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Beyond The DL

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by Rose Afriyie | Photography by Selase Kove-Seyram

It’s April 24, 2007, and LaQwanna Finkley, then 19, sits in her pediatrician’s office stumped. Finkley, a Bronxite who believes in spending every free minute with her friends and family recalls, “I had headaches so bad it brought me to tears.” She went to the doctor, and they ran tests to get to the root of her symptoms. “‘All your tests came back negative except for one,’” she remembers the doctor saying.

“Which one?,” Finkley quizzed.

“The HIV test,” her doctor responded.

Finkley, 24, initially dismissed her doctor’s willingness to retest. “I wanted to know the next steps,” she says. Finkley is no stranger to adversity; she was born legally blind, with no vision in her right eye and partial vision in her left. “I didn’t get to lose my virginity like most girls,” says Finkley. “I was forced into having sex when I was 14 by a classmate’s brother and molested by my father when I was 16.”

Finkley’s first boyfriend, whom she started dating after the molestation, left her immediately after she confided in him about her father. After her next boyfriend seemed more sympathetic, Finkley remembers feeling as if she was beholden to him. “He didn’t abandon me, and so maybe I owed him something,” she recalls.

Soon after, Finkley was pressing her new boyfriend for answers about a woman who braided his hair and cooked him dinner—for free. “I did care,” Finkley said after her boyfriend finally admitted to sleeping with other women. “But because my self-esteem was so low, it didn’t take much for him to get me where he wanted me to be. I still willingly had unprotected sex with him.”

LaQwanna Finkley’s story is one of many illustrating how traumatic experiences can affect future sexual decisionmaking, and how concurrency— having more than one sexual partner at a time—can lead to HIV infection. These factors fueling the HIV crisis among black women aren’t as publicized as, say, bisexuality in men, but deserve careful consideration.

In the U.S. today, more than half a million black people are living with HIV. In 2009, the Centers for Disease Control (CDC) reported that black women have an HIV rate that is 15 times higher than their white counterparts, compared to black men who have a rate that is six and a half times higher than white men.
 
“If we really genuinely want to help black women,” says Dr. Gail Wyatt, director for the Center of Culture, Trauma and Mental Health Disparities at UCLA, “we need to recognize the context of women’s lives and not simply apply the same concepts that are true for men.”
 
That context, which includes black women’s sexual histories, addresses a profound, but key question: Knowing the risk factors, what would make a woman engage in unprotected sex with a man who has disclosed he has been having unprotected sex with other women?
 
Apparently, the question is partly answered by trauma, which Dr. Wyatt defines as an “experience of terror, 0r fear, and the inability to process those feelings to the extent that your body then develops other ways of coping, like using drugs or having sex.”
 
According to a 2010 study, 22 percent of black women have been raped over their lifetime. Forty-four percent of black women have endured rape, physical violence, and/or stalking by an intimate partner, compared to 37 percent of Latinas and 35 percent of white women.
 
“Trauma is one of the highest predictors of HIV infection,” says Regina R. Quattrochi, CEO of Bailey House, a Harlem-based organization that provides housing and access to health services to people living with HIV/AIDS .
 
It was Bailey House that helped Finkley find subsidized housing after she faced the twin tragedies of trauma and HIV.
 
On December 1, World AIDS Day, Bailey House will launch a Behavioral Health Clinic to address HIV-positive people who have suffered from trauma. The clinic will survey HIV-positive individuals to assess how much trauma people have been subjected to, a practice not often done when servicing HIV patients.
 
“So often mental health systems fail some of our clients,” said Quattrochi. It is very powerful when people feel like they are being given a choice.”
 
Although Finkley’s father and boyfriend had disappointed her, encouraging words came directly from her boyfriend’s father: “‘You think that you may have a disability,’” she recalls him telling her, “‘but you deserve so much better than my son.’” After her boyfriend impregnated his hair braider, she broke it off.
 
Trauma also had an impact on Linda Hamptlon, 64, a Harlem native who was diagnosed in 1998 after spending more than 40 years battling a range of addictions to alcohol, crack, cocaine, PCP, and later—men. “I started out drinking… after being sexually abused at the age of 10,” says Hamptlon.
 
When she became an adult, saying no to sex was something Hamptlon had trouble doing because she could not say no to drugs and alcohol. “I had to use,” said Hamptlon about her life as an addict in the infamous Kenmore Hotel, now called Kenmore Hall, located near New York’s Gramercy Park.
 
“There was 22 floors in that hotel, and I ran through all those floors,” Hamptlon said of the sexual encounters she had, sometimes with intravenous drug users, in the red brick building she called home. “I would knock on their doors and present myself and see if they had any money, drinks, or drugs, and I would give myself to them for those things,” recalls Hamptlon of one theory she has about how she became infected with HIV.
 
