1. Women Action AIDS Network COMMON THREADS © HIV Positive Women The Impact of Violence Vanessa Johnson, JD NAPWA

2. Common Threads Description of Prevention Intervention Common Threads is a three day small group prevention intervention designed to reduce HIV/AIDS related stigma by building the capacity of people living with HIV/AIDS to effectively share their life experiences in select geographical areas where there is a high incidence areas for HIV/AIDS.

3. A Story of Two Girls One Story is About Thriving One Story is About Being Buried Alive

4. Theme: It’s Like Being Buried Alive Framework for this talk – An explanation of HIV vulnerability – How our ability to meet our needs impacts HIV vulnerability – A look at some of the factors that lead to HIV vulnerability through the use of a personal story

5. HIV Vulnerability GenesRaceGender Human Needs Family History Trauma Primary Factors Leading to HIV Vulnerability

6. HIV Vulnerability GenesRaceGender Human Needs Family History Trauma Primary Factors Leading to HIV Vulnerability

7. HIV Vulnerability GenesRaceGender Human Needs Family History Trauma Primary Factors Leading to HIV Vulnerability

8. Spiritual Needs Self - Actualization Needs Esteem Needs Love and Belonging Needs Safety Needs Physiological Needs Maslow’s Hierarchy of Needs

9. Physiological Needs –Breathing, drinking, eating, excretion, & sex –Can control thoughts and behaviors Safety Needs –Personal, financial, health, and well-being –Can lead to frustration, apathy, and weakness

10. Maslow’s Hierarchy of Needs Social Needs –Friendship (or peer pressure), intimacy, family –Can overcome physiological and security needs –Can lead to loneliness, anxiety, and depression Esteem Needs –Self-esteem, self-respect, and to respect others –Feeling accepted and values –Low self-esteem, inferiority complexes, hyper seeking attention, and depression

11. HIV Vulnerability GenesRaceGender Human Needs Family History Trauma Primary Factors Leading to HIV Vulnerability

12. Family History Importance Our most powerful memories and important experiences come from our families A knowledge of our family history helps us know who we are and makes sense of our lives The family tree can shows family connections between individuals and document their effects

13. My Family History My family history is one of love, spirituality, perseverance, and hard work. But it is also one with a history of substance use (alcohol, prescription drugs, and illegal drugs), violence (verbal, emotional, and physical), and sexual molestation/abuse. My family tree shows how this history flowed through the family, touching multiple generations.

14. My Family Tree – Violence g3 m g1 oj g2 sjtjdj vh mj g1 wj bj f jj

15. Family History CHALLENGES Vulnerability to HIV Infection: Challenges –Emotions: Difficulty in Expressing Feelings Anger Domestic Violence Lack of Intimacy –Mental Health Disorders: Depression –Coping Mechanism: Withdrawal Substance Use STRENGTHS Gateway to Recovery: Strengths –Mother’s Resiliency –Generous spirit –Closeness: Family Gatherings Available & Dependable in Times of Need –Open Minded: Celebrate diversity –Father Valued Education

16. Impact of Family History Unmet Needs Family met survival needs However, there were family challenges to meeting –Safety needs –Love and belonging –Esteem needs Impact: Although I felt loved and wanted by my mother I also felt a tremendous amount of fear & anxiety as a result of family violence FAMILYHISTORYFAMILYHISTORY FAMILYHISTORYFAMILYHISTORY Why me?

17. HIV Vulnerability GenesRaceGender Human Needs Family History Trauma Primary Factors Leading to HIV Vulnerability

18. Timeline Importance A timeline shows events and when they occurred A timeline allows one to plot events in a graphic way, to see the possible relationships, to help memory, and to grasp how things my have happened in sequence. A timeline, especially going from earliest to latest, can suggest the possibility of cause and effect

19. Impact of Trauma Trauma and HIV Research findings indicate that sexual abuse before age 1 8 increases a woman’s risk for becoming HIV- positive more than any other factor. Why me? TRAUMATRAUMA TRAUMATRAUMA I am alone.

20. Timeline Map Orange: Violence Blue: Sexual Abuse Episodes Green: Substance Use Purple: Positive Events 1 st Red Line – first incidence of sexual molestation 2 nd Red Line – diagnosed with HIV Green Shading – exposed to substance use Light Purple Line – Entered an inpatient recovery program

21. My Timeline Diagram 0246891010 1212 1414 1616 1818 2020 2222 2424 2626 2828 3030 3232 3434 3636 3838 4040 4242 4444 4646 exposurechaosrecovery

22. Response to Trauma Substance Use and Sex Age 1 6 Started going out to clubs Age 18 Started binge drinking Started smoking marijuana Promiscuity Age 1 9 Partner violence Why me? I am alone. SUBSTANCE USESUBSTANCE USE SUBSTANCE USESUBSTANCE USE I need to escape.

23. Trauma History CHALLENGES Vulnerability to HIV Infection: Challenges –Witnessed abuse at an early age –Sexually molested at an early age –Experienced intimate partner violence –Relations with Male Partners with HIV Vulnerabilities STRENGTHS Gateway to Recovery: Strengths –Family supportive –Family counseling –Family acknowledgment of hurts –Family realizing that HIV is a disease and not who I am

24. HIV Vulnerability GenesRaceGender Human Needs Family History Trauma Primary Factors Leading to HIV Vulnerability

25. My Vulnerability to HIV was High Multifactor Impact What I did not realized was that my genetics, race, gender, unmet human needs, family history, and trauma would invariably lead me on a collision course with HIV. Why me? I am alone. I need to escape. HIVINFECTIONHIVINFECTION HIVINFECTIONHIVINFECTION My life is over.

26. Living with the Monster HIV Related Stigma The fear of discrimination, rejection (stigma), and violence keeps people from being tested for HIV, from seeking care and treatment if they are diagnosed HIV- positive, and from disclosing their HIV status to partners Why me? I am alone. I need to escape. My life is over. STIGMASTIGMA STIGMASTIGMA I really am human underneath all this.

27. Recovery Age 36 Entered Rehab Family Counseling Age 37 Volunteer Age 38 Passed NY Bar Exam Age 4 2 CDAACA Age 4 8 NAPWA Finding Me Again

28. Contact Information Vanessa Johnson, JD Executive Vice President NAPWA 8401 Colesville Road Suite 505 Silver Spring, MD 20910 240-247-1016 (p) 240-247-0574 (f) vjohnson@napwa.org