Chapters Transcript Video LET’S TALK ABOUT SEX: SEXUAL HEALTH AND HIV - HOUSTON LET’S TALK ABOUT SEX: SEXUAL HEALTH AND HIV Originally Broadcast: October 1, 2020 | 3:00pm – 4:30pm CDT Yeah, Hello and welcome. I am Christopher Chauncey Watson, a senior product manager, Gilead Sciences. And on behalf of Juliet, we would like to welcome you to tonight's program, which is a community speakers program entitled Let's Talk About Sex Health and HIV Prevention. These programs are designed to create an opportunity for really a conversation for us to really understand. How do we begin to talk about sex and sexual health as well as HR Prevention really in these communities that are most vulnerable to HIV? Uh, Latin X transgender as well as African Americans, particularly those in the regional South. And so tonight's conversation will really focus us on the novel partnerships that are happening within the Southern US and really focus on the role that historically black colleges and universities can play in addressing the end to the epidemic as a product. An alum of an HBCU. I know the importance that HBC use play in the communities of black folks, as well as understanding that HBC use are the root of the black community. And so we follow you, too. We invite you tonight to really have a conversation after a short presentation to participate with us in a panel discussion. Where will really begin to uncover ways that we can have sexual health conversations within these communities in forge partnerships to help us in the epidemic. So tonight I am excited. Toe have a great deal of Panelists ranging from Texas to North Carolina, as well as after our robust discussion. We'll have an opportunity to invite you to come into a networking breakout session were in these virtual worlds. So it allows us an opportunity to meet with some people we may not know and meet with the representative of Gilead Sciences, our community liaisons who cover the Southern U. S. And now, without further ado, I would like to turn over things to Dr Beth Sheba Johnson, who is a senior director in HIV field director for the Medical Science HIV Prevention team here at Gilead Sciences. Bathsheba, I turn it over to you. Thank you so much to be Dr Watson. I really appreciate that. I'd like to remind everyone there is a button below your screen that you can press in order. Thio, ask a question. I'd like to begin our session by introducing our moderator and Panelists today on this program, but I was missing that Salt and Pepa song. Let's talk about sex, but that's all right. We'll move on from there. So our moderator is Mr Joey Correra, who is a well known Houston journalists and influencer who is an advocate for LGBT Q rights. He is a music critic for the Houston Chronicle and covers various aspects of pop culture, including the local drag races and my favorite, RuPaul's drag race and Houston's L G B T Q Community. He has been named multiple times by a journalist of the year by both Outsmart magazine and the Face Awards. Now let's begin with introducing the Panelist. So for our panel today we have the lovely Tanya Bass, one of my sorority sisters, who is the founder of Southern Sexologist, where services include training and consultation on health related topics. She is a sexuality educator and a subject matter expert in the areas of health, equity and sexual health. Now let's move to this lovely young lady, Jalen or LeDuff, who is a program manager at AIDS United, an organization that seeks to end the HIV epidemic in the United States. Miss LeDuff is an emerging leader in the LGBT Q I plus community who is an educator, advocate and leader for black trans women and, last but not least, my old friend Venting Hill Jones, who is the CEO and founder of Southern Black Policy and Advocacy Network, which sets out to improve health, social and economic disparities impacting black communities living in the southern United States. He previously led the implementation of empowerment and in HIV prevention and intervention funded by the Centers of Disease Control and Prevention. So now let me turn it over to our moderator, Joey Gurira. Thank you. Receive a thank you, everyone for being here. I'm very excited to be part of this. And before we get into our panel discussion, which I know is what a lot of you are looking forward to, we are gonna look at some of the current stats in Texas regarding HIV, Um, current, based on 2018 data, there are more than 94,000 people living with HIV diagnosis. Almost 5000 people received an HIV diagnosis and almost 2000 people received an AIDS diagnosis. Among those people, more than 3/4 of the people living with HIV are men, and in that number they are. The highest burden is on black men who have sex with men. Um, and then trans people in the South where the largest percentage of new HIV cases breaking it down. We're gonna look at Houston in Dallas, first at Houston, More than half of newly diagnosed cases in Houston were young people. That is, people 25 to 44 years old and then looking at some of these other numbers. Black women were more than 18 times is likely than white women to be living with HIV. Black men were almost five times as likely than white men to be living with HIV. Latin women were more than three times as likely than white women to be living with HIV and Latin X men were almost two times more likely than white men to be living with HIV. Now that was Houston. We're gonna move on to Dallas, where 63% of new HIV diagnosis were in persons under the age of 35 years old. That's important to remember, um, in terms in terms of HIV prevalence rates. Black women were more than 13 times more likely than white women to be living with HIV black men more than two times more likely than white men to be living with HIV. Latin X women were almost three times more likely than white women to be living with HIV and Latin X men were almost one times more likely than white men to be living with HIV. And now HIV and AIDS in Houston is increasingly becoming an epidemic, which impacts people living in poverty, people of color communities facing multiple forms of discrimination. And then the access to healthcare breaks down really strikingly along racial lines. Compared to white people, blacks are twice as likely to be uninsured, while Latin X people are four times as likely to be uninsured. Those air big disparities right there in Texas in 2017 about one in four diagnosed persons were not getting medical care for their HIV diagnosis. And then, from 2016 to 2017 of the people living with HIV in Texas, 20% received a late diagnosis. Now we're gonna look at health disparities, um, throughout Texas, communities of color face long, longstanding disparities in health and health care. 15%. Those who report having little or no choice in terms of where to seek healthcare breaks down again along racial lines, 15% whites, 22% blacks and almost 30% Latin X and people of color are disproportionately represented in health professional areas. They represent less than they represent mawr than 25% of the total population. But on Lee, 10% of health professionals now hbc use conserve as a resource to address health care, workforce shortages and growing needs for a divorce. Divers Health workforce Now the roles, like we said of HBCU in the black community, are very, very important. They are rooted in faith, community and service. They were established prior to 1964 with the principal mission. Of course, of educating black Americans, black churches have also long been pillars of the black community, and HBCU s have long been incubators for research and development. They represent less than 2% less than 3%. I'm sorry of colleges and universities, but produce 23% of all black graduates. They educate 40% of black health care