When Disclosure Is Dangerous: Remembering Cicely Bolden
Cicely Bolden is a name I won't soon forget. She allegedly disclosed her HIV status after having sex with a man. He responded by getting a knife and stabbing her to death.
When I heard the news of Cicely's death, I was going to write a simple piece about what a stark illustration this provided of the dangers of disclosure, as well as the close connection between HIV and violence against women.
But things have gotten more complicated in the past few days.
Murder is gruesome enough. But the heartbreak is in the details. Like how Cicely's young children came home to find their mother slaughtered. Like how the man who murdered Cicely demonstrated a profound misunderstanding of life, death, and HIV by allegedly explaining, "She killed me, so I killed her." Like the fact that Cicely found the courage to disclose where a lot of people can't, and instead of getting support or the opportunity to respond to questions about her personal situation or the chance to learn more about how to navigate a life with HIV, she died. And instead of her death opening up discussions on stigma and violence and health, we're now talking about whether she deserved it.
A Shameful Debate
The headline of an article in The Stir asks the cringe-inducing question, "Man Accused of Killing Girlfriend After She Told Him She Had HIV -- Do You Blame Him?" The author states that Cicely didn't deserve to die. But with that nicety aside, the author undermines the claim by using a lot of space to attack Cicely:
She betrayed him, she lied to him, and she put him in danger. Had she told him before they had sex, had she laid out the facts about being in a relationship with someone who's HIV positive, had they dealt with the disease together, instead of separately, maybe the day wouldn't have ended in death. It was unequivocally a reckless and selfish mistake.
Then there's the response I got to a tweet I sent out. I wrote, "Here's how disclosure can be unsafe: Man in US kills girlfriend after she reveals she has #HIV" and included a link to a news piece. Someone tweeted back, "very misleading Tweet!" followed by "Wait! she didn't reveal to him prior to having sex unprotected. Disclosure can be safe if you do it open and honestly."
Others on Twitter have been even more upfront with their prejudice, posting, "She deserved it!!"
These are examples of the issue being framed about whether Cicely's death was deserved. Was it Cicely's fault she was killed?
This is not the question we should be asking.
Here are some of the problems with making the issue about whether a woman deserves to die for disclosing her HIV after sex.
Disclosure Is Complicated and Never Fully Safe
There is no protocol for disclosure that is guaranteed to avert violence. I wish it were as simple as following a three-step procedure. Step one, step two, step three -- open and honest disclosure completed, safe and sound! But the stigma surrounding HIV makes disclosure an emotionally fraught process. Even in the best of circumstances -- a very courageous person discloses to someone trusted in a comfortable space -- it's still terrifying. There is intense vulnerability involved in disclosure. And the fallout can be traumatic. For many, disclosure can lead to rejection and loss of friends and family. It can lead to the loss of economic support. It can lead to breaches of confidentiality, where a private disclosure is shared with others without the discloser's consent. It can lead to children being abused or taken from the home. And for women with HIV, many of whom have lived histories of violence, disclosure brings particular dangers from male partners. It can lead to verbal and emotional assaults. It can lead to physical and sexual violence. Women have been beaten, attacked with weapons, and raped after disclosing their HIV.
The potential negative ramifications of disclosure are wide and serious. Women who experience multiple layers of stigma may face more challenges. A Black woman with HIV like Cicely Bolden faces sexism, racism, and HIV-related stigma. In a study of women with HIV who face intersectional stigmas, women identified as African Caribbean described the ongoing stress brought on by experiences of racism: "I can go on for days with the racism. Everything just builds up." They articulated their high risk for violence: "Women with HIV often end up in abusive relationships, suffer from violence. People don't want to talk about that. There's no program specific to women with HIV in violent relationships." And they explained how "discrimination is everywhere once they know you have HIV." When women encounter stigma every day, and their energy is going into coping with this, and their sense of self-worth is reduced, disclosure becomes even more difficult.
Cicely Bolden likely had to work up a ton of courage to disclose her HIV. Even if her disclosure wasn't perfect, it should not be wholly dismissed or condemned. She didn't have to say anything. And let's say that she had disclosed prior to sexual involvement with the man who killed her. Would that have safeguarded her? Not necessarily. Her partner might still have subjected her to various kinds of violence. He might have hit her, insulted her, threatened her, blackmailed her, made her feel worthless, attacked her with a weapon. We just don't know. And when we remember that this man was willing to kill a woman, it seems even more ludicrous to suggest that she should have been able to prevent him from committing violence against her.
