In recognition of Women's Month & last weekend's National Women & Girls HIV/AIDS awareness day I interviewed a good friend and Health Education Specialist about the impact that HIV/AIDS is having on women and particularly in African American Women.
1. Share with our readers a little bit about your
professional background as it relates to women's health & why you're so
passionate about women's health issues?
Sure. My name is Nakisha Floyd,
M.A., CHES, RHEd. Professionally, I currently serve as an Education Consultant
with the State of North Carolina. I am a Certified Health Education Specialist
(CHES) and Registered Health Educator with a Bachelor of Science in Community
Health Education from North Carolina Central University (Durham, NC) and a
Master of Art in Health Education and Promotion from East Carolina University
(Greenville, NC). I’ve been practicing in the field of health education for
over 14 years and most of my work has been centered on sexuality education and
reproductive health among adolescents.
My passion for adolescent and
women’s health issues developed while working as a Health Education Program
Coordinator in a semi-rural county located in Eastern North Carolina. I remember
talking with so many teenage girls about issues regarding their sexual health
and so many of them were clueless about their bodies and/or the decisions being
made that would affect them for a lifetime. Often times, I would ask this one
question “Why did you decide to have sex with your partner [that person]?” No
matter who it was, or how many times I asked the question, most of them would
start off their response by saying “I don’t know…” What was extremely
disturbing to me was that majority of these young women were African-American.
I knew then that I needed to go above and beyond the “9 to 5” to educate them
because if not addressed, these same attitudes and behaviors would follow them
into their adulthood. It’s not just about gaining the knowledge; it’s about
applying it. I know that I would have to provide these young people with the
knowledge and SKILLS to change those attitudes and behaviors that could impact
their quality of life or end it prematurely.
2. According to statistics, HIV is the leading cause of
death for Black women aged 25 -34 years. The rate of AIDS diagnoses
for Black women is 23 times the rate for Caucasian women and 4 times the rate
for Latina women. These stats show that Black women are
disproportionately affected among women in other ethnic groups in the United
States. Can you give us some thoughts and facts on why this is the case?
Although recent statistics record African-Americans
representing only 14% of the U.S. population, our community faces a number of
challenges that contribute to the higher rates of HIV infection.
The Centers for Disease Control and
Prevention (CDC) cite some of the following reasons for the HIV infection
disparity in Black America, particularly among African-American women.
1) The greater number of people living with
HIV (prevalence) in African American communities and the fact that African
Americans tend to have sex with partners of the same race/ethnicity
means that they face a greater risk of HIV infection with each new sexual
encounter.
Most
women are infected with HIV through heterosexual sex. Some women become
infected because they may be unaware of a male partner’s risk factors for HIV
infection or have a lack of HIV knowledge and lower perception of risk.
Relationship dynamics also play a role. For example, some women may not insist
on condom use because they fear that their partner will physically abuse or
leave them.
African
American communities continue to experience higher rates of other sexually
transmitted infections (STIs) compared with other racial/ethnic communities
in the US. Rates of gonorrhea and syphilis are higher among women of color than
among white women. The presence of certain STIs can significantly increase the
chance of contracting HIV. Additionally, a person who has both HIV and certain
STIs has a greater chance of infecting others with HIV.
Both
unprotected vaginal and anal sex pose a risk for HIV transmission. Unprotected
anal sex presents an even greater risk for HIV transmission for women than
unprotected vaginal sex.
2) The socioeconomic issues associated
with poverty, including limited access to high-quality health care, housing,
and HIV prevention education, directly and indirectly increase the risk for HIV
infection and affect the health of people living with and at risk for HIV
infection.
Women
who have experienced sexual abuse may be more likely than women with no
abuse history to use drugs as a coping mechanism, have difficulty refusing
unwanted sex, exchange sex for drugs, or engage in high-risk sexual activities.
Through my years of community work, I’ve
experienced a number of instances where issues of sexual abuse have occurred;
yet have gone unaddressed. By not talking about it and acting as if sexual
abuse does not occur within the black community, we are giving power to
perpetrators and making a silent statement that sexually victimizing people is
acceptable. It is not OK! Believe it or not, talking about sexual abuse and giving
young people quality sexuality education so they have the language to discuss
all issues of sexual health, including abuse indirectly strengthens the fight
against HIV infection.
Injection
drug and other substance use increase
HIV risk through sharing injection equipment contaminated with HIV or engaging
in high-risk behaviors, such as unprotected sex, when under the influence of
drugs or alcohol.
3) Lack of awareness of HIV status can affect HIV rates in communities.
Approximately 1 in 5 adults and adolescents in the US living with HIV are
unaware of their HIV status. This translates to approximately 116,750 persons
in the African American community. Late diagnosis of HIV infection is common,
which creates missed opportunities to obtain early medical care and prevent
transmission to others. The sooner an individual is diagnosed and linked to
appropriate care, the better the outcome.