professionals and 70% of black physicians and dentists earned degrees at HBC use. Now we're gonna look at two examples of partnerships making impacts in these cities and HIV Houston with Ford Foundation and AIDS United and Dallas County with Fast Track City. Those were just examples, uh, in terms of HIV prevention plan in Texas. Here are some of the things that we're using to eliminate HIV transmission and reduce HIV related deaths. They are increased HIV awareness, increased access to prevention, diagnosis, HIV infections, increase participation and systems of treatment and, of course, increase viral suppression among people living with HIV. Now, today, we're gonna talk about sexual health and health care, HIV, of course, and partnerships in the community. Um, so what are some of the factors that can impact sexual health and access to care, employment situation, socioeconomic status, geographic location, relationship, status and partner and then, of course, race and ethnicity. Now, when we talk about sexual health and health care, what might be the impact of reduce stigma, greater willingness to get tested, more inclined to enter into and stay in care, more social support for people living with HIV, improved quality of life? These were just a few of the examples sexual health and HIV. Everyone has an HIV status, so everyone falls on the HIV status, neutral care continuum and status neutral incorporates people living with HIV and those at risk regardless of their status, and engages them to move toward a desired income. So whether it's to the left side, which is prevention, or to the right, which is suppression and some of the things that can influence this continuum misogyny, racism, transphobia, poverty, violence, stigma, homelessness, um, they can influence these things even before an HIV diagnosis is made. Now, in closing, we want to talk about what is undetectable equals un transmittable. According to the Department of Health and Human Services, people living with HIV who take 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 we are going to get into our panel discussion with our Panelists, and we're going to start off with a few questions for each member. Um, so let's start up with how do we overcome our discomfort around having these conversations? And I'm gonna ask Kanye that question, right? Thank you so much for asking, um, what the way I think about how we can overcome our discomfort and having conversations around sex and HIV is really taking an intergenerational approach where we can have conversations for multiple generations and really learn to make it a part of everyday conversation. So for me and thinking about it as a sexuality educator, sex is life. Sex is health. And so these are life long discussions that we need to have these air life skills that people, um, starting early in age, need thio understand and know, including utilizing language. So I think it's about being able to have conversations just like we would about bathing and hygiene, eating and diet exercise. Like all the things that we talk about to take care of ourselves and have the best and healthy life that we can. That's the approach that we need to take with sexuality. And in that I'll offer to be a little bit uncomfortable with being uncomfortable or get comfortable being uncomfortable and that, um, it's about privacy. But it's also about shame. And if we can remove the shame, we can maintain the privacy but still have conversations that help us, Um, as we go through our development and growth, absolutely making these everyday conversations like others that we already have? Absolutely. Yeah, now. Jade, how do our community support or not support these types of conversations? Well, thank you for asking that question. It's It's very interesting when you think about community and when you think about how community support and or don't support or lack support for the conversations that we're talking about. Um, I grew up in New Orleans, Louisiana so deep in the South, Uh, and there's so many things that traditionally we just don't talk about, um in sex was one of those things. Um, so one of the the other dynamics when you think about communities that are, um, perceived to be different in black community um that is also another dynamic that that somewhat separates the specifically T G and C folk from the overall community in general. And it's an unfortunate reality. However, there's so many things that are transpiring that are taking place currently to essentially shift the paradigm of how people, um, in the black community perceive, um, people who from some people's perspective, our, uh, education may be different. Um, which is okay, so I think it's it's a twofold answer to that question. There are support their support in some ways, and there's a lack of support and others. Right, Um, now that Sheba had you had an opportunity to mentor others who are having difficulty talking about sexual health in these types of things. Thank you, Joey. I have had lots of experience mentoring others not only other health care providers, but community advocates. Azaz well, as's friends and family, and that included my 70 year old mother. But the way most health care providers, that's the aspect that I'll speak. Thio aren't taught adequately enough on how to do a sexual history. There are a little worried about offending their patients. So in a study that really looked at medical students, residents and fellows, they found out that they're very uncomfortable talking Thio the LGBT Q Community on sexual health due to that lack of experience. But even in my own experience, heterosexual health care providers are also uncomfortable talking toe heterosexual patients. And so, if I were to begin a conversation like this, I would start with leaving your bias at the door because it's not about you. It's about your patient. It's about do no harm. And if you're engaging a student and an HBCU really start initiating those conversations in the non emergent arena. So they're coming in for a vaccine. That's when you check in with them how you do and how you know what's going on. Last time I talked to you, you were so and so now you know what's happening. And so that's important and really preface it. Like I tell healthcare providers use the c d CS five piece. Tell them you're going to talk about some very personal things, like we're going to talk about partners, practice protection from S T eyes, pregnancy. We're also going to talk about pleasure. Some people believe that out of the question and we need to talk about that. I know. So are you are listening to that, But we need to know in this day of erectile dysfunction and vaginal dryness that we need to know and we want to talk about instead of having sex with men. Women in both. Let's talk about what body parts do you use engage in sex that will give you a clear picture of really what you want to dio and look at them when you're talking, not at the laptop, but at them look for cues and clues on discomfort and what you should need to know, because you want them to look at you as if you're interested in them. And that's my answer to that. Thank you absolutely. Now does anyone would anyone else like to add comment to anything that's been said so far? I would like to add that it's so important and it's so critical. I'm so glad vest Cuba that you mentioned how we talk about bodies when we are talking about sex that is one of the most critical components. And speaking from the lens of ah, woman of trans experience, it's so important to make people feel comfortable with talking about their body. Um, and I think shifting that dynamic where we talk about body parts and not necessarily, um, we're talking about who you're having sex with as their gender, it that's so