It Is Never Her Fault
I don't know why I have to explain once more that violence against women is not justifiable.
Oh, right. Because we live in a patriarchal society. Men have more power and women are devalued.
Fine, I'll say it again: Violence against women is not justifiable. Violence against women is rampant and embedded in our society, and we uphold a culture of violence when we suggest that a woman had it coming.
A woman dressed sexily does not have it coming. A married woman does not have it coming. A woman in a bar does not have it coming. A partying teenager does not have it coming. A sex worker does not have it coming. A woman walking down the street does not have it coming. A Black woman does not have it coming; a woman with HIV does not have it coming. Cicely Bolden did not have it coming.
There exists an abhorrent tendency in society to try to pin the blame for the violence on the women who suffer it. She must have done something. She must have asked for it. If she hadn't done that, it wouldn't have happened. Stop blaming the victim! Why do we ask what she could have done differently? Why don't we ask what he should have done differently? What could the murderer of Cicely Bolden have done to prevent her death? Well ... he could have not killed her! He could have not responded with violence. He could have decided not to walk to the kitchen and pick up a knife and stab her. He could have asked questions about HIV. He could have asked about living with HIV. He could even have asked Cicely why she didn't tell him about her status before they had sex. He could have been upset, he could have been angry, he could have been confused. But he didn't have to become violent.
Women in general are vulnerable to violence. But HIV and violence against women have a tight relationship. Violence can lead to HIV. HIV can lead to violence. Having HIV makes women even more vulnerable. Apparently it's easy to blame a woman for the violence she experiences; when a woman lives with multiple layers of stigma, it's even easier; and when one of those layers is HIV, it's a breeze. But that's wrong. It is never her fault.
The Risks and Responsibility Are Shared (but Often Relationships Are Unequal)
"She killed me, so I killed her." Allegedly this is what the man who killed Cicely Bolden told police. But guess what! She didn't kill him. Obviously information about HIV is lacking here. So let's look at some, courtesy of the Canadian HIV/AIDS Legal Network.
- The estimated per-act risk of transmission from an HIV-positive women to a male sexual partner through vaginal sex is 1 transmission in every 2500 sexual encounters.
- When an HIV-positive women's viral load (i.e., the level of the virus in the body) is low, the risk of HIV transmission to her male sexual partners drops to 1.3 expected transmissions in 10 000 sexual encounters.4
- When a condom is used, the per-act risk of transmission from an HIV-positive women to a male sexual partner through vaginal sex is at most 1 in 12 500 sexual encounters.
Here are some basics to glean: Biologically, the receptive partner is at more risk for HIV than the insertive partner. So generally a woman is more at risk of contracting HIV from a man than a man is of contracting HIV from a woman. This isn't to say that men have a low risk of getting HIV. But consider this: When a person with HIV is taking medication, the risk of transmission is greatly reduced because the viral load is lessened. And even better, when a condom is used, the risk is really, really low!
I don't know if Cicely was getting HIV treatment or even had access to it. I don't know what her viral load was. But I know that men often have the power to determine condom use and that if a condom had been used, there wouldn't need to be much worry about whether HIV had been transmitted. We should all take responsibility for our sexual health as much as we can and try not to make assumptions about the health of our partners. I certainly want prospective partners to disclose their sexual health to me honestly (and to be responsible about protecting their sexual health and getting tested regularly). But I know I can't rely solely on words, because words don't prevent the transmission of infection.
Educated, Not Panicked
Rates of HIV among Black women are high and increasing, and in some areas HIV is even a leading cause of death for Black women. In the United States, the rate of new infections for Black women is fifteen times that of white women and more than three times that of Latinas. In Canada, the rate of new infections for Black women is seven times that of the rest of the population. As a post on a new Facebook page called Cicely: Our Daughter so forcefully put it,
Black women are being allowed to die while the general public, in the words of Vito Russo, is "being panicked -- not educated, panicked -- into believing that we deserve to die."
So was it Cicely's fault she was killed? People are being panicked into asking this question. It's the wrong one.
Let's change the direction of the debate with better, more educative questions.
Why is HIV disclosure difficult and what do we need to do to change that?
Why are women subject to so much violence and what do we need to do to change that?
Why are Black women particularly hard hit by HIV and what do we need to do to change that?
Why is sexual health education falling short and what do we need to do to change that?
I would have loved to hear what Cicely thought of these questions. Let's reframe the discussion so we don't lose another Cicely Bolden.