Chapters Transcript Video Community Speaker Series: Let’s Talk About Sex: Sexual Health and HIV - DC Community Speaker Series: Let’s Talk About Sex: Sexual Health and HIV - DC Originally Broadcast: November 17, 2020 | 4:00 pm – 5:30 pm ET So hello and welcome. I am Christopher Johnson Watson, senior product manager Gilead Sciences. And on behalf of Gilead, you would like to welcome you to today's program, which is the final event in a series of four community Speaker Siri's programs that are part of a new Gilead initiative to support local and regional efforts towards ending the HIV epidemic. E want to first begin today by thanking all of you all that are doing the work each and every day to support communities impacted and affected by HIV, particularly in a time where there is a global pandemic. In such social injustice, your work has leaders in the HIV community. It's critical to the goal that we all share, which is seeing and into the HIV epidemic through open conversations like the one you're participating in today. In this virtual format, way hope to bring to life challenges faced by those living with or at risk for HIV, such a social determinants of health or stigma and how they could be addressed effectively to begin today's program. I am delighted and humbly thankful to introduce Dr Gina Brown, who is a prevention medical scientists at Gilead scientists Gina Thank you, Chauncey. I'm really delighted to be able to participate in this program. I think any of us who have worked in the HIV field really understand that whether you're living with HIV or not, whether you're at risk of HIV or not, you should be able to speak freely about sex and about your sexual health. And it's only through these open conversations about sexual health. But can we really continue? Individuals and communities impacted by HIV toe understand risk to understand the importance of knowing one's HIV status and also don't know what the options are for HIV prevention and HIV treatment and care. I'm happy to introduce our speakers today who really guide us through this discussion. Our moderator this evening is Earl Folks. He's the president and CEO of the Center for Black Equity in Washington, D. C. The center is a national leader in connecting members of the black LGBTQ plus community with information and resource is to educate, engage and empower their fight for equity and access. We will be joined by Martha Sichone Cameron, and she is the regional director, a regional coordinator of International Community of women living with HIV in North America, and she's actively involved in various HIV policy advocacy and research forms, including the positive women's network, the U. S. Persons Living with HIV. It's caucus or P L. W H A Caucus in D. C. Center for AIDS Research Abby Charles is a program director at the Institute for Public Health Innovation. Abbey provides leadership and coordination for two programs in D. C in Northern Virginia that aim to increase the participation of people living with HIV AIDS in medical care, using a network of peer community health workers and by increasing connectedness among clinical and non clinical service providers. Last but not least, is Savannah want Sir. She's the executive director and founder of Trans Pride, D. C. And May is all about Trans. Savannah's been a recognized community advocate and an HIV educator for more than 20 years and is honored to have been the first woman of transgender experience to serve on the boards of Whitman, Walker Health and the Capital Pride Alliance. I'd like to thank all of our speakers and all of our Panelists for agreeing to participate in this program and for adding their voices and expertise to today's conversation so I'll turn it over to Earl, folks to get us started with some background information. Thank you very much, Dr Brown. This is a great opportunity. I'm very pleased and honored to be able to participate. Please pardon my throat a little bit. I'm having some allergy issues. And if I start something like froggy for the Little Rascals, you know why, Um I have We're gonna start off by looking at the state of HIV in the Washington district, Washington, D. C. And for those of us who have been doing this fight for many years, this information is going to be a stark contrast from away. Used to be 25 years ago. So the first slide is a 2018 year in data snapshot. So we have as a 2018, we have 12,322 people living with HIV AIDS with 360 new HIV diagnosis is the important number for me. Looking at that jumped out at me was 75.6% of the newly diagnosed people, the 360 were black and one and five were black women. And I'm not gonna read everything on every slide I'm just gonna highlight certain things and leave for you to determine which, which is of interest to you If we look at the next slide. We're looking at the health HIV, healthcare, HIV care dynamics here in Washington, D. C. So I think all you would agree that assessing a Chevy care dynamics is a step is a very important step in understanding the strength of HIV AIDS programs in Washington, D. C. As well as an opportunity to identify and resolve gaps in case Karen Continuum. This number I'm about to give you is the one that jumped right immediately off the page. For me. Between 2000 and seven and 2018, we saw an incredible 73% decline in new HIV diagnosis. Is was two of three of those people living with HIV and care and the next side the next slide. You'll see. The district has a goal of achieving complete eradication of HIV as a health public health threat by 2030 and I think we would all agree that closing the gaps of HIV care and prevention are essential in order to meet this goal. But the threats to this goal or the things that we're gonna talk about some of the things we're gonna talk about today. HIV related stigma, homophobia, the lack of awareness that HIV remains a significant public health threat among the factors that could lead to a resurgence of HIV in our community. And we don't wanna have that happen moving over into the next slide. Sure, Trump, you will see there's a strategy. The chart there has a strategy of how we will end the HIV epidemic, and ending the HIV epidemic will require a whole of society effort and basketball. We call this a full court press. Innovative partnerships and collaborations are key to this effort. These multi sector partners would include people with HIV or those at risk for HIV community and faith based organizations, healthcare providers, city, county, tribal and state health departments and other agencies. In short, people like those of you on this program and the agencies that you represent and moving forward, we have three examples of innovative partnerships and collaborations, and I'm not gonna go into great detail, but I'm just gonna touch space on each one of them. In 2000 and eight, the DC Health and the National Institutes of Health, N. I H. Collaborate to establish the D. C. Partnership for HIV AIDS Pro Progress, a partnership for community based clinical care and research, with the aim of reducing the incidence and prevalence of HIV AIDS in Washington, D. C. The second example is Whitman Walker Health and HRC Foundation partner in 2015 to release an updated Mawr inclusive, safer sex guide and then, in 2016 released a first of its kind, safer sex for trans bodies. Guy. The guy has also issued in Spanish, which is very important to deal with our Latina, Latin X, my sisters and brothers. The next slide. Please teach. I'm sorry I'm not