critical to creating a comfortable environment. Thio even have the conversations in general. So I just wanted to amplify that and elevate that, uh, that that's that's one critical component about this whole dynamic. Absolutely. And now bitten what air? Some of the factors that can impact sexual help and access to care. Thank you, Joy. And there are few I'd like to to mention on the call today. And just considerations as we look at, um, navigating the conversation isn't just easy to just go. Go have the conversation. And so one economic situation. Not everybody has the ability to leave their jobs for a doctor's appointment. Um, much less several doctors appointments. So when we're talking about this comprehensive care, um, you know that that includes physical health that includes mental health that includes other providers. So making sure that from unemployment situation that they're allowed to have that time to be able to, um, Thio access and and and and take part in that care another social economic status. So again, as I talk about multiple visits, we have to talk about copays. We have to talk about care plans that sometimes may include more expensive foods, um, equipment, tools and and being able to have the resource is to be able Thio take advantage of those care plans and then also last is medication. So again, a conversation about medication and the ability to pay for medications that may be needed that that that maybe access in in care and then, of course, relationship status and and partners. Can you have a comfortable conversation is best, Eva said. With your provider, if you are a member of the LGBT community, there was actually researched, um, that was released that continues to show how providers still are uncomfortable, um, talking with patients about sexual health, especially if it does not align with their practice or does not align with their religious beliefs. So it's very important to be able to really understand, um, not only how that is a barrier in the context of health care, but also in our homes to and the ability to have conversations about sexual health. And what does that mean for anyone at any age and at any income level? Now, when we talk about sexual health and health care, I wanna ask Jade, how do we start to talk about sexual health with our health care providers? How do we start that conversation? Yeah, um, that's a great question. Um, and I think one of the most important concepts when you think about having conversations about sex is the trust trust dynamic. Um, one of the things air speaking from my own personal experience. One of the things that was so critical for me when I when I went on this journey of finding a health care provider, was to locate someone that seemed that I could trust. Um and toe have the conversation with ah person, let alone about sex. But just in about my own body and about, um, you know, other dynamics, uh, related to my personal health. Um, it's so important to trust the health care provider. Um, and there are several dynamics that established trust. I'm going into a health care provider and you see, um, culturally humble material. You see comprehensive paperwork to complete. You see someone that looks like you, that works there, those air also, many s o many critical things toe even getting to the conversation about sex. So trust, um yet again is is such a n'importe dynamic and an important thing to to elevate into this, um, to this conversation and from my own personal experience, the conversation that I had with with my health care provider. Um, it e went through several. Let's say that I definitely went through several health care providers until I was able to locate one that made me feel comfortable and that, um, made me feel that I could trust them enough to share, um, personal things related to my sexual health and, um, how I engage with with partners or what have you. So I think again, I know I say trust a lot, but it's so important that we establish trust toe have these conversations. Now I wanna ask Bathsheba, how do we find a provider who's comfortable, who makes us comfortable talking about our sexual health? I think there are resource is out there, joy and to the audience that help identify people that are LGBT Q friendly. But even for heterosexuals, it's difficult to find a provider that is comfortable with these sexual conversations. And if we really focus this back to the HBC use, it might even be more difficult because if you're using the student Health Center, you may not have anyone that looks like you represents what you stand for and how you feel. So I think that's a problem. And I was discussing with Chauncey invention. You know, I've tried at several HBC use here in Texas to get in to talk to the medical providers about HIV prevention, and I met a brick wall. No one was willing to speak with me about what's going on. The one school that I did get into was Grambling, and there were health insurance issues for their students, making it really impossible to access care. So it's about shopping around. It's about word of mouth. If you know someone who has a good health care provider, try and get in with them. But unfortunately we have to go back toe educating our providers on how to be comfortable and doing sexual histories with someone. As Vint. Ince's does not align with your own sexuality, right, and we touched on this already with these answers. But forbidden. I wanna ask, What role does stigma play and inhibiting open conversations about sexual health? Well, it's been mentioned several times around conversations about shame, about about trust and and it's really opening, um, providers and those in your your circle of influence and support around, um, sexual health. So that can include conversations that are stigmatized. So not only talking about issues that that impact LGBT individuals, but as best, Shiva said. This conversation that's navigating various sexual appetites. And what does that mean to be able to have conversations that fit for each of them were not just having kind of conversations about like like, you know, for lack of better words like missionary sex? We're talking about sex that exists in many different ways. Shapes, forms, um, positions and all that. And so, um, you know, from the from the conversation around stigma, how can you make sure that those conversations they're having a nonjudgmental way in a way that that advances sexual health in a way that allows conversations around harm reduction to take place and speaking with somebody in a way that meets them where they are in that conversation and stigma plays a very important role in people being able to to really have, um, the ability thio to be empowered toe have those, you know, courageous conversations with providers about the health that that they need in order to achieve the quality of life that they desire. Absolutely see these air such great points. Does anybody have something they'd like to add to this part of the conversation? I love that jade invented or so on point, with their answers to these questions. It's amazing on I hope the audience is like on this soaking it all in. I hope the audience is also Oh, sorry, Jade. Just thinking about, um, it's a two way partnership in that there's a comfort level for providers. And then there's a comfort level for patients and people seeking care. And we just have to meet each other in the middle and understand we're gonna work through this and have, um I love that you offered event and as a courageous conversation to say, we're going to talk about these things and I wanna be able, going, um, circling back to you j toe have this trust relationship with you so that I could be vulnerable and disclose what I need to disclose and in transparency. You answer and share