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HIV Frontlines: Executive Director of New Jersey Women and AIDS Network Talks About Gender Issues and Obstacles to HIV Prevention

A Conversation With Monique Howard

June 21, 2011

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This podcast is a part of the series HIV Frontlines. To subscribe to this series, click here.

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Right. No, it's true. Some of the programs in the salons are set up that way; a lot of times, when you are dealing with older women, not all of them are very comfortable talking about sex.

I interviewed someone a couple of years ago who said, "Well, we have to talk about heart disease, and then we have to talk about breast cancer. And then we kind of stick HIV in there." And it's just, like, really? This attitude still exists in 2011. It just really, really amazes me how far we've come, and how far we haven't.

Yeah. I don't know if we're not angry enough; we're not frustrated enough; we're not taking to the streets about it; we're not asking our elected officials about it; we're not asking our neighbors; we're not talking to our doctors about it. There's just nothing.

Yeah. It's sad. It's frustrating. It's really frustrating. It just isn't on the radar anymore. I mean, it is, but then it's not. I just don't know how seriously people take it. And I also think that there's a lot of misdirected blame around gay men, down-low men, being the ones that have brought it into the community, and the women are just completely taken advantage of -- it's pitting one community against the other, which is very counterproductive.

Now, the agency, we are doing something. And so one of the programs that we have, which is our HIV awareness campaign, "I Stand With NJWAN," is about that. It is about bringing awareness to HIV. And I'm from a research background, so I know that awareness doesn't equal behavior change. But you can't work on a behavior change piece if you're still in denial that HIV exists.

And so, bringing HIV 101 education, and information and awareness about HIV, to the streets is critical, as is trying to sign up people, hold roundtable discussions around HIV and the issues that are surrounding HIV, and bringing the awareness to outside of our choir. Because all AIDS service organizations, we all have a choir. And when we have an event, our choir comes; but how do we bring it to the masses? We just need to be really creative and strategic on how we educate the everyday folks about HIV and AIDS. So that's one of our programs.

We also have a theory-based Safer Sex Boot Camp, which is a really intensive HIV 101 program intervention that teaches skills -- teaches communication skills and condom use skills -- to reduce the risk of contracting HIV. So those are some prevention initiatives that we have going on that we're hoping work. And some of our data does demonstrate that people are reducing the number of partners that they're engaging in sex with, increasing the times that they engage in sex and use a condom, or bringing up the topic. That, in and of itself, for many of the women that we work with, is a big thing -- that they can even bring up the topic of HIV.

That leads me into the next question around what are some of the challenges and obstacles that women and your clients face in talking about condom use? And actually treating and dealing with prevention with women who are positive and negative?

From the prevention perspective, it's still: Can women carry condoms and not be thought of as a slut, or promiscuous, or however? says it's tacky to carry condoms.

And you know what? The thing is that it brings you back to Charles Barkley who said years ago that he's not a role model. Part of me understood that. He just is going to work. His job just happens to be playing basketball nationally, internationally. But he's not a role model. He should not be the man responsible for raising your child. But his voice, whether he wants to acknowledge it or not, is significant.

And's voice is very significant. So there's a level of responsibility and accountability that he has when he says something. It's very damaging that he said that it's tacky for women to carry condoms. That's actually very damaging. Because the work we do every day is making women feel OK about carrying condoms, about learning how to use them, and about bringing up that conversation. And so that one comment just destroys the work that we do that saves the lives of women.

Yeah, it does.

And so that shifts all of the barriers right there around our society's support of women who carry condoms, and know how to use them, and will have the audacity to say, "No. I'm not going to have sex without a condom. We can have sex, but it's not going to be without a condom." And having a response to all of the excuses that are out there: "I don't have one with me." "The store is too far away." "It doesn't fit." "It's too big." "It's too small." "It smells." And having responses to all of those that are realistic.

Because we're sex positive, and so, yeah, I want you to have sex at the end of the day. But I also want you to have safe sex at the end of the day.

How do you address the women for whom condom negotiation is damn near impossible? Because I think that this is something that we know exists, but we don't necessarily publicly talk about it. Because, for a lot of people, no matter how much condom negotiation training you give women, and as much sit-down time and therapy that you give women, if their lives are dependent on a man, talking doesn't always change their outcome. And so how do you personally cope, knowing that, doing the work that you do? And what do you guys do? Because so many women are just going to say, "I can't."

Yeah. You know what? You are absolutely right. There's a lot of, I'm not in control of my sexuality issues that many women deal with -- because of violence, or because of just control issues, or just the life issues. Those pieces are really hard. And there is no way that a woman who sits in a class for three hours is going to be the pro-condom woman at the end of the day. But there's a whole slew of baby steps.

So one of the things that we do at the network is, we create a network that you can keep coming back to and call up, and we'll continue to see you and move you toward condom use. So maybe it's not, you use condoms by the end of the month. It's, can you bring up HIV in a conversation? Can you bring that up and still get your need met? Can you bring up an awareness of what's going on realistically in your relationship in two months? Can you bring up a conversation about condom use, and have that be ongoing? Can you talk about testing?

All those pieces are very significant in risk reduction. It's not just, "Hey, you've done my program. You didn't use condoms at pre; you'll be using condoms at post." It's impossible for me to think that's going to happen. But within what's going on in your life, can we get you to a place where you feel better, where you might be able to negotiate at your job for something extra, so that maybe you don't have to rely on this person for cable money?

That's an awesome point, Monique.

Yeah. I mean, maybe you get another job. Maybe you get job No. 2, and maybe you don't have to negotiate hairdresser money. But let's just take those small steps.

I had an opportunity to work with a bunch of moms, because we do education all over. So I worked with moms once. They were multi-cycle public assistance users -- mom, grandmom, great-grandmom, all in the family -- and had no idea that they could function outside of the home in a 9-to-5 job, because they had never seen that negotiated before.

And we held a facilitator training. We trained these women who live in housing developments to be facilitators of a risk-reduction program. And there was 11-day training, from 9 to 5. And those women got jobs. They hadn't known they could negotiate their life, and leave the house, and be gone from their children, and still do all the stuff they did during the day. So it's the baby steps.

And I'm happy to do one-on-one work with women to get them to the baby steps. The relationship issues are really, really critical when you're talking about negotiation of condom use. But you know what? Sometimes, when you talk to the guys, the guys say, "Hey, she never asked."

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This podcast is a part of the series HIV Frontlines. To subscribe to this series, click here.

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This article was provided by TheBody. It is a part of the publication HIV Frontlines.
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