finished. The third one, The third one, the most important one. And that's the mayor. Bowser announced a public private collaboration to develop a plan to end the epidemic. And you see a array of partners, including DC Health, another district government agencies, federal agencies such as her PSA Ryan White, Part B and C Housing opportunities for people with AIDS Hapa D. C. Apple C, which is an advocacy organization in the district, and George Washington University, which is also located here. The goals or the goals are very simple is to increase the number of people living with HIV, to know who know their status and retain and care, and to reduce the rates of HIV infection in D. C. Now we may move forward. And this is the HIV H plan, and I think we went over many of the goals. Reduce new infections, increase people care and improve health outcomes and reduce HIV health disparities and inequities and achieving more coordinated national response to H B A pandemic. The next one. Please let's talk about sex starting the conversation, what factors that can impact sexual health and access to care. And this is not always an easy one for us to wrap our arms around. But the fact of the matter is, is that stigma? It's still a problem, my community and there's another issues that impact our access to care and how we deal with sexual health and and employment situation, especially given this time of Kobe with so many of us, are not working social economic status, geographic location, whether you're in the urban area or underserved urban area or underserved rural area, sexual status and partner relations and your race and ethnicity moving on would please sexual health and health care what might be the causes that we could. Well, let me put this another way. What might be the impact of reducing stigma? So the impact of reducing stigma is very important for our communities. More willingness for individuals to get tested for HIV were willingness to this disclosed HIV status a greater inclination to care to enter into care and stay engaged in care. Greater motivation of starting antiretroviral therapy and adhering to the therapy or social support for people living with HIV and improve called your life. And I think we all can support that. Moving forward sexual health. This is a very important aspect of the care. Mm, I'm sorry for people living with HIV, with people living with HIV or a risk for HIV. HIV status is just one element of the person's health. As you see, the steps along the care continuum are similar for people living with HIV or at risk for HIV. We all know that sustained engagement and care is important to achieve and maintain health, but unfortunately, HIV negative individuals may not be accustomed to the importance of sustained engagement, care, social and other stigma. Other social determinants can influence HIV care, continuing before HB diagnosis has even made. And in the next slide, we'll see examples off these, um, stigma, social determinants, racism, transphobia, shame, misogyny, poverty, violence, homelessness all contribute to adding to the stigma of shame. And after 40 years of this disease, you would think that the shame would have been reduced. But we still have in many cases, the same levels of shame and stigma as we did when the H. I V started and our last slide in the Siri's. What is you equal? You? A lot of people have not heard this term, but it's you equals you means undetectable equals un transmittable. It's a campaign to underscore the fact that people with HIV who take their medications every day and achieve and maintain an undetectable viral load for six months or more have effectively no risk of transmitting HIV through sex. Now, having said that, U equals U does not preclude the use of other prevention prevention measures, and those include the use of condoms and or other forms of prevention, including prep services and safe sex practices. Thank you for listening in. Now we're getting to the heart of our discussions. Hey, and we are panel discussion, and we we had Gina, Martha and Savannah with us. I have some questions. I'm gonna ask you a serious of questions, and I would like you to respond. You don't have to just jump into the conversation. Let's first part of our discussion. We Let's talk about sex starting the conversation and ups I blocked myself, and I remember when I was 13 years old and my father came into my room very somber to have the discussion about sex, and he was uncomfortable, and I didn't have the slightest idea while he was in my room sweating in the middle of winter time. But the conversation he started to tell me how babies were born, and I stopped them. After about two minutes, I said, Daddy, we learned this in biology two years ago and he looked at me, said okay, and he walked out the room. And it's the last time we talked about sex before incense, and I think my brother's got even less conversation than that. The fact of the matter is, many people in our communities particularly African Americans have difficulty talking about sex and sexual health, which is a non starter in our community, and I want to start with Abby. How do we start to talk about sexual health in our part with our partners and those we love? Yeah, And it's interesting that we started with talking to our partners first, right, without really thinking about how do we talk to ourselves first, about sex and sexual health? How do we talk to ourselves about our bodies? Andi really develop knowledge about our bodies at that young age of 13 or even younger than that. It's really difficult toe have clear conversations with our partners if we don't even know what's going on with our bodies ourselves. Andi, I've been having a lot of these conversations with my friends about how do they have conversations about sex with their partners? How do they bring up conversations about East infections, about bacterial vaginosis, about issues going on with their bodies? And many of them have no idea how to start having those conversations with their partners on DIT starts with us from a very young age, getting holistic knowledge on information about how our bodies react. I'll start. I'll start the conversation there. The other piece is at some point we have to be prepared to get uncomfortable. Onda. It gets easier as I've gotten older toe have those uncomfortable conversations. You know, one of my colleagues says that a lot, as she's talking about race and racism, you have to get get uncomfortable on when it comes to our sexual health. When we begin toe, value our bodies and value our lives, having those uncomfortable conversations becomes more and more important. But that first piece, really valuing our lives is what we have to encourage our young people to begin to dio. And I'll put it out to the other Panelists to hear. How do you encourage younger people to begin to value themselves earlier? Um, I am for background. I'm in o b g Y n on. I practiced for a long time before I came to Gilead, and I think one of the things is the misinformation about what our bodies do, how they function. And I think we need to be ableto have clear understanding from a young age. Body parts are what the correct names are, what they're there for how they function. I used to spend a lot of time with teens like and send them home with a mirror. Say, you know, go home and take a look. I want you to touch here. I want you to touch there. I want you to touch your clitoris. And I can remember having a conversation with my