information as my provider as best you can, and we'll work through it together. Yeah, yes, absolutely. One thing that I wanted to note, um, and I'm so glad that you said it. Telling it is that the provide a relationship with the client or the patient is so critical on guy wanted toe offer up something that is common for T GNC folk When T G and C. Uh, individuals go to the doctor. They want to be a patient. They don't necessarily want to be an educator. They don't necessarily want to be an advocate. They don't necessarily want to be a spokesperson for community in that moment, speaking from my own personal experience, that sometimes is a barrier for people to access healthcare because the conversation is more around someone wanting toe understand different dynamics that may not be related to my visit. So I think it's important, Thio understand, and it's important to amplify that, um, people are accessing these resource is for specific reasons, and it's important that, um, that those reasons are elevated and those reasons are respected. Um, in the in the moment, absolutely way. When we talk about HIV in this conversation, I wanna ask Tanya, how do those in the communities you speak to think about HIV prevention? So I have the privilege to actually work in multiple communities working at an HBCU in North Carolina as well as working in various communities throughout the state. And what I'm finding is that sometimes, uh, community members based on their on social identities or somewhat feel removed And by that I mean that when I'm in workshops and doing community education with older African American women, their heart and their concern is actually not even for themselves. They're more concerned about HIV prevention for younger people. And then when I'm talking to younger folks and whether their college age or high school, I feel like their concern not necessarily because of this invincibility, but almost because, you know, HIV has been a while for from a while they haven't known the world without it, so they don't necessarily see it as something that could impact them. And that it might be, um, they are removed based on their age as well. So it's been, um, challenging Thio here the conversations and try to get everyone to see that it's important for you, no matter your age or any other social identities, that HIV is a real thing, and that we want Teoh be able to protect ourselves as much as we can. And then we want to be ableto love and support those who might be living with HIV, Um, and then in the faith community that I sometimes work with. I think it's still a split as well. And and the idea that monogamy, um, is the is the way to protection etcetera like there are so many misconceptions. But I am hopeful and grateful that a lot of faith communities have still been keeping conversations about sex and HIV prevention and care at the forefront. Now for J. I wanna ask you, how can we begin to think more broadly about HIV prevention as a whole? List practice, I think one of the most important things thio, um, to think about, um whenever we're talking about HIV prevention, it's about the whole person. It's not just about preventing HIV, so going into HIV prevention with the idea that we need to focus on that person in their entirety is so very important. Um, there are so many dynamics as we as, uh, several individuals have mentioned on this panel earlier. Um, social, I believe, was mentioned earlier. A social determinants that impact people's ability to do a lot of different things, especially accessing healthcare. Um uh, accessing, uh, ample employment accessing resource is related. Thio food, security, all of these different dynamics. So it's so important to see the whole person when we're having these conversations about HIV prevention on. We're having these conversations conversations about different communities that essentially are being impacted in so many different ways. So seeing the whole person understanding the whole person, creating space for someone to show up as their whole self and, uh, creating space for someone to show up as their whole self one more time creating space for someone to show up as their whole self, uh, can do so much good in the world in general, especially as we have conversations about prevention. Absolutely Now we touched on the status neutral approach a little in the slide presentation. But I'd like to ask Bathsheba, How can the status neutral approach to HIV expand how we think about HIV prevention? Great question. You did such a fabulous job introducing the topic to the audience, but I'm of that age that I was was around decades ago, when HIV treatment and prevention were totally separate entities, HIV treatment was done in an HIV clinic or HIV prevention was condom distribution done in community based organizations or AIDS service organizations. We realized over time that was not working, and so people decided it should be a continuum, so New York City, said, Hey, let's make a new approach. And so they really reoriented HIV related services using that status neutral, continue philosophy that you mentioned earlier Joey and it's really bi directional framework. That means all people, regardless of their HIV status, are treated the same way. It all begins with offering that HIV test, which is paramount. The CDC says 13 to 65. The task force talks about 15 to 65. I'm not gonna go into why we cutting it off when it gets to my people my age because we still have a heartbeat. But anyway, as a result of this, if you have any test results, it's positive or negative. You'll send that patient to either side of this continuum, So if a patient test positive they will be sent into treatment for further engagement and it's continuous treatment. Whereas they go and they have a negative test, then they go into the other side, the left side of the continuum, and they stay engaged every time they have a negative test and hopefully we can reach the same goal, which is having a none detectable viral load and no transmission toe. Other people. And so this is really the importance of really expanding. Where we are is starting with that HIV test in the continuum. Now I'd like to ask Vitton how do we sort of address the stigma around HIV in the community, which is still so prevalent in so many ways? Well, when we when we're looking at solutions for ending HIV, particularly removing stigma and discrimination out of communities, we have to be clear of the power of stigma and and how it's still impacts, um, people's desire to to be able to be open and share. So hopefully we've seen from the current political environment the power of just a rumor and and saying that enough times for that rumor to become someone's truth. So when we talk about and put this in the context of of HIV, the fear alone that someone has to navigate around what if someone knows that I'm gay? What if someone knows that I am HIV positive? What if and that that power of that conversation kind of playing in your ears, you know, over and over again. And so that that is stigma and that how it how it it still continues to manifest. So when we when we talk about solutions to ending stigma, we have to address those those points that creates. That creates high levels of anxiety and fear and paralyzing fear that still have individuals hiding medication, not being able to, you know, as as doctors and other providers say, If you wanna, you know, take your medication and they put it in a place that you can see it. Some people may not have that privilege because the fear of someone finding out that they need, whether it be medications or prep it's still enough for for those things to manifest and the reality that people are still facing a zit relates thio HIV and and and how it is received in in in