care facilities are not as easily accessible. Combine that with the fact that an overwhelming number of African Americans are either underinsured or lack health insurance altogether, and you have a group of people virtually locked out of the health care system. While many who have medical insurance are tested for AIDS during their annual checkup, which leads to an early diagnosis and treatment, those who lack insurance tend not to have yearly exams. And unless they visit community agencies or community fairs that offer testing, these individuals tend to go untreated.
AIDS advocates are hopeful that under the nation’s new health care reform, which will serve those who had previously gone without care due to lack of insurance, more African Americans will have yearly exams that include HIV testing. Those who are positive will know their status early, which will help prevent the spread of the disease.
Once testing positive for HIV, receiving treatment and adhering to that treatment is vital in stopping the spread of the disease. Those who take medication and adhere to a strict regimen have less of the virus in their bodies, thus are less likely to transmit the virus to others. Men have few alternatives when it comes to routine annual exams which could lead to HIV testing, unlike women, who can rely on places such as Planned Parenthood for quality, affordable health care geared towards their needs.
Along with access to health care, several other factors – including poverty, stigmas and the lack of knowledge and prevention education geared specifically towards African Americans – work together to fuel the spread of the disease.
Numerous studies reveal that there is a strong connection between HIV and poverty. According to the Centers for Disease Control and Prevention, one in 50 heterosexual adults living in poor neighborhoods are HIV positive – more than double that of the rest of the nation. With numerous studies indicating that people living in poverty are indeed more likely to contract the virus, it stands to reason that African Americans – the nation’s largest poverty-stricken ethnic group – would bear the brunt of the disease.
Poverty and lack of access to health care is only part of the problem. There are multiple stigmas in the African-American community associated with HIV. These stigmas prevent open discussions about the virus, discourage disclosure of positive status and deter African Americans from getting tested and accessing services.
According to the national Black AIDS Institute (BAI) – a Los Angeles-based AIDS organization whose goal is to stop the AIDS pandemic in the black community – African Americans tend to avoid testing for fear that if they test positive and others are made aware of their status, they will be shunned by their family and friends. This plays right into the hands of the virus. According to the CDC, people who are unaware that they have HIV are nearly four times more likely to transmit the virus to others than those who know their status. In other words, when people know that they have HIV, most take the steps necessary to protect others.
The CDC also reports that 33 percent of the African Americans testing positive are diagnosed late in their infection, which means that they have not been treated early in the disease. The late diagnosis leads to higher HIV death rates among black Americans.
In addition, homophobia in the black community has created a cloud of secrecy that has greatly contributed to the high rates of infection. Due to the stigma, many black men have sex with other men but do not see themselves as gay and are therefore not open to hearing messages of prevention or risk reduction for gay men. Statistics show that a significant number of women contract the virus through heterosexual intercourse with these men.
As AIDS advocates continue to work to address the issues that fuel the spread of the virus, Locke says that the Springfield Urban League will continue to distribute information and perform tests via the Wellness Wheels. On June 14 and 15, the SUL will travel to Peoria for a Teen Health Summit. On June 28, the agency will hold a community fair at Springfield’s Prairie Capital Convention Center. The “Summit of Hope” is a one-stop shop, providing a variety of health tests and screenings, as well as informative information.
The League will also continue conducting its workshops to train young adults to educate their peers about HIV and other STDs. To date, students at UIS, Blackburn College in Carlinville, Southern Illinois University Edwardsville, and Washington University in St. Louis have completed the SISTA Project and NIA program. When the students return to school in the fall, the Urban League will assist them in organizing informational programs and activities on their campuses. The agency also hopes to host SISTA and NIA workshops at other colleges in the area.
Jolonda Young is a former IT staff writer. She currently serves as director of Intercultural Programs and Services at Blackburn College.