mother, who was a nurse trying to explain to her that a vagina was not the whole area. But it was, you know, inside the whole up inside your body. And she just like Mom. I do this for a living. But she, a health care provider, didn't have a good understanding of her own anatomy. So I think that's a place to start. Is making sure people understand what their body parts are for what they're there, how they function. What what's healthy, What's not. Okay. Yeah, The other piece to add to that is having clear conversations about what you enjoy sexually to on Ah, lot of us don't even know that because our first exposure to sex was not enjoyable or our first exposure to even conversations about sex or our body wasn't safe. It wasn't, uh, healthy um, exploration either. So getting to that space where in addition to having conversations about here, is what sexual health looks like Sexual health is also about Here is what I enjoy on so many people. I don't I know aren't comfortable having those conversations with their partners, either Of Savannah. Let me ask you a question. Why is it that we have such a difficult time talking about something that we tend to do so much of? I don't know why we really actually have that conversation. I mean, the fair, the phobia off, enjoying sex. Did that answer your question? Who should we be talking to then? If our parents aren't giving us the information? And we're learning in this and we're learning information from dubious sources, Um, who should we be talking to About sex as adults who are empowered and have information. Who who should you? Who do you talk to? I talked to a mentor, someone that I trust someone that I believe in ah, family member. To learn mawr about the after effects what comes with sex, like STDs and STS and try toe educate after I've been educate, try to educate other people of safer practices. How do we change this paradigm? What we have to do to get because this is not only hurting us with HIV is hurting us with S T. I s and STDs and pregnancies and all kinds of things that happen, people, young people aren't equipped with the information. Well, how do we change that? What do we have to do? I think health care providers are obligated when you go for a primary care visit. Part of, you know, just like we want to know how your lungs are. We want to know what your genital tract is. And I think we need to be more work put on having providers ask the appropriate questions and also provide the appropriate education around. And that's gonna be a little hard because some providers don't have the greatest education around. It is well and certainly aren't all that comfortable talking about your sex life, including the people who do this for a living like an o b g y n or you're wrong. And so I think we need a um if you're seeking care right, those questions down and then ask them out loud is one of the things you have to do with the providers not comfortable. You can challenge them on it. And then you can just like you find some shoes that fit. You find a new provider that fits. You think that providers have a difficult time in talking about the sexual health? Yeah, e don't wanna hear it. I don't want to see it. Yeah, yeah, I have two pieces that I'll add to that that yes, we need providers who can have comfortable conversations about sex. But we also need providers that look like us that look like people who are asking these crash friends who've had experiences like what? The people who are asking these questions are too. So we have to do work to diversify who are providers are especially in communities of color where we're seeing statistics like the majority of persons who are developing infections from HIV are black on who look like us. We need providers that look like us to write on, you know, ensuring that we increase the diversity and inclusion and leadership in our health settings is gonna be critical. Part of that is expanding our community health workers. So people who are living with or at risk for HIV young people, ensuring that they are integrated into health settings so that when a young person comes in, they're not necessarily having that sex conversation with someone who's in their forties or fifties. But they have any conversation with someone that looks like them so somebody could call them and say they could say, You know what? You want to talk to somebody about this? Let me get let's go outside, Talk to this pair on. We're not investing in that type of work force, but that has to change. Uh, so you want to add to that you're on mute? I know having a conversation with my doctor. I'm 100% open, and it's more us both educating each other as me being a transgender individuals. Ah, lot of doctors just don't know what to say and how they actually care for transgender individual. They feel uncomfortable. And so I go to, um, the doctor that doesn't have any phobias off my lifestyle. And I also go for reasons of someone representing my category of life as ah black woman and also active and mental health those air to you know, rate areas that we need to be covered because it's so much stress in our lives. So you and you, you and you brothers and several important issues about we look at the impact of sexual health and and access to care. You know, obviously having doctors or medical people, personnel who look like us, but necessarily, um, sometimes people look like us May not. There may be some embarrassment, some shame. And so what are some of the factors that impacts of sexual health? Besides not having someone who looks like this? What are some of the other issues that impact access to sexual health? Well, maybe if I could if I could jump in a little bit. I think there is really need to unpack what everybody has kind of, like been calling misinformation generally because I really believe that various layers to that, um, and what it took for me personally as a woman living with HIV to get to a point where I was comfortable speaking about my sexual health, it took taking off certain layers. It took, um, what I had learned, you know, earlier you mentioned the African American community. We have many sort of traditions and cultures that, um, essentially make sex a taboo. Or, um, if you add religion to that makes sex sacred when in a sense, those two situations have ended up covering up a lot of situations for for women. Andi, just generally everybody that have been very traumatic, including, um, you know, issues of abuse and other kinds of sexual trauma that happened for people in the young years. I think a lot is not talked about when certain things are secret and not open and considered taboo. That leaves room or adult open for a lot of, um, traumatic things to happen to Children that end up filtering into their ability or inability to talk about sex on. Then there is also that layer that comes with being HIV positive. I think you mentioned a stigma. You know, we usually tend to look at stigma is coming from the outside world, but there is a self stigma that would have come with a devastation off on HIV diagnosis that makes you feel worthless. That makes you feel, um, off less value than anybody else and and makes you feel like you would never be able to have a normal sexual life. And, um, they're things that happened to you. The things that happened to your body after having taken medication for over 20 years have seen my body change. I have seen, you know, um, you know, issues to do with life or dystrophy, for example, that just make you feel