communities. And so we have, um, efforts like U equals you. We have to understand that conversations around U equals you started around changing the hearts and minds of scientists and researchers to just be comfortable and saying If a person is undetectable, um, their ability to transmit HIV is zero and and being able to to not say it's a it's a little bit, it's almost effective. It's just about effective it's zero and and getting those individuals to say that now we have the important work of shifting that conversation to community, which is not. It's not gonna be enough to say the medication works, because we know that, um, if you take HIV medication, it will. It will eliminate your chances of of acquiring HIV. But we also know that if you take your medicine for your diabetes or if you take your medicine for your blood pressure, you know all of these different things that communities are still navigating. So why do we expect HIV toe have that special place when we are still navigating? Um, conversations around wellness for communities? And what does that need to look like? So tying It's gonna be imperative that when we're talking about stigma and we are addressing stigma and HIV that were pulling in those conversations into our narratives of reports and plans and different strategies to thio end HIV and making sure that those things are known and we don't just use stigma, community engagement. Black lives matter as thes thes buzzwords that they're really behind concrete action and concrete plans and solutions for ending the HIV epidemic. Now I'd like to ask everyone on the panel and whoever would like to answer how do we start to talk about sexual health with our partners and those we look because I know this is something that probably everyone has asked themselves. At some point, I think I'll just jump in when I had the opportunity again the perspective of my own individual perspective and that of the sexuality educator, I often talk to folks about the before the pants come off before the lights go off. Like really having conversations about what you like and what you want to dio and what brings you pleasure. So I love of course, uh, Bathsheba that you talk about that. But we could have conversations around pleasure with our Children. Like I really like ice cream. Y'all and ice cream takes good. It makes me feel good. And I literally could eat it every day. It makes me happy. And when we can be able to have conversations about what makes us happy, what makes us feel good? We can normalize that once again, using that inward of normalized. Then we can have conversations with our partners about what makes me happy. what makes me feel good. What am I really willing to try? What makes you happy? Maybe we'll write down a list of things that you know are definite things that make us happy. Ah, middle line of some things I'm willing to try if you are. And then some. No girls, like maybe these air some dale breakers that I'm not ready yet. Um, or some things that are completely off the table. And so having those kind of conversations will allow us to make talking about sex and sexuality so easy. And if we release people from our own bondage, our own thoughts around what is supposed to be normal, what what different means and all of that. I think if we just normalize being different, we can have those conversations. I so love that normalizing it. And that's really talking with parents and educating their Children, which ah lot of us are uncomfortable doing. But we have to educate the parents to educate Children about what feels good and what doesn't to give them that power and also empowered them with their pediatricians. Um, having you step out of the room so that they can engage with their health care provider and talk about body parts and what feels good and and what's normal for them is important. I did that with my son when he was that age. I would leave the room, and I'm like you talked to him about everything. And if you need me to come back in, I will. But we have to you as adults empower our Children with that knowledge before they could be whole. And I think that goes a long way. I think so. Or where you were on point. Absolutely. And I mean, as a as a dad. I know that all these thoughts and ideas like I've been through my head, You know where to go with these conversations? Um, now I'd like to shift a little bit, too. Partnerships and collaborations among policy members and community leaders. And I'd like to ask Jane what air the services you think are most needed in communities that have been severely impacted by HIV. So, in hearing you asked that question, um, uh, several things come to mind on, I would be remiss if I did not mention, um, that as someone who identifies as a woman of trans experience, who is also black. The first dynamic or the first thing that is of great concern for me is my safety. And is the ability for me to exist in my community? Um, both the T GNC community, the LGBT community, the black community as a person who is seen as human. And I think that before I can even talk about, um, the different types of services and the different dynamics of things that I as an individual, may need one of the things that the most one of the most impactful services that is needed for T Genc folk, specifically women of trans experience, specifically black trans women. Our protections in place for people to be people off course. There are so many services that are necessary to maintain someone's health. And when you add the layer of being impacted by HIV and severely impacted by HIV, those services become that much more critical. So we're talking about care services linkage to care we're talking about, um, you know, the the essential services that are provided. Um, Orel care, dental care. I mentioned earlier food insecurity. Um, ample employment opportunity. There's so many different services that are critical to someone's existence. And the one thing that I wanted to be sure and amplify into this conversation is the critical, critical, critical state that we're in where we need to ensure that black women black trans women have protections in place to even be able to access the services that are necessary and needed. Okay, Absolutely. Um, Kanye, I'd love to ask you about the impact of social determinants of help on the risks of people living with HIV falling out of care. Okay, Right. Um, one of the things that I was listening to Jade and I wanted to say to you. And now I get the chance when you said you just have to keep mentioning trust and I c trust as a social determinants of health. Um, it's going to determine how you access when you access and where you access. And even if you access any type of health care services, So as I think about where we live, where we play, pray and work, all those things are gonna impact our ability to navigate taking care of ourselves and our bodies. And we're in the housing crisis. Like when we think about um what Vincent, you offered Theobald bility and the privilege to store medication. Well, we are facing challenges with housing, and so we know that that is a privilege. And so when we're having Thio really talk about the determinants of health care not on Lee, for persons living with HIV, but for the world, for many marginalized populations and we compare that down. But if you shake it all out, we know exactly who's gonna be impacted the most. We've already even seen this statistics in the disparity. So I think if we address those things and not get caught up in using terminology such as, um, non adherent or non compliant, but really dig deeds to what my options are, maybe my I don't have that storage. I have a story situation. Or maybe my priorities are I really need to keep my lights on. So traveling to the clinic