4) Stigma, fear, discrimination, homophobia,
and negative perceptions about HIV testing can also place too many African Americans at higher risk. Many at risk
for infection fear stigma more than infection and may choose instead to hide
their high-risk behavior rather than seek counseling and testing.
Source: The Centers for Disease
Control and Prevention - www.cdc.gov
3. Seven out of the top 10 states with the highest rates
among women are in the South and the rate of women in DC infected with HIV/AIDS
is 12 times the national average. Why are a greater portion of women
infected below the Mason/Dixon line?
There are a number of social factors
contributing to the reasons why HIV infection is concentrated in the Southern
region of the United States. The greater portion of women infected with HIV are
below the Mason/Dixon line due to many of the socioeconomic
issues discussed in Question #2.
Factors linked to poverty, which include limited
access to high-quality health care, housing, and HIV prevention education may
be the driving force behind the increased risk of HIV infection among black
women in the South. This issue is extremely complicated
as many of these factors are interrelated.
The African-American population is concentrated in the South, as well as
rates of extreme poverty. Another issue is that the region below the
Mason/Dixon line is also referred to as the “Bible Belt”. Many view sex as a
moral issue instead of an issue of normal human growth and development. Talking
about sex and receiving quality sexuality and reproductive health education is
very sensitive, political and often times taboo. Many have this idea that
discussing sex makes young people “promiscuous”. This is a major myth! It has
been proven that the more factual and medically accurate information that young
people receive, the more likely they will be to prolong sexual involvement.
Lack of knowledge is not just a young persons problem. If an individual never
received the education as an adult, 9 times out of 10 s/he does not have that
knowledge as an adult. KNOWLEDGE is POWER…the earlier that an individual is
exposed to age-appropriate sexuality education, the better. It serves as empowerment in a number of ways.
4. What can women do to protect themselves? What are your
thoughts about testing in dating relationships vs. marriages?
Women can protect themselves from
HIV infection in the following ways.
1) Choose abstinence. If you are not in a monogamous relationship,
not having sex is the easiest way to prevent HIV infection. Both individuals in the relationship must
practice monogamy, which is defined as the practice or state of having a sexual
relationship with only one person, in order to be effective. This may not be a
realistic option for many, especially with the high rate of African-American
women who are not or may not marry in her lifetime. That’s where the other tips
are helpful in protecting your sexual health and your life.
2) Get tested regularly and know your status. An individual should
get tested every 3 to 6 months after every act of unprotected sex (oral, anal
or vaginal). You have to ask your healthcare provider for an HIV test. It is
not done automatically, even during routine blood work.
3) Limit your sexual partners and know your partner’s status too! A
person can become infected after being exposed only one time. You don’t know
what people do when they are not with you; therefore, it is empowering to
practice regular HIV testing in any relationship. Again, it’s about monogamy,
not one’s marital status.
4) ALWAYS use a latex or polyurethane condom. HIV is transmitted
through the exchange of 1) blood, 2) semen, 3) vaginal fluids and 4) breast
milk. Latex and polyurethane (for those who may have a latex allergy) condoms,
if used properly, act as a barrier to the exchange of bodily fluids during
sexual activity. Lambskin condoms are porous and do not act as an effective
barrier.
5. How does the healthcare community view HIV/AIDs?
Twenty years ago it was painted as an absolute death sentence. Now I see
commercials on TV stating that after treatment HIV can be "undetectable"?
How is that?
Now that HIV infected people who are
taking prescribed medications properly are living longer and have an improved
quality of life, the healthcare system is starting to view it as more of a
treatable chronic disease versus an absolute “death sentence”. Chronic disease
is defined as a disease lasting 3 months or more (U.S. National Center for
Health Statistics). The problem is that many HIV/AIDS medication assistance
programs that aid low-income populations in receiving life-saving medications
are losing their funding. This is another issue all together.
There are medications out that can
reduce the viral load to the point that HIV can be undetectable in an infected
person’s system. Many feel that this is working its way to a cure; however, at
this point there is no cure for HIV. Taking medications treat the symptoms but
do not cure this disease. This is the difference between a treatment versus a
cure.
6. In your opinion, will we ever see a day where HIV/AIDs
will be a thing of the past? If so, what is our role in seeing this
disease retreat from epidemic stage in our generation?
I pray that one day there will be a cure to a virus that
has wreaked havoc among people on every continent of our world, but right now,
the closest thing that we have to a cure is PREVENTION! Prevention starts with
YOU! Do your part by educating yourself about the virus that causes AIDS, get
tested regularly and know your status (you have to ask your healthcare provider
for this test), limit your sexual partners, and use protection with EVERY act
of sex (oral, anal, and/or vaginal)! Remember, HIV is totally preventable. It’s
not who you are, but what you do that puts you at risk for HIV infection!
Thank you to Ms. Nakisha Floyd for taking the time for this very informative interview! If you have any questions for her or would like her to speak at an organization that you are a part of, please leave a comment below!