ugly, make you feel worthless on. But it's taken a lot. It's taken all this sort of advances in medical treatment. It's taken, I think, what Abby was trying to describe some of this community intervention that is really critical for people to come together and then pack the trauma, the self stigma before you even talk about the stigma that is outside of the community before you can fill, um yourself worth worthy to be loved again, worthy to experience love. I mean, there's certain things that have happened in um in HIV that have made it possible. You mentioned you because you we have prep that have made it possible for us to even consider the fact that we can have sex. Um, Andi made it possible for us to have certain conversations that could never happen before, So you need to consider that there's certain layers that need to be broken before people can even begin to feel free to discuss their sexual health. Um, with other people I let alone with their health care provider. Mhm. I mean, we still hear that piece about that immoral immorality around sex, right? That there is. This concept of you are immoral if you are having sex with more than one partner or you know So the question when you walk into that doctors of Office, you are walking in with yourself, stigma related to the behaviors that you are engaging in or the narratives that you've been taught on. That provider also has some of those same narratives as well. That's affecting how they interview how they ask questions. And it just it becomes really uncomfortable until you have the confidence to really advocate for yourself in that room. So we have to do a lot of breaking down exactly as Martha's saying off those stigmas so that when people walk into those rooms, it's totally comfortable. So it feels like you know, you having a conversation with a girlfriend or boyfriend or, you know, partner, it's like, Yeah, well, this is what happened last night. You know, how can you help me have these conversations with my partner about the risk that I'm engaged in or not? You know, that still is a very good points. But how do you get to that point? You're talking about the endgame you've you've You've gone through all of this And you you're at the point where you can you're empowered. Thio, address your health care provider and you have overcome the stigmas and all the other things to get to a point. How do you do that? And before you answer that question where you're thinking of it, if you have any questions, please, you can submit them were You know, if you have a chance, you still can submit questions and we'll will be submitted to us and we'll be able to ask our esteemed Panelists. But again, I'm gonna ask again. You talk about the end game, how do you get to that point? Especially if you don't have a provider or you have structural issues that prevent you from having a good relationship with provider? How do you overcome those things? You know, we often don't challenge our providers. Andi, I think as a former health care provider. I think it's a necessary thing. Savannah said. Something about she. She has providers, and then she there's some teaching of that she does so that they better understand her. And I think we have toe we have to challenge, you know, it's, you know, if you go to a grocery store and you look and see, you know, all that set out is the meat. That's bad. You say better than this in the back and that same kind of demanding. What you need to service yourself is, I think, something we have to be willing to challenge with providers, which are Wait, no, this is the problem I have and I need to talk to you about this or you know you're making a face because I had Clementi. What I need for you to do is teach me how to not have chlamydia. You know, I think it's hard for people to do, but I think we have to push back and challenge, and it makes providers have toe, learn and be less stigmatizing. I also think we have other work to do with provider organizations and education and stuff like that. But I think you know you're paying your money or your insurance company's money and Medicaid because somebody's paying the money for this person to see you. You need to get what you went there for. And also we definitely have to build a trust issue with our doctors and providers, because once you feel that you don't have a trust, you will not be open and you will not receive the care that you need to receive. And also, doctors cannot look down on their clients because I know I have some friends that are so but that participate in survival. Sex and the doctor will look down at them as if they're just a prostitute. And they have to realize the background in the history of the trains in the community that we have been rejected from our families and loved ones. And the only way that we can survive is sex, sex, work and with sex work come other things that we might have to go to the doctor regularly to cure. So uh, that's that's my point. I wanted to get across. So what do you do when you have a doctor who does not treat you well and does not respect you when you come in with your issues around sexual health. I changed doctors, E I almost feel like you know that. Will it will take a generation. It seems like they, uh, doctors, um no offense, Dr Gina. It like, you know, Well, they all seem to be just very serious and, you know, very focused on what they need to do. But one of the biggest barriers I remember when I was working in D. C and working for a community based organization, Um um, was that and this was, you know, when they were trying toe shift from a lot of, you know, sort of community based into interventions to sort of this whole third party. You know, insurance based system where a lot of people needed to start seeing doctors for interventions that there could have otherwise gotten through community based organizations. Doctors literally have five minutes if that to spend with you on in that five minutes, they are looking at a computer. They're not interested in looking at you. They will look at their computer, ask you five questions, and they're out of that room. Um, and We used to find that a lot of, um, clients used to say this was a huge barrier because one of the most important things to us as people living with HIV is that relationship with our doctors on board. It has be it zine such a huge barrier for people that we had to figure out a way as community to sort of have a stopgap Andi, figure out ways to engage people so that they didn't completely have to depend on on that five or 10 minutes with a doctor. That could be very traumatic on I think, you know, I'd be raised it. And I'll continue to support the fact that community based interventions community based organizations Andre Pierre or community health workers um, need to be equipped and empowered, um, to, um, even go a Sfar as I mean, they can't really give medical advice, but they can break some of those conversation barriers that we have, you know, in some of the community based interventions that we had, whether there were support groups or interventions that dealt with prevention of STS and things like that, that's where we could talk about sex, you know, that's where women felt free to share about. You know, this thing that they're concerned about, that that's happening to a certain part of their body or this encounter that they had that scared them. That's where we could talk about, um, sex toys. And you know what made us happy and what didn't make us happy and what