"What makes Mothers' Voices a special organization, and a different organization, is that we're not going around the parents and directly to the young people. We're telling the parents, 'You are the primary sexuality educators for your children, and you need to assume that responsibility and take it very seriously. Whether you are talking about this at home or not, you're sending very powerful messages to your kids.'"
The speaker is Ed Galloway, Director of Community Programs at Mothers' Voices, and he's talking about his agency's unique approach to preventing HIV infection in young people. "We run a peer educators network about primary HIV prevention that is different from other prevention efforts in that we specifically target parents," he says. "There are a lot of wonderful prevention programs out there that speak directly to teens, or speak directly to drug users, or speak directly to specific at-risk populations. Our niche is that we speak directly to parents."
Recognizing that children are influenced by their parents is one thing. Helping parents exercise that influence in positive ways, in ways that will steer their kids away from risky behavior, is quite another. Mothers' Voices works to do that by educating parents about the basics of HIV/AIDS and its transmission and by helping them develop the skills needed to communicate with their kids in age-appropriate ways.
Galloway stresses that the Mothers' Voices program is not limited to mothers. Fathers are part of the equation, of course, as are the increasing number of grandparents, aunts, uncles, and other custodians who fulfill parental roles in the lives of young children and adolescents.
"These volunteers are then on track to do community seminars themselves," says Galloway, "with their own peers, parents in their own communities." The idea is to equip volunteers to go into their own communities and conduct culturally appropriate seminars, an hour each, for parents and guardians. Mothers' Voices provides curricula for these one-hour seminars on Facts About HIV/AIDS, Basic Parent-Child Communications (one seminar for parents of young children and another for parents of adolescents), Raising Sexually Healthy Kids, Taking to Your Kids About Drugs, and Advocacy Skills for Parents.
Galloway stresses that this two-day session is a very intensive train-the-trainer effort, with a curriculum filled with medical and technical information, presentation skills, and group facilitation skills. Even then, the volunteer is not ready to go out and conduct seminars alone. Mothers' Voices staff, usually Galloway or Program Associate Laurie Rodriguez, are there to do some necessary hand-holding. A new graduate of a two-day training starts by observing a more experienced trainer, then by conducting seminars in tandem with a staff member or veteran volunteer. There is a stipend system that reflects the incremental nature of becoming a fully fledged trainer. A new volunteer who conducts half a seminar, co-facilitating a session with someone else, gets a stipend of $25, while a solo volunteer trainer receives $45.
Not all Mothers' Voices volunteers become trainers. Galloway points out that public speaking is the number two fear of most Americans, and at Mothers' Voices they are asking people not only to speak in public but to speak in public on a subject that is fraught with anxiety. "So we also have volunteers who don't stand up in front of a group of people and talk about sex," he says, "but who know their basic HIV/AIDS information, who know their parent-child communication skills, and who can then be community leaders, talking to other parents in their community about why it's so important for them to talk about it with their kids."
Staff and trainers conduct about five of the one-hour seminars per week, fewer during the summer months, more during the school year. They are conducted in almost any venue where parents congregate: school, parents' associations, churches and faith communities, corporations and unions, even Boy Scouts leadership councils. "A large part of it is word of mouth," says Galloway, "and we encourage people to think creatively. Most of our volunteers don't live in a vacuum outside of Mothers' Voices; they're active people. We tell them, 'Think creatively about the people you hang out with. Are you a soccer mom? Maybe that's a place where you're in touch with other parents. Are you a regular person at a community center in your neighborhood? That's a place where other parents are hanging out.' Or people will stumble onto our website, or somebody who has been to a training will go to church and have the pastor call. It's a ripple effect."
Mothers' Voices tries to match the volunteer trainer to the audience. Galloway explains: "We try to put people in their own communities. Then you've got someone who's talking to their own community and saying, 'I know what it's like to be you, I know what it's like to live out here, I'm a neighbor, and maybe I know some of the people in the group.' You don't have that whole credibility-building period that comes with having an outsider go in. It's better if you have, which we do, a diverse group of volunteers that we can plug in to the organizations in a specific area."
In both the booklet and the seminars, according to Galloway, "We talk a lot about teachable moments, trying to get parents, or people who are parental figures, to attune themselves to what those moments are that occur just in everyday life -- when there's something on television, or when your 6-year-old comes home from school and says, 'Mommy, what's HIV?' The parents need to know how to answer that in a developmentally appropriate way."
