Making HIV Testing Routine in the Heart of Harlem: Creating Unique Partnerships to Promote HIV Prevention and Testing

An Interview With Vanessa Austin

Contributing Editor

My name is Vanessa Austin and I work at Harlem Hospital Center in New York City.

In New York City where we're in the epicenter of the HIV crisis, we have a collaboration of hospitals and CBOs [community-based organizations] working together that's really making a difference. Doing major events and minor events, working together, getting where the people are -- that's what seems to work.

It's not just one agency. Harlem Hospital provides state-of-the-art, excellent care for the people in the community, but it wouldn't matter if we didn't partner with other CBOs, so that we can get the people. Our collaborations are what's making the difference with the community. So that's what I see working.

For an example, for National Black HIV Awareness Day, we partnered with Abyssinian Church, and NBLCA [National Black Leadership Commission on AIDS], and Harlem Hospital and the Ryan Center [William F. Ryan Community Health Center] were able to test over 100 people. We had some people test positive and we were able to link them directly to care right there in front of the hospital. We were in front of the Schomburg [Center for Research in Black Culture], which is right across from Harlem Hospital.

You mentioned earlier that you've worked with some church groups. Can you talk a little bit about those?

Yes, yes. I have some very, very good, powerful partners like Greater Mount Zion and Abyssinian and, oh, just a host of churches. We're in the midst of a revolution. I worked with World Changers, Creflo Dollar's church. We're in the middle of a revolution of changing lives. In the old days, churches were the social service agencies. Now churches are stepping back up, especially in my community. They're stepping up to come in and to bring us in to do testing, and counseling, and educating.

As a Christian woman, I have a really good inroad with the churches because I have to indoctrinate the information warriors. I have to let Grandma know that if she tests, she can wave her paper at her grandson and say, "Grandma tested. What's wrong with you?"

I have to be able to take people who can sit down and write down every single word that the pastors say, and make them information warriors for HIV prevention, because they can, and they will, and they do.

What do the "information warriors" do once you've spoken to them?

Once I've spoken to them, they invite us to their health fairs, their neighborhoods, their senior centers. They go home and they take the information that we give them, the pamphlets, the flyers, the literature. They go and talk to their family members. They go and talk to their friends. They go and talk to their friends in the senior centers where they're having a lot of activity -- they're seeing a lot of activity in their senior centers as well. So we do as much work in the senior centers as we do in the schools. We have those two populations that are really rising in HIV rates.

I have to have an army of people helping me educate. We can't just educate by ourselves. We just have to train everyone to pass the positive, correct information, and bust some of the myths.

You said you work with the seniors, but you also work with youth and you work in schools. Can you talk a little bit about that?

Yes. That is such a wonderful experience. I recently did a youth health fair in a charter school in Manhattan. Some of the things that the young people told me, it was incredible. Like a young man who said if he has sex with his boxers on, he won't get any diseases. Or the one young lady who said, "Oh, if I drink bleach, a teaspoon of bleach in a glass of water, I can wash away all the infection in my body." Not only will she not wash away the infection, but she might wash away her life drinking bleach!

But the thing is that they are very candid and very open to information. The school invited us to come in because the kids need us to talk to them because it starts young. If we don't start young, it's too late after they're an adult and we're trying to change behavior. We have to shape behavior from the beginning, not change negative behavior when it's too late.

Speaking of myths, you mentioned a couple right now. What are some of the craziest, most outlandish myths you've heard about HIV?

Oh, one of the myths I was talking about was the drinking bleach. Where that one came from, I have no idea. And another thing: The kids really think that oral sex and anal sex are not dangerous. Anal sex is the most number one way to transmit HIV. They think that if you have oral sex, you're not at risk for HIV. You're definitely at risk for HIV and you're at risk for a lot of STDs [sexually transmitted diseases] like herpes, the gift that keeps on giving; and chlamydia; and syphilis.

They don't know that there are stages of syphilis where you don't see any symptoms, but you could be shedding cells of syphilis in someone else's mouth.

They really are not clear that they're in danger. We have to let them pass the information the way they're passing this virus. That's the only way we're going to combat it -- if we grow up a group of people who are information warriors and who know for themselves what's right and what's wrong and what's going to keep them safe.

Testing is not just "Do I know my status? Who am I? Do I know if I'm positive or negative?" No, it's what is the information that's going to keep me negative, or what is the information if I'm positive that's going to keep me from contracting a different strain that'll make my medication no longer valuable to me?

Counseling is a big, big part of it. When you're identifying someone who is HIV positive, it's so important to connect with that person to make sure that they get something right away that they can hold onto, so that you don't just test them and throw them away. You want them to know that you're a part of the family now and we got you.

Could you talk a little bit about what you think are risk factors for people who are in vulnerable communities with high HIV rates?

I think it's like if you were swimming in a lake and it had one crocodile in it. If you're a good swimmer, you could probably swim to the other side and get out with your life. You wouldn't get touched. But if you're swimming in that same lake and it has 50 crocodiles in it, you're going to get bit. And you might not get out with your life.

It's like that for African Americans and Latinas because there are so many people in our population that are infected and affected. We don't want to believe that that wonderful person that we're dealing with sitting across from us could possibly give us a life-altering, life-threatening disease.

Denial, and disparities in health care, and the fact that we take care of other people and not ourselves, that's why we have high cholesterol, diabetes, high blood pressure and HIV -- because we're not concentrating on how to keep ourselves healthy and how to keep ourselves safe.

The disparities don't help because a lot of us are uninsured and underpaid. So our risk factors have to do with our socioeconomic condition, our sensitivity, stigma and lack of adequate health care.

What do you think can be done to fight that stigma?

We have to unmask the stigma. We have to make it so that if you have high blood pressure and you have HIV, that you're looked at the same way. We have to stop people from thinking that "this is because I was a bad person."

The only way that we can fight stigma is with education. The only way to fight fear is with hope -- holistic, optimal, personalized, excellent care. HOPE. And that's the value of Harlem Hospital, Harlem Family Center. We replace fear with hope.

Shifting gears a little bit: How do you fund the programs that you do that are outside of your work?

I have to be creative. Working in Harlem, the hospital has a very, very extensive inpatient and outpatient program, but what I do is community outreach. I have to bring the information to the community and I have to do that in a variety of ways. I partner with area CBOs, like I partner with Food for Change who feeds the homeless. I partner with HCCI [Harlem Congregations for Community Improvement], which houses people who don't have homes. I partner with NYCHA [New York City Housing Authority] in housing projects. Like Metro Plus, which provides health care for those uninsured -- that's a big problem in our community.

I go to the people that have the products and services that want to reach the population that I serve, and I partner with them. We're able to reach more people that way.

Cookie Johnson [Magic Johnson's wife] came to Harlem last year, so I have to partner with the company that she works with.

We have to be creative. We're doing an event called "Stomping at the Voodoo Lounge," and we're going to be partying with the college crew. They get tested, they get in, they get a little information, have a little fun, but we have to make them understand that this is a real epidemic and we've got combat it together.

So we have to be creative in how we come up with ways to reach the population. We have to go where the people are. We can't just have this great event. We have to go where the people frequent, so that's what we do.

Thank you so much.

You're welcome.

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Vanessa Austin

Vanessa Austin