#MeToo Movement Founder Tarana Burke Opens the Biomedical HIV Prevention Summit -- and a Conversation About Sexual Violence and Harassment

Senior Editor
Tarana Burke
Kenyon Farrow

I am a survivor.
I am resilient.
I am a strong Black woman.
I am a proud transgender woman.

These were just some of the ways each of nearly a dozen speakers ended testimonials about their experiences with sexual assault and intimate partner violence and their relationship to HIV at the plenary session that kicked off the third Biomedical HIV Prevention Summit in Los Angeles on Monday, December 3, organized by NMAC.

Tarana Burke, founder of the #MeToo movement, opened the plenary session and spoke about her personal connection to HIV. She told the story of her sister, a young woman who'd been a sex worker and used drugs, contracting HIV and dying in 1987. Burke described her shame around her sister's death and the way she disappeared from any and all discussions of HIV/AIDS, while a male and presumably straight community member received sympathy after it was thought that his HIV diagnosis was due to a philandering wife.

"It wasn't until I started on my own path to healing from child sexual abuse that I managed to find some empathy for my sister," said Burke. "I often think about the long-term effects from shame, fear, and trauma of sexual violence, and how so many people are lumped into categories like race, class, or gender identity when examining their risk for HIV, but not by the trauma they might have experienced."

Burke's account of the shame she's carried around her sister's diagnosis and ultimate death is not uncommon, even among people who do social justice work. I've complained personally to people over the past decade about this tendency. I am uniquely situated to have relationships with writers, academics, and activists across many disciplines and issue areas. For many years, I was the only person who would mention HIV at all in any discussion of its impact on Black communities, or as a centrally defining feature that shaped politics and culture, domestically and globally, in the late 20th/early 21st centuries.

I've been approached quietly by well-known activists and academics thanking me for my work and writing, naming their own relatives and loved ones who succumbed to HIV. Some have even reached out when their loved ones needed assistance with health care, access to antiretrovirals, or housing. But most have never included HIV in their political or intellectual work. It was good to see Burke speak about her own need to shift this in her work in the #MeToo Movement, and the connection between sexual assault, adverse childhood events, and experiences of trauma for women.

The plenary continued with a mix of powerful personal testimonies of people living with HIV sharing stories of how they've survived the trauma of sexual assault -- Black and Latinx women, transgender women and men, young and old. Some were overwhelmed when they left the stage and seemed to leave the ballroom to go take advantage of the mental health professionals on site, before coming back into the plenary.

But the plenary also presented research and data on historical trauma, intimate partner violence, adverse childhood events, rape, and their associations to being vulnerable to HIV acquisition.

Sexual Assault Trauma And HIV Among Black Queer Men

Given that the highest rates of HIV diagnoses are among Black gay and bisexual men, it was curious that there weren't any speaking at the opening plenary. There are a number of studies about high rates of childhood sexual trauma and Black gay men that show an association with the likelihood of HIV acquisition. Nina Harawa, Ph.D., with Charles R. Drew University of Medicine and Science in Los Angeles, raised this issue in her incredibly insightful presentation at the closing plenary. She presented a number of studies and an analysis to get the audience to consider cisgender Black men as also being vulnerable to sexual assault and intimate partner violence.

"I think we need to rethink the way we've gendered the conversation about intimate partner violence and sexual assault," she noted. "Because Black gay men are experiencing these at too-high levels."

I have Black gay friends and loved ones who have been victims of violence in intimate relationships, including rape. I've written and discussed being fearful of abduction and assault when I've been approached on the street by men in cars and vans, sometimes late at night. It seems that our organizations and programs have to consider these as possible issues Black gay men are facing when they enter doors for services and programs as well. And as reproductive justice activists have called for more pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) resources for trans folks and cisgender women as a part of rape crisis services, HIV programs for gay, bisexual, and queer-identified men also need to have systems in place for rape crisis.

But there's also a more pernicious issue that should be taken on within the HIV movement that I think needs to find space for discussion, engagement, and strategies to transform: the workplace culture of HIV organizations themselves.

Stopping Sexual Harassment in HIV Organizations

A large part of the #MeToo movement hasn't been just the worst examples of physical harm and rape -- it has forced us again to think about the workplace as a site for sexual harassment. It happens in far too many of our organizations, and often to young gay men. I have heard young Black and Latinx gay and bisexual men in particular discuss having to navigate a range of sexual harassment incidents in the HIV workplace over the years. This includes unwanted advances by coworkers, supervisors, board members, and sometimes clients. Or reports of people being asked for sexual acts in exchange for being considered for a job.

In the early 2000s, I was working for a homeless shelter in New York City doing Medicaid billing. Every few weeks, I had to go to our mobile van to pull medical files to run Medicaid numbers to ensure the organization was paid for its medical services. I was propositioned to perform a sex act by the mobile van driver. I rejected his advances and left, but as the days drew nearer for me to return, I began to have anxiety about being near him (especially in a closed and confined space). I eventually reported the incident to human resources.

Just a few years later, I worked for an HIV nonprofit that shared an office with another HIV nonprofit and was daily harassed by an employee at the organization we shared space with -- so much so that I started locking my office from the inside to avoid him coming into my office at all. I happen to know many men with even worse stories, and many people who have left the field as a result. This is of course not to suggest that consensual sexual and romantic relationships don't exist among people who meet at work. It's quite common. But when a rejection of an advance doesn't stop continued advances, or men are put into compromising situations with people who hold power over their livelihoods, it becomes another thing entirely.

It is critical that those of us who labor in HIV and other health care-related settings think about how we research and implement trauma-informed care programs and services as a response to people who come into care having lived experiences with intimate partner violence, rape, and other forms of violence. But just as important is that we begin to ask the difficult questions about what the conditions are within our institutions that are in fact creating the need for trauma-responsive systems. I'm not endorsing call-out culture and social media dragging of people as the solution -- even on a conference stage. But I do think it's critical for us all to consider our institutions in the field of HIV prevention, treatment, and advocacy, and the work that needs to happen to ensure our institutions are safe spaces for people who work there, while we build systems that also support and nurture the people who come to our doors who have been harmed in their lives elsewhere.

As Tarana Burke said in her closing remarks at the Biomedical HIV Prevention Summit, "We come to the work because we are the work."