HIV and the African-American Community More of What’s Working and Less of What’s Not Jacqueline Coleman, M.Ed, MSM Vision Que!, LLC Washington, DC

2 "When I dare to be powerful to use my strength in the service of my vision, then it becomes less and less important whether I am afraid" -Audre Lorde

Objectives To increase awareness and understanding of the HIV prevention needs of African Americans [men, women and youth] in the United States To explore a social ecological perspective to uncover potential and promising elements for successful outreach and programming. To increase participants‚ understanding of the need for meaningful participation of African Americans who are HIV+ in prevention for and by positives. 3

Premise of Session Creating and implementing culturally-tailored HIV prevention and treatment/care programs for the African American community could prove advantageous in curving the overall spread of the disease particularly in the Southern region on the United States. 4

Working with African Americans Techniques for Sub-populations: –Men –Women –Youth –Heterosexual –LGBTQ –Other 5

Having Faith! 6

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Cultural Competency “Having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities.” (National Prevention Information Network, 2007) 8

Social Determinants Social determinants of health can affect an individual's probability of acquiring HIV, through influences on behaviour, limited access to preventive measures, and limited access to healthcare providers or testing sites. 9

Let’s Deal with The Brothas Nia is a six hour, two to four session, video-based, small group level intervention. The goals of this intervention are to educate African American men about HIV/AIDS and its effect on their community, bring groups of men together, increase motivation to reduce risks, and help men learn new skills to protect themselves and others by promoting condom use and increasing intentions to use condoms. 10

Let’s Deal with The Brothas Nia is based on the Information-Motivational-Behavioral Skills (IMB). The IMB model assumes that people need information, motivation, and behavioral skills to adopt preventive behaviors. The target population for Nia is African American men (ages 18 and over) who have sex with women. 11

Let’s Deal with The Brothas A Key Session: Inducing and enhancing motivation to reduce risk for HIV by having men identify themselves and their behavior with the HIV epidemic through: (1) providing Personal Feedback Report on sex behaviors and condom attitudes (2) showing and leading discussion of videos featuring men who have been affected by HIV with whom participants can identify (3)conducting HIV Risk Continuum activity (4) eliciting and exploring personal risky sexual situations. 12

Let’s Deal with The Brothas A Key Session: Building skills for identifying and managing sexual risk situations: (1) eliciting and exploring personal risky sexual situations (2) building trigger-identifying and safer sex decision-making skills (3) facilitating trigger-identification and safer sex decision- making skills using movie clips. 13

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The Bayard Rustin Project (BRP) The Bayard Rustin Project (BRP) is a concentrated HIV testing initiative for at-risk African-American MSM in Washington, DC. The Project aims to increase their access to and use of HIV prevention and testing services, prevent new HIV infections, address HIV/AIDS stigma and homophobia, and provide a model for controlling the HIV/AIDS epidemic in the nation's capital 15

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17 Let’s Deal with The Sistas

Social Determinants Women’s Vulnerability to Contracting HIV Gender stereotypes and double standards Socio-economic disparities Homelessness Income Poverty Health care coverage Dynamics of power in sexual relationships *Factors are prevalent however may not be specific to women. 18

Social Determinants Women’s Vulnerability to Contracting HIV Substance Abuse and its effects on HIV vulnerability Sex Work and its effects on HIV vulnerability and access to care Mental Health* Biological and Physiological make up* Other co-occurring conditions TB, Hepatitis (viral)* Racism (inequalities and discrimination based on race and ethnicity)* Putting family and significant others needs first * 19

Empowerment Theory In order to reverse increasing HIV infection rates for U.S. women, there is an urgent need to: –Empower women and transform the way women and men relate to each other –Recognize empowerment is important for women of color because they are at increased risk of sexually transmitted HIV infection from men –Recognize risks that are further exacerbated by male control of sexual decision-making, male partner violence, and histories of child sexual abuse. 20

21 Gender Analysis Gender blind Gender neutral Gender sensitive Gender specificGender transformative

COMMON THREADS Building a Community of Storytellers to Combat HIV-Related Stigma and Disparities Common Threads is a small group HIV prevention training organized around intense, interactive, skill-building sessions. This training is designed to enhance the ability of women of African descent living with HIV/AIDS who are willing to share their life experiences (including their experiences with HIV/AIDS and other health disparities) with family members, partners, friends, and community members. 22

Effective Prevention Interventions for Women & Girls SISTA SIHLE

Ethnic & Gender Pride Sisters Informing Sisters about Topics on AIDS (SISTA)

Two Key Questions 1.What does it mean to be an African American woman? 2.Who is a strong African American woman in your life? 25

SISTAS Assertiveness Model S – I need to think about SELF first. What do I value? I – I need to use the INFORMATION that I have about sex and HIV/AIDS. What is safe for me to do? S - I need to think about the SITUATION I am in. What trouble does it put me in? 26

SISTAS Assertiveness Model T – I need to state the TROUBLE to my partner. What are my options? What are the consequences? A – I need to tell my partner in an ASSERTIVE manner what I would like to do. S – I need to SUGGEST an alternative. Can I live with he consequences of the alternative? 27

Which Type?  Means standing up for yourself at the expense and possible shame of others; language is threatening and punishing to others; we fail to consider needs of others.  You don’t feel you have the right to be heard or acknowledged; uncomfortable expressing yourself  You are able to stand up for yourself in an honorable manner; without being punishing, threatening, or putting anyone down Assertive Aggressive Non-aggressive 28

SIHLE Sisters Informing Healing Living and Empowering

SIHLE Key Exercises: 1. What do healthy and unhealthy relationships look like? 2. Love & Kisses – participants use cards to determine if behaviors are safe, safer and unsafe. 3. Media Masquerade – pictures are used to discuss how men and women are portrayed in society and media. 30

31 Check out our SIHLE Sister of the Week This 17 year old is inspiring writers young and old with her gift of poetry. She helped make Philadelphia #1 in the world for youth poetry and she is a champion in our eyes. Our SIHLE sister of the week is... Safiya Washington. To find out more about her please CLICK HERE CLICK HERE

Let’s Deal with Generation Y 32

33 Dialogue Between the Sexes

34 The Five LOVE Languages Dr. Gary Chapman If we are to develop an intimate relationship we need to know each other’s desires. If we wish to love each other, we need to know what the other person wants. Words of Affirmation Quality Time Receiving Gifts Acts of Service Physical Touch

The Art of Dialogue Each person has the right to define him/herself without being labeled by others Each person has the right to express his or her beliefs, ideas and feelings Each person has the right to ask questions that help him/her understand what someone else has said Each person has the right not to change or be coerced to change Each person has the right to expect that what is said will be held in confidence 35

Workshop Presenter Jacqueline Coleman, M.Ed, MSM Vision Que! [cell] 36