happened. And Andi, through those some of those interventions, we could redirect to the point where we would say, Well, you need to be talking to a doctor about that. So I I really want to highlight the roll off community based interventions in addressing trauma and addressing stigma, and in breaking down some of these barriers that have to do with talking about sexual health because you saw the women come running. When they felt they needed to get a test, they came to the van they came to the office on. Then we would have to redirect to take them to a doctor. So the idea of getting, you know, comprehensive services that include places where people can get education. People can get support, people can have a safe place to speak, to appear or a community based health worker um is really important so that you could bridge that gap to then get them to the doctor. And so even if they do spend that five minutes with the doctor, it will be an effective intervention, because we will have spent time to be able to prepare them to be able to help them understand, and to give them the confidence to go and speak to somebody about the situation that they're facing. I have received a question here, and I want to pose it to you. Um, someone's asking for an operational definition of of sexual health. Um, so what is your operational definition of sexual health on the old get shy? Yeah. It's recognizing what makes you feel good sexually ending your anatomy. Um, being able to be comfortable in your own sexual identity. Ah, and not embarrassed, not uncomfortable with it and being free from illness, you know, um, be it infectious, be it, um, you know, other abnormalities, but and being able to advocate for yourself to allow that to happen. And I think the word abnormalities and illness, or probably the worst words I could choose for that, but and also recognizing what's normal for you. You know what's normal in your anatomy, what's normal and its function, what's normal in terms of when something feels good and when something does not feel good and being able to understand that for yourself, right? And for me, you know, so health is this complete physical, mental social well being. And it's not merrily the absence of disease, right? So for me, sexual health is all of that. It's mental, its well being. It's enjoyment. It's the physical aspect of my sexual health. Andi. Anything related to sex? Eso It's all of that. It's the complete holistic view of what health is, uh, connected to my sexual expression on by willingness to be sexually expressive is also a part of that as well. When I think about sexual health, it's much broader than just the absence of illness or presidents of illness. Okay, on bond, you know, a little bit before that is also just having the knowledge, you know, having the knowledge that empowers you to be able to know what you want and what you need. Um, you know, we talk about, um, comprehensive sexual education for young people or they lack thereof. Onda how critical that is to be able to set the stage and the foundation for you. Thio just feel empowered and just feel free and we talk about especially with HIV. We talk about these new advances, um, in treatment that enable, um people who are HIV negative to be able to protect themselves on discreetly. Now we have, ah, full package. You can use a condom. You can ask for your partner to use a condom, or you can use a condom yourself. Or you can take a pill that your condom like your condom that your partner never has to know about on protect yourself. Um, you know, we way we have to understand that we have access to these two bucks on. Yet we also have to be cognizant of the fact that they're people who do not still have access to some of these tools or do not understand that they are able to have access to them and don't have that empowerment don't have, um, full access to their rights. And that leads to things. You know, when you talk about what is this sort of full package of sexual health? You know, we were still living in an age where people can be criminalized. Um uh, for issues to do with HIV and HIV exposure and things like that because of the lack of understanding or lack of knowledge. So I think it's a full package starting from your education, your own knowledge of your body. You're feeling empowered to know what you want on bond. You're having access to the tools that help you live. A healthy Andi protected life. Thank you. There's a great definitions. Let's take a little bit of a shift we saw in the slide presentation that 360. I believe 360 people tested positive in 2018 and the District of Columbia, and that's a great number. But HIV H is a completely 100% preventable disease. So why are people still getting a becoming to be positive? And what do we need to do to get the message out about this HB In our communities, we have to start getting the message out through our churches through health care provider. Um, was advertisement, um, card games, social events, the club. We have to get the's word out there to everyone that we still can have enjoyment, but it z safer way to enjoy ourselves. I know I enjoy pleasure and lots of it. So I have to take the steps to make sure after that, two minutes is over. I'm still healthy. Mhm. Well, you know, you mentioned the data about the infections that came up in D. C. Andi, I think earlier you had talked about how, um you see that overwhelmingly, the people that are affected are the communities of color. Right on. Do you know one of the things I always like to point out is especially among women living with HIV and trans women living with HIV, you find that you know the statistics, statistics even are worse in terms of you know, nine out of 10 women that are living with HIV are black. And you wonder why. Um, but we know the answers, right? We're living in that age off just racial inequality on oppression and injustice on. So we mustn't forget that when we look at that data and when we look at a place like D. C, we're probably looking at areas that are impacted as those that are already impacted by poverty on racial injustice and, you know, just systematic stuff that goes on on. So you could, you know, educate and give prevention stuff all day long. But if you don't deal with some of the health disparities that are pervasive in those communities, uh, these things will continue to happen. So when we look at HIV prevention, that also needs to be looked at in a holistic way in terms of ensuring that you're looking at programs that also target you're educating poverty are dealing with those systematic and racial injustice and oppression, uh, to be able to get to them as the root, cause off things that predispose people to HIV and perpetuate HIV in our communities. So I also think some of it is being able to get to where people get their information and their trusted way. Yeah, and you know, how often do you see a health care provider if you're you know, once a year, maybe. Maybe unless it's episodic for a problem where they don't have the time or take the time to talk to you about sex and things like that. So I think it's being able to recognize where people get, get their information and being able to provide information and accurate information in those spaces. Accurate information about prevention are some of the approaches that could be used again. More open, uncomfortable. We get thio about these conversations around sex, sexuality and sexual health and pleasure less about. Oh, you're trying