or spending money here like we have to make way toe understand the why behind perhaps the behavior that providers might see as being non compliant or not congruent with someone who says that they want Thio obtain the maximum health, But dig into the UAE and I'll add to that we have systems in place that assess folks for different determinants of health and human like abuse, etcetera. Here's my challenge to providers and health care systems. Don't just ask the questions, because now you have answers that you do nothing with. So what other other other resource is and, um, services that you can provide to ensure that people maintain or the best health that they can, um, in their medical care. Now, I know that everything we're talking about is, uh, I'm sure inciting a lot of questions in our audience. So I want to remind people to please submit questions for our Panelists, which we will answer after the discussion. I have another question, actually, for you, Tanya, about the role of historically black colleges and universities in the African American community. And if you would speak to that, yes, Now that's my heart right there. So I am a double eagle from North Carolina Central University in Durham, North Carolina, and our HBCU was actually the first toe actually create a peer education program on campus. So when we think about HBCU s, I believe there's about 100 and one or so Alabama has the most, um, followed, I think maybe Georgia and then, um here in North Carolina and North Carolina. Actually, Population Wise has the highest number of enrolled students in HBCU, so we're a great place to model on dicey Aggie pride in the chat. But ego pride overrides right now, but it's all hbcu love. And in our state we have had tremendous strides working with historically black colleges and universities. And given that even my Almer mater yes, North Carolina A and T and Winston Salem State University, to name just a few, have made tremendous advances and not only research but service delivery one of the things that Bathsheba mentioned, um, I even wanna highlight this. So we have made strides and HPC use are doing Maura around testing. So we have colleges here that provide testing services, linkage to care and case management. And this is ah, environment in which some of the cultural challenges may not be present, so you may be more likely to see a provider that looks like you, and that's great. However, I think you offered up in the beginning the root and the foundational theological framework off some of our colleges and universities, and that is the same belief system that many people have who are serving in student health. And so, having worked in student health, I know just like the training that she even mentioned that health care providers don't get. They're not getting it, whether they're working in a student health or the local health department. And so we have to make sure that they're getting diversity training, Um, trainings on understanding various social identities and gender identity on the college campus. So we were fortunate enough at NCCU on some of the other local universities. Thio. You know, it was that one day a week you can get tested for HIV and that we were able to train all the staff so that no matter what day and even no matter what you came in for, you could get tested for HIV. You could have a conversation. We went beyond placing condoms in the dorm rooms but actually training students toe, have conversations with their peers and talking to other the residents whole advisors our race, uh, to have conversations with students and host programming that not only were centered on HIV prevention, but we're student driven. So it's not the staff as adult. Well, we're all adults, but the older adults coming to campus, we're programming services. The students were able to drive the services and the educational programs, and I think they were highly successful. And I think other HBC use could definitely learn from some of the ones in North Carolina and certainly expand even the research connection now with HPC use. Now, I'd like to circle back to the original point that I made at the beginning of this section. And what can policymakers, community leaders and advocates do to ensure that people at risk for or living with HIV are linked to preventative or preventive or care services? I'd like to ask venting that. Thanks. So as we're in this conversation, that is very policy, not just a conversation. I'm sorry. In this moment where near the election, we have, um, into the epidemic and, you know, plan that that that's happening. The national HIV AIDS strategy. I'm sorry, the National HIV, A strategy and the national SD I strategy that that's also being released. We have to make sure that these strategies in these conversations about sexual health are not just existing on platforms like this that they actually get on paper about the importance of addressing sexual health, the importance of addressing shame and stigma and and and being able to make sure that, um, the roadmap thio ending HIV, you know, is is paved with with with an understanding of how do we navigate in those spaces? So, to particular areas of policy, um, that are that are particularly important right now for the the end of HIV is one, of course, the end of the epidemic, um, planned for America, where it's targeting currently 48 local jurisdictions and seven rule states, 23 of which and all rule all states are in the south. So, um, as those plans are being crafted right now, there are there there. It's very important that we make sure in conversations under stigmas, conversation of their discrimination, prevention and treatment are we reflect Those strategies for addressing sexual health and elevating the ability for communities toe have healthy dialogue around sexual health not only with providers, but within, um social and and family circles in order to navigate and facilitate more healthy conversations about prevention and care. Because you can't have those conversations about HIV prevention without having a conversation about six. And so they don't exist, you know, in a in a hole. And so, um, navigating the space of being able to successfully make that happen is critical. Another area is this policy on the policies that are emerging around the black lives matter. Um um, policy platform. And so most of those conversations, particularly as we talk about and we advocate for the preservation of black lives, those conversations have been rooted in conversations regarding public safety. We now have to elevate that call for, um, black lives to matter. Also in public health, where we still are losing black lives to covert, we're still are losing black lives to HIV. We still are losing black lives to cancer. All of those different conditions that that really, we have to continue to talk about because we still haven't been able to navigate. How do we still have a entire community that's at the top of every health disparity, including this very conversation about HIV? Now, I'd love to hear if any of you have something to add, Bathsheba, I think you would be a great voice to add to this is, well, thank you vent in really covered so much in such detail. I barely have anything I can add, but I think you as individuals out there, could make a difference as community leaders and advocates and using your voice and your pen to make sure that your voice is heard for the people. Because we cannot solve this problem without each individual going out and voting in the election or like venting. He advocates for people on a regular basis as well as Jade Antonya I've been to the Senate to talk on prep and black women. I've also worked with the company I work. We have an affinity group of women who have placed our voice