The book stresses that talking with kids about sexuality and related subjects like HIV is not a one-time thing, not that old sitcom staple, The Talk. "We're trying to tell parents, 'Don't think about it in terms of, we're going to have The Talk when she's 12, or we're going to have The Talk when he starts hitting puberty," says Galloway. "Instead a parent should think of this kind of education as incremental, as something that happens throughout the kid's life. There are developmentally appropriate conversations about sexuality and about HIV that can happen at a very early age. Granted, the level of detail that you impart in a conversation with a 5-year-old is very different from the level of detail that you want to give to a 12-year-old, but the conversations can happen all throughout that time."
Galloway describes the agency's early growth: "As the years went along, the agency became activist, became known as mobilizing mothers to talk to Congressmen, because of the presumption that mothers, by virtue of their motherhood, had this moral imperative that could cross socioeconomic lines, racial and ethnic barriers, and say to decision makers, 'We are mothers of young people in America, and you can't backtrack in this fight against this terrible epidemic. You've got increased funding for research, for treatment, for housing.'"
Galloway remembers his first contacts with Mothers' Voices, when he was working in the Public Policy Department at Gay Men's Health Crisis. He would travel to Washington, D.C. on lobby days with a "ragtag group" of GMHC volunteers and clients, trying to get an audience with their Congressional representatives. Along would come the Mothers' Voices delegation, wearing gloves and pearls, and the doors of power would fly open to these "activists in aprons."
Over the years, as the face of the epidemic changed, so did the face of Mothers' Voices, from a primarily white, fairly empowered group trying to bring AIDS awareness to communities that did not see themselves as at risk to a more diverse organization with a broader purpose. It was in the late '90s, as it became clear that the initial euphoria surrounding the development of protease inhibitors was premature, that Mothers' Voices shifted much of its emphasis to prevention education.
The agency has not, however, abandoned its advocacy role. Advocacy Skills for Parents is one of the hour-long seminars taught under the Parents Educating Parents program, with the aim of enabling parents to talk not only to other parents and their own kids but to decision makers. "We want them to be able to go to their school boards, their community boards, Congressmen," says Galloway, "and let them know that we still have HIV in this country. People are still getting infected at alarming rates, and over 50 percent of them are young people. And this translates into the startling statistic that two adolescents are infected every hour."
Mothers' Voices operates a nationwide e-mail list and sends out alerts about once a month, letting people know when to call their legislators about important votes and national developments.
Mothers' Voices' advocacy portfolio focuses specifically on prevention issues. "We talk a lot about comprehensive sexuality education," says Galloway, "and the need for that, as opposed to the vast amount of federal funds that are being spent on abstinence-only-until-marriage education. There's practically $500 million floating around out there, a combination of federal dollars and state matching funds, being spent on what's being called abstinence-only-until-marriage education in the schools, targeted at young people. Mothers' Voices is as supportive of abstinence as a choice as anybody else. The problem is that these abstinence programs as they are now have never been proven to work."
Galloway spells it out: People talk a lot about failure rates of condoms, but people don't talk very often about failure rates of abstinence. The reality is that condoms, when they're used consistently and correctly, are highly, highly, highly helpful in prevention of HIV infection. Abstinence also has to be used consistently and correctly. And a lot of studies have shown that by the time the kids are graduating from high school, up to 80 percent of them have engaged in some form of risk behavior.
So Mothers' Voices definitely believes that we need to encourage abstinence as a choice, but also to be realistic as educators, as parents, and say that most people aren't choosing abstinence, and therefore we need to arm them with all the tools they need to protect themselves so they can get through their adolescence without HIV infection, without teen pregnancy. That means you have to talk about birth control, you have to talk about condoms, and you have to talk about safer sex. "Just Say No" doesn't work. It didn't work with drugs, it doesn't work with sex, and it's still not working.
"There's a wave of people in this country who are pushing for this old dinosaur of 'Just Say No.' There's very little evaluation, if any. The people who are running these abstinence-only-until-marriage programs are resistant to allocating an appropriate amount of money to evaluating these programs for fear that they're going to be shown that they don't work. It really is based a lot more on ideology than it is on public health. It's a lot more about politics than it is about something that's going to protect our kids."
Laura Engle is a freelance writer with a special interest in HIV/AIDS and a former editor of Body Positive.