not to get this disease and more about how do you have a player and enjoy this and be healthy with it? Um, we can get better at this eso and it's that systematic piece that Martha mentioned as well, like ensuring that we are investing in housing, investing in these strategies that truly ensure that people are supported to be ableto have the choices that they want to choose because their underlying needs are taken care of. So that's one piece. But then the other thing is like I think about I grew up in the era of wrap it up by Bt, which I no longer see anywhere on. That message was so pervasive on in the same way as like wearing a seatbelt is something that continues to be pervasive message related to safety. I find that I'm not seeing messages related to HIV and HIV prevention and STD prevention in the same way as I waas years ago. And I think that has a lot to do with the change in investment. So, yes, we need you. You equal you, we need, um perhaps we need as many strategies as possible. But we cannot forget the basic messaging and communication, as Gina said in the areas where people received their information best on a regular basis about just basic prevention and about sexual health and enjoyment and all of those pieces but linked together, which I don't see enough of. Listen, when it comes to talking about sex, right? I remember the first time I heard about sex toys. I was 40. Okay, which was not so long ago. I had never heard or tried or used a sex toy ever. And I went to this workshop at a conference and the title of the workshop. Well, actually, I wasn't I didn't just go for it. I was invited. I was a Panelist on. I had been asked to go talk about prep, but there was, you know, the workshop was about self care and self love. Andi, I had no idea what I was walking into on when I walked into the other two Panelists. Oh, my gosh. I mean, I heard things about my body and parts about my body and which parts, Um, you know, that I'd never heard anywhere. And these women were giggling and laughing and sharing all these things that could make you happy Make you love yourself, you know, make you feel, um uh I didn't know why If you were preparing to go have sex with somebody, for example why you needed to have a pedicure? In my case, it was very necessary, you know? I mean, it's things like that that Look, if if if you want to talk about sex, you know, don't invite people in under the guise of talking about, you know, prevention, and so they're not gonna come. I walked into this, and I and by the way, I never been got to present. My segment ended up giving out flyers and stuff because people were just Maurin trolled in all this other stuff that was being presented. And I'll tell you, I walked out of that session with a little toy myself. And I can tell you, my life has never been the same since you know what I mean. Like you, their their women are willing to talk about their willing to hear about it. And I think it's also just kind of like the environment or the way you end up presenting it. I mean, people have tea parties over these things, and people have on. I think it's really important even as we grow older, you know? Now I understand why they said life begins at 40. Because there were just sort of things I didn't know about before that I wish I had known. Uh, but the pedicure. You never. Why did you need that? I don't understand The pedicure. You didn't understand that part. Well, let me tell you, let me put it this way. I did not know I had feelings in my toes. Oh, on That's part of sexual right? That is that sexual health. So prevention has to be linked to those messages. We can't be separating these conversations. They have to be integrated. You you can have conversations about safety as pleasure, right? Because, as Savannah said, two minutes after the after the two minutes of pleasure, what you're thinking about your body, but you know you can have pleasurable thoughts about prevention to on. We don't educate enough about that, right? So when you're laying out your rose petals around the tub, also lay out some red condoms, right? Or also layout different pieces that make it just a sexy on That is part of the enjoyment, Um, and starting to message around that. Well, we've been messaging around that, but doing that even more, I think we've We've moved away from that. Well, Abby, you're the one who taught me. Remember, you're the one who trained us on the female condom. Yes, you were. You know, you call us how to put it on beforehand and you know, a little while before you encounter, And that in itself is like a, you know, a little sexual pleasure, which we didn't know about. Andi, you know, and I tell women like, you know, you go to this boring trainings about wearing a female condom, and your training changed the way I ever looked at about female condoms and went home and tried it. So that when you're telling women, right, you know, you have to tell them. Look, it's gonna make a thumping sound But, you know, if you had worried before and you you can use it, um you know, in a way that engages pleasure, Then there's it used Tend to start looking at this prevention tools a little differently. So given we have covert 19, how this prevention look way you know, there's no longer these thes safer sex workshops and these how they get pedicures and stuff. You have things differently. I was giving a talk once about, um, safer sex in the time of Kobane. And I talked about, you know, wearing a mask level about how that can feel a little weird and someone piped up. Or that could be incredibly sexy because you could make it part of sex play. And so, I think, even before, right, Abby before co vid it's the concept that letting people be free to be creative in this intimate space. Andi record. I also think if you own your sexual health, own your sexuality, own your sexual identity, you could be a scree Ativan as you want, and the person or people that you're with, whatever they feel or think about it, that's on them. And I you know, I think raising up a generation of folks for them to understand that you know, when your your pleasure, you're talking about your pleasure. And if someone else can't deal with it, keep it moving. But the other thing I want to bring up is it. We all have mothers, fathers, grandmothers, grandfathers, aunts, uncles. Oh, they had these conversations. We have to get kicked out of the rooms for them. You know, just take yourself out of grown folks talk, right. You get a bunch of my mother and all of her sisters in a room, get yourself out of grown folks talk. Yeah, I think these conversations that still happening despite co video, um, people are having their what's up conversations and having their talks in their groups about, you know, how did you have a conversation? Well, I asked my friends like, How do you talk to your partner is about sex and they're like from the minute we start getting intimate, this is what we talk about. So we just had, like, a rich discussion on WhatsApp, and I think you know, those types of conversations are still ableto happen, even though we are in a virtual space and I've seen organizations hosting zoom conversations just like this, where they're doing the same pieces around cheek ing. They're having conversations about sex, toys and safety, they having conversations about, you know, stimulating your mind. And, you know, even though you're isolated in your apartment, where they were by yourself or not how to enjoy yourself. So I'm still seeing these conversations happening. I wish they were happening more, but I think there's a lot of opportunities through technology to continue these types of talks, especially since people are using social media to hook up men, women. They're you know, they're using social media, people are still having sex, and people are so engaging in sexual activities on especially older, um, older, respectfully, uh, men and women because I think, you know, there is this misconception and we have a lot of women pushing back on that. Ah, lot of men and women pushing back on that that you know, they're still having sex on. They still need to talk about it because, you see, um, infections arising among older, you know, people a swell. And so those are conversations that are still happening, and we had on especially interesting conversation about that as we were doing, Ah, strategic plan for organization because we discovered that ah, lot of people who are members well, actually older on that. This was a really important topic for them because you find that a lot of people start getting really depressed and lonely on trying to find means and ways and tools to be able. Thio, you know, essentially hook up and get like it. You know eso you know you. It's it's it's so important that these conversations need to take place and they need to take place in the context. Off. Safety. Yes. Um, let's let's shift the conversation for a moment as well. I think the last of our time together, um, we had some examples of opportunities for, uh, innovative partnership in collaboration When I came to D. C. 25 years. Uh, because a director of a small HBH organization, very little collaboration. Everyone kind of carved up their territory and their populations, and they kind of worked in silos. Um, things were starting to shift a little bit. How do you see that playing out in the future? And is it? A good thing is, is it going to resolve our, uh, HIV AIDS, Or how do you see this? Uh, AZM or organizations? They're working more variety of populations. I think the greater opportunity for partnership and collaboration on day one of the good things in D. C. As you saw that dramatic decrease in new infections, I think that's been because of a lot of the leadership of the health department in the district. Um, really focusing on effective collaborations from a community based partnerships. I know. D. C. Department of Health now has a project called Impact D M V, which is almost like a community health, with a model where they please pairs at different organizations who have been trained and our community leaders to engage in prevention and care conversations and to support with linkage, etcetera. Andi, that's you know, the the Department of Health sort of coordinates that model, but those persons are placed at multiple organizations. There's regional partnerships that have been coordinated by D. C. Department of Health as well, and northern Virginia and Maryland, recognizing that this region has no borders and those partnerships have threats, been thriving and growing toe prevent HIV, and then, you know D C. Department Health also has a really strong partnership with the D. C. Center for AIDS research, out of which is a partnership of multiple universities. So the research that has been supporting um, how we address the epidemic in this community is also really strong because of those partnerships. I know we are also this is like four that I'm talking about. We are also working with the Department of Health to try to get community health workers recognized as, ah, job class in D. C. And you know it's in process. But they are open to these types of innovative ways of addressing HIV. Um, I think setting up meetings I'm getting to know the Department of Health well is a way for organizations to really push the needle forward. If you have new ideas, I think they're open to it. And that is a big and important piece in addressing the epidemic here in D. C. Now I think that it's important I have ah, variety off organizations come together as one, and especially if they specialize that LGBT Cube services. We have to make sure that it's a representative from every community that's worked there color wise, Um, transgender individuals are are being used just by name and receiving funding, and none of the money is spent on us that's important back to that. People just include that in grants and say that they support the transgender community. But they really don't support the transgender community because number one, they don't understand the transgender community because you are making decisions for me. Where is I? Can I can make decisions for myself as a transgender woman? So that's very important that we have to help in house representation. Mm, Anyone else? I also I think having make sure that we also have organizations that for serving the community in the way the community wants or needs to be served. There's, um, Ah health care facility called the Young Men's Clinic in New York, where I live. And it is a young men's clinic in the middle of a black and Latin X neighborhood, and it pulls in people from the Bronx and parts of Harlem. And but as a young men's clinic, it allows men and males from teenagers. They end up seeing people up to the age 30 to come and get health care to deal with sexual health to without having to be identified as they may or may not want to be identified as a man who has sex with men. Although they may be a man who has sex with man, they may not have come to the realization that that's their preference. Or there may be a man who has sex with men and men have sex with women, but they come to a place and get their healthcare in a place that doesn't label them in a way that might be uncomfortable in the communities in which they live. Um, and so I think having organizations that serve people the way they need to be served is kind of my point. The way they want to be served are most comfortable. Being served is kind of my point as well. It's if you are a person who's of an community and you're comfortable doing that, you need to have services where you can go get services and information in a place where you're not gonna be made to feel uncomfortable. If the place where you're not necessarily gonna be comfortable, you need to know that you can get all of this information someplace else. And communities have toe work together Thio to see that the different needs of different parts of the community are being met. I think also some of the status neutral interventions. Before, it was very, very silent. We had, you know, interventions for people living with HIV on dyuh. Yet there were people in the community, um, that we're facing, you know, many similar barriers. And we're, you know, we would literally were waiting for them to become HIV positive. Um, and so the I think this is sort of latest interventions, and you know where prevention and care services and status neutral interventions have. Bean, uh, are going to go a long way, um, in dealing with some of the stigma on issues around because, you know, when you have people in the same place, it will be easier to address that. You know, both prevention on care issues. Um, I am in a Sarah discordant marriage. Andi, that's been happening for 13 years. Um, but it was It was difficult to navigate in the sense that I had all these services and support, but there were no real services and support for the person that was HIV negative. Andi, that's critical eso even in in the advent off you