for the F. D. A s Office of Women's Health to say, Look, we need more around clinical trials and women, so you don't have to be a health care professional to do this. You don't have to be, you know, the president of a company. We need all your voices out there to talk about HIV prevention and treatment. We need those drugs protected. We need them affordable. We need them accessible to everyone and everybody's voice matters now I know we're gonna get to some audience questions here very, very soon, but I have a few more questions before we do that. Jade, I'd like to ask you if you would Are you if you would be able to speak to what it means to be a transgender person of color today, what advice would you give a young person who is beginning to come out as transgender? Who's just taking that step? That is a very, very good question, Uh, and it's not one that I I It's not one that I often think about, um, as someone who didn't have the words to define or describe how I felt, Um, I think it's important to know that I'm going to speak directly to whoever this individual is. So just so everyone understands, um, so know that there's nothing wrong with you. First and foremost, there is nothing wrong with you. There is nothing wrong about the way that you feel there's nothing wrong with the way that you look. There's nothing wrong with the way that you are in your entirety, and I think it's also important to know that there are people in community who have walked similar strides who have been through similar struggles and who may be able to shine light on some of the things that you may have questions about. One of the things that I can say that is one of the most important things is that you learn to love yourself fully, for who you are and for everything that makes you unique. It's so important that self love is the driving force in life. So regardless of what you may hear and social media, regardless of what you may see, um from political individuals know that there are people that there are advocates, that there are kings, queens, goddesses, uh, individuals, ancestors that are advocating on your behalf whether you know it or not. And we will get to a better place today, tomorrow, the day after that and so forth. Um, and just continue Thio, live your best life and continue to show up as your full self. Hey, thank you. That was That was very beautiful. Very moving. Thank you. Really? Um, I'd like Thio the first audience question and this is gonna be for all Panelists. I have concepts like treatment as prevention and U equals. You affected your understanding of HIV perfect prevention. Okay, No one saying anything. I'll go so treatment as prevention or a task as we nickname it. It is very important. It's taking your HIV antiretroviral medications to hopefully become undetectable. And as Joey and his presentation mentioned and vent in talking about U equals U, that's the goal to be viral logically suppressed, using treatment as prevention so that you don't transmit the virus to another person. That would be, in a nutshell, anyone else like to add something. I'll just add that when I think about either one of those concepts in particular u equals U, it allows it has expanded my thoughts around prevention toe add to my Lexus kind of thought of like, What does prevention look like? So, you know, early on my career, it was like a B. C s. And even that is involved, like abstinence be monogamous, you know? Okay, I got feelings about that, but I'll leave those there. But that was what I was brought into. And so, as the technology and the science and information is provided to us, I think it allows me to have Mawr. Thoughtful conversations about prevention. Mhm. Okay, now we have we have a second question. How can providers, community members and faith based organizations address the self stigma of an HIV diagnosis? Did you say the self stigma, the self stigma of an HIV diagnosis? I think that that's a very important conversation. If I'm understanding it correctly and if I'm not, I'm gonna take it somewhere else. Um, this conversation is so important because really, really, when you have the pressures of leadership in a space, um, being able to also navigate again conversations around shame. I am a health provider. So I shouldn't have became HIV positive. I am a faith leader, So I shouldn't have engaged in this action that led me to become HIV positive. And so how do we have conversations that are focused on community but also the understanding and identifying the very critical need of the conversations that are that are needed to support the thought leaders that we elevate to continue to come and and put their stories on the line on behalf of community and making sure that they're supported because that conversation around shame and stigma is so much more amplified again this place of what if's what ifs, what ifs. What if they find out? What if they, you know those things are can be so much, uh, amplified? Um, if you are in a position of leadership toe where there are economic or social consequences to not making the right decisions for, like a better word, would anyone like to add to Britain's answer? Think he think he got it? So we are. We are still taking audience questions. We're waiting on Mork questions from the audience, so please feel free to submit your questions. And if there's I mean, we've, we've we've touched on a lot of things today. A lot of information. Is there anything that any of our esteemed Panelists would like to add that they think it's something important for our audience to know or to remember? I think it's, um, it was mentioned earlier today by several of the lovely Panelists that this conversation isn't one that we want to end here. And this conversation isn't one that we want to, uh, document, um, yet again without action. And so I think it's really important that we continue to have these conversations and continue to create space for these conversations to be had. Um, and Tanya mentioned earlier, Um, the to normalize, you know, conversations around, um, sex and to create this this energy where we can talk about sex without, you know, goose bumps and without, you know, cringing or without someone looking at you in a way that you're saying something that's wrong in all actuality, almost. Well, every almost everything on this earth has sex in some way. But humans are one of the few thing the few creatures that seem to have an issue talking about it doing it or what have you? I love the Nature Channel, and it seems like every time I turn on the Nature Channel, some thing is having sex. So if animals can not have that issue humans, I think, you know, we have to get to a point where we're normalizing the conversation and were ableto be our full Selves and to enjoy something that is enjoyable, you know? So, yeah, I want to jump into because I love that you bring up nature because we always if you're thinking about the stigma around the conversations in the shame and people talking about things being unnatural nature. It shows us all things are possible and that it gives us valuable lessons that we can learn about sex and sexuality and even relationships. So I had to jump in on that. And then I wanted to offer up. My response would be to engage in, regardless of your age and advocate for for young people comprehensive, inclusive, sex positive, pleasure centered, age appropriate, culturally relevant. Um, youth friendly. You've centered all the things, um, queer identifying focus all the things sexuality education locally on your on your school district and in your community based programs. Just get into it. Start learning the things you don't know and expand your worldview so that we can navigate a space in the world where we won't have toe have these types