Authorities came in 1997 to arrest Hamptlon for solicitation, only they came on the day of her sister’s funeral. “You can’t arrest me today, my sister passed and I have to be with her,” she recalls pleading to officers. When her begging fell on deaf ears, she found herself appealing to a higher power. In a cold cell at Central Booking, she got down on her knees and asked God “to take the taste of alcohol and drugs out [of ] my mouth.”
 
Soon after, Hamptlon, who is the seventh of 10 children, mustered the courage to detox for five days in the Cornerstone of Medical Arts Center in New York. She then spent six months in the Realization Center outpatient clinic near Union Square in NYC. “It was God and the people He put in my path,” she says of the therapist, psychiatrist, and the women’s groups she frequented.
 
It seemed that Hamptlon’s prayers had been answered, until she fell in love. “I ain’t using alcohol and drugs, but I want to use somebody,” Hamptlon remembers of the man who was 10 years her junior, who would arrive to her apartment often with flowers, teddy bears, and cards.
 
He was also carrying something else.
“I wasn’t feeling right,” Hamptlon said about her health shortly after her affair. She tested positive for HIV. “I want to tell you something,” she started to tell her partner with a Realization supervisor in the room, “I tested HIV positive today.” Her partner kept his composure until they went home together that night. “He was so angry he beat me and threw me in the bathtub saying I messed up his life,” she says. Although Hamptlon acknowledges that condom use could have prevented transmission, one thing was clear to her about her boyfriend. “He was trying to kill me,” she said. After he left, she went downstairs and told the security guard he was no longer allowed to come and visit her.
 
Three months later, her ex-boyfriend wrote her a letter saying he was sorry. He had the virus all along.
 
In response to trauma, Dr. Wyatt has designed Healing Our Women, an intervention developed for black and Latina women. For 11 weeks, women are encouraged to talk about their experiences and identify the most terrifying aspects of their trauma. Instead of engaging in a risky behavior to cope, the women learn new skills to handle their experiences; how their abuse has affected their decisionmaking; and how to reduce their sexual risk-taking behavior, havingunprotected sex with an uncommitted partner.Surveys between 2008 and 2010 by the University of Chicago give further insight into concurrency. Considering those who have been married, 37 percent of African-American men admitted to having affairs, compared to 19 percent of white men; 17 percent of African-American women admitted to having affairs, compared to 11 percent of white women.

“Concurrency in the black community is attributed to the fact that there are more black women than men, and the mass incarceration of black men,” explains Phill Wilson, CEO of Black AIDS Institute (BAI). “And part is due to black men being more vulnerable to young death.”

Wilson, whose institute leads the only national social marketing campaign targeting the black community in 40 markets across the country, also points out challenges in disclosure. “Many black men do not have the experience of sharing their feelings—physical or emotional. Because they do not have the practice of doing this, one’s HIV status or high-risk behaviors become an additional area that is difficult to discuss.”

Having disclosed and undisclosed affairs com-bined with the interconnected nature of sexual networks contribute to “population dissemina-tion of HIV,” according to a report by American Journal of Public Health. The report also shows that in the past year, 15 percent of black women had a male partner who they knew had more than one partner, almost twice the rate of white women and two and a half times greater than Latinas. These rates are much lower than admitted “affairs,” presumably done in secret.

The numbers tell some of the story, but the consequences of concurrency are best understood by the toll it has taken on women’s lives.

“I thought I found love,” says Monique Howell-Moree, an Oklahoma native and Army veteran. “I had two kids prior to him marrying me. It was just like, this is the one.”

Less than a year into their marriage, Howell-Moree became pregnant with her third child. When the doctor called with news that her HIV test came back positive, Howell-Moree was in disbelief. “You have the wrong person, it’s not me. I am a wife, this man loves me and my children,” she recalls saying.

“Three months into my diagnosis another female calls me and tells me that she had an affair with him the whole time of our marriage… That she, too, was infected with HIV,” said Howell-Moree, who never knew of her husband’s affairs. “There was so much going on in my mind: confused, disgusted, heartbroken,” Howell-Moree says. “We ended up divorcing eventually.”

Dázon Dixon Diallo, CEO of SisterLove, an Atlanta-based HIV/AIDS organization focusing on women of African descent, believes that when concurrency involves a lack of honest communication between intimate partners, this drives the HIV epidemic.

SisterLove’s key intervention championing these issues is the Healthy Love Party. “We are like the Avon lady, except our products happen to be HIV intervention,” says Diallo of the program, which has been included in the CDC compendium on evidenced-based programs that work.
 
From Finkley to Howell-Moree, each woman’s story comes to a close when they leave their dysfunctional partnerships. The end of their relationships marked an opportunity to channel their strength, work toward a suppressed viral load, and engage in efforts to address trauma or concurrency.
 
Finkley overcame trauma and built her self-esteem through prayer, having access to counseling beyond the question “how do you feel about that?,” and by taking herself on dates. “[Now] I define sex as something totally different. It’s like physical poetry or learning another language,” Finkley beamed.
 
“I think of myself as an STI doula,” Finkley says of her work as