because you and prep it has become so important for people living with HIV to openly have this opportunity that they can have relationship with whoever and whoever they want. You know, um, you know, forest long as they understand this science. And it's so critical for us to share this because it brings a certain level of freedom on empowerment to people living with HIV to be able to believe they can be in relationships with with people that you know who love them for who they are and not have to compromise. Um, because they believe they are blessed value because they're living with HIV, stuff like that. So it's really important in the shifts that have taken place and breaking down some of these silos and some of these stigma. There's still a lot of work to be done, but I think you know you because you and prep has bean and should be a game changer for people living with HIV in terms of the way they can have relationships. Excellent. Excellent. I have I have one. I'm gonna ask two questions. I know we're pressed the time I'm gonna ask one quick questions. So one of the audience, once Abby and Martha, to give the links to the self love and and self love sites and tools mentioned Is that possible? The those are workshops. We will just alert you when they're happening. Um, those air workshops that we hold for i C w for for for women living with HIV. So we just, you know, watch a space watch Facebook and we haven't had one virtually though eso That's one of the things that we haven't been able to do virtually. But we should probably think about doing that soon because, as we're saying, it's it's possible to do it in a virtuous It might not be as fun, but I think, um, you know, watch this space, Yeah, yeah, and I haven't done those trainings in a long time, but I do train on checking as well as different types of tools that I'm totally open to partnering with Martha to offer that community wide if needed. That's an excellent idea. I think that is needed. So I want to give everyone the opportunity to make one closing statement before we go to our virtual, I guess Happy hour or whatever We how we call it. Um So start with Martha. Let's let's go around In this bank of final statement about sexual health, we had a lot of the conversation about sexual health. HIV prevention. What do you what? Do what do you wanna leave those on on this zone called with? Um, I just want to say, you know, it was It's been a long journey, but I really do believe that your sexual health has to start with you eliminating yourself stigma on loving yourself. Um, even with all the bumps and bruises that you've come along with, just believing that you can love again and you can be happy. And I think that's really, really important that, you know, um, just work towards, um, loving yourself before you can share on love with other people. I think it's really, really important. And I'm speaking from that perspective of being a person living with HIV that has had to deal with a lot of self stigma. Onda lot of issues around my self image and self worth. Love yourself, love yourself. And that opens the door to just so many possibilities. Mhm. Very encouraging words. Thank you. Yes. Who's next? Roll? Sit down before now everyone's freezes up. Come on, Savannah. I want to make I want to emphasize what Martha say love within dolls with healthy sex because healthier body and education and for the youth to listen to the older individuals so that they won't have to experience what I'm going through. But when I was a teenager, I've never, never listened. And I always say on Lee I would have lessons. But this is my life, and I'm living it and living it Travis lately. So thank you, Lord, for everything. Yeah, for me. Education and pleasure going to happy. Well, no, my I'm sticking. Sorry, I'm done. So I was saying, Oh, I was going to say that at the individual. Like for the parent who is uncomfortable having conversations with their child about sex and sexual health, I encourage you to do as much reading. And if reading is a challenge, talk to someone else. Talk to a friend, talk to someone else about how can you start having these conversations? Because I have too many friends who never had conversations about sex until they were in college because their parents were uncomfortable that we cannot allow that to continue. If you're not comfortable, find someone else, trust toe, have those conversations with and at the systemic level. We have to do better at integrating people with lived experience in prevention on care to ensure that people are having conversations with people who they could trust because they speak like them or look like them or are from the same neighborhood as them. Or know how hard it is to take the bus, uh, from one part of town to the other part of town so that they understand the barriers that people are facing toe. Being safe on can have real conversations about those challenges related to sex and talking about sex and then our doctors. We know that people are more like plea to stand care and engage in care when they are working with people who look like them. As much as we can invest in ensuring that we are supporting people that look like us into careers in medicine and in the health systems, we will only create a system that's better for HIV on sexual health. Um, and sexual health. Pleasure is a right. It's not a privilege, it's not an embarrassment. And it's not something you should be uncomfortable about. Owning on git is something you should take charge of for your own life. Thank you very much with for extraordinary women who have living extraordinary lives. And I thank you for sharing your wisdom and your experiences with us all. We're all better. We're edified because of what your things you've said. And I have the opportunity to give it called action because it's stuff we need still need to be done. And so let's start talking to those we care about. Bet. Start talking to our health care providers. Let's stop. Let's start talking with about HIV. You know, we don't talk about HIV very much because Kobe, 19, is kind of taking over the press. But we still have HIV. We need to continue to have that conversation and remind people that they're still a pen, an epidemic around. And the question is, how can we empower all individuals to start talking about their sexual health? Thank you very much, Earl. I want to thank you. And on behalf of Gilead Sciences. I'd really like to thank everyone who participated in today's program, both the speakers but people who are very active chat box. I want to thank Earl in particular for serving as a moderator and all of our Panelists Martha, Abby and Savannah. I'd also like to remind the attendees that you'll be receiving a short follow up survey by email, and please take a few minutes to send us your feedback on the program. Your opinions are really important us, and it's really part of how we make improvements and really deliver what the community needs. And finally, we know that it's gonna take more than medicine and this, this really end this epidemic of HIV and really it's our united efforts. You've heard lots of what these efforts are. One of the suggestions for efforts, um, for us to have a chance to realize our shared aspiration of ending the epidemic when at this point we welcome anyone to join us in the networking breakouts by clicking the button below your screen and you'll be sent to a networking room. Thanks. And for your time this afternoon, this evening yeah, Created by