of sessions anymore. I mean, I know that's a dream, but ultimately, that's what I'm hoping and reaching for. And we have one more question from the audience, and I think each of you could probably address this quickly. Um, could you briefly describe the partnerships and collaborations with which you are affiliated? Sure. Um, um, the chief executive officer of the Southern Black Policy and advocacy network. I also am involved on the federal level. Um, as a, um uh, part of the CDC hurts advisory council on HIV, viral hepatitis and STDs as well as locally on my local Ryan White Planning Council and chair of Thebes, Dallas County HIV Task Force and Neighborhood Precinct chair. All right, I'm gonna jump in. I didn't see anybody is green Box. So I am a member of the American association of, um, sexuality educators, counselors and therapists. A sect. I'm on the board of the Journal of American Journal of Sexuality Education. I am a member of the Women of Color Sexual Health Network, s O pe black Women and Protect Black Women and films. I'm also a member of Sister Song Reproductive Justice Collective, and, um, I am the founder of my own Conference North Carolina Sexual Health Conference. In an attempt to make sure that professional development is available to anyone doing any type of sexual health work in North Carolina and beyond through the lifespan, just to name a few Uncle last bets, Cuba. I have ah, long list, but I'll just say for now the Texas HIV syndicate is very dear to my heart where we worked on achieving the end to the epidemic for the state of Texas. I'm also in black women's, um Initiative, the Texas Black women's initiative that does a lot of training with the school's Texas Southern and Prairie View A and M. So they do testing there. It's just harder to get to the health care providers. And I'm gonna leave off the last of my list because it may not even be relative to the conversation. So J thank you very much s So of course, they mentioned earlier that I am a program manager with age United, Um, specifically working with, um fund for Resilience, Equity and Engagement. I also volunteer with Black Trans Advocacy Coalition, which is a black trans, um, organization that eyes run by and supported by black Trans people. I also work with or I am also an advocate, um, facilitator, consultant, um, subject matter expert related Thio women of trans experience, specifically black trans women, Uh, and a number of other dynamics, um, that makes up my unique abilities and gift. We actually have one more audience question before we wrap up. What do you feel are the barriers, normalizing conversations about, um, stigma and shame. And and so one thing that I think that is is so amazing and really continues to be. It's crazy that we say this but groundbreaking that we have shows, Um, for example, now on TV that are exploring sexuality and visibly showing sexuality in different ways. And and and we're starting to have conversations and normalizing conversations around, um, bisexuality and sexual fluidity. So we're opening up a conversation. It's not just you have to be gay or you have to be straight. But there is, um, a conversation around fluidity that that really has to continue to to advance. So I'm hopeful that barriers like that are addressed as we move forward, because those are gonna be the critical things that, as people are, are in their living rooms, you know, talking about these things that they're seeing, that they bring those conversations to their providers, their doctors, their families, their, their their faith leaders about what does that mean to them? And how do they navigate, um into a space of wellness that they desire? I wanna add to vent INS list. Faith can be a barrier. There's medical distrust. There's mistrust we have in Sid Emmick right now and racial injustice as well as's Coben, 19 and HIV. And because we can't have those face to face conversations. Sometimes I think that could be a barrier if people don't feel comfortable doing it on Zoom or whatever, what other virtual platforms we have? I would like toa add another barrier, though. I think, um, what Benton mentioned was was really awesome that we do have so much representation, um, in the media in, um, movies and films and television shows. I think that's important. I'm one of the things that I do Fecal is and component a component that is oftentimes overlooked. Um, in these representations that we see in the media and in movies, I think it's important that we we create narratives that arm or um in alignment with what we know to be true. Um, there's so many different movies and films that have been, um, okay that have become staples in in community that don't necessarily give accurate depictions of individuals. Um, I don't know, can I don't know if I can say specific movies, however, There's so many movies that that depict, um the idea of a transgender person or the idea of someone whom is, you know, who may toe the line when it comes to, uh, gender. Or there is something that's ambiguous on. And oftentimes these characters that that play several different roles on film there made Thio have some type of, um, mental. Um, uh, some type of negative dynamic connected to how they are, how they are appearing as this particular character. And I think that sometimes those narratives do more harm than good because they've established, um, a normalcy, um, around what someone is seeing versus what the reality is. For instance, someone can see a character where we know the character to be, um, a man that is portraying ah, female figured person. Um, but someone may look at that and see something completely different and complete associate that with with someone's gender identity. And those two things are not synonymous, um, in the in that particular way. So I think it's so important that we understand what we are seeing and we we start to be more mindful about the ways in which we part portray characters on that we are portraying people and more accurate ways that really reflect how people live and really reflect the communities that that that they're representing. I think that that's the That's really important as we continue to see more representation in media and in film s Oh, yeah, I think that that's something that that we should definitely continue to dio I would like to thank each and every one of you. Bathsheba. Ventana, Thank you for such an enlightening conversation. Thank you for stressing the importance of so many of these things regarding sexual health and HIV with the people we care about and with our health care providers. Andi, I will now turn it back over to the amazing Bathsheba. Thank you so much, Joey. I was gonna think everyone also. But in this session, we've heard from a panel of policy makers like vent and community leaders and advocates around health, sexual health and holistic prevention for the members of the Latin, X, transgender and black communities. We've had a really robust discourse on sexual on the importance of sexual health and understanding, HIV risk and the overall impact of persons living with HIV, pulling through information on potential opportunities for innovative partnerships and collaboration among other policymakers and community leaders. And I would like to give a heartfelt thanks to our knowledgeable moderator and music critic Joey and our Panelists, Tanya Jade Benton. And I'd like to think Chauncey Watson, we're spearheading this program and the Gilead community liaison team and you the wonderful virtual audience who participated on this topic. So now I would like to encourage all the attendees to please join the networking breakouts to engage with the Panelists and your colleagues by clicking on the button below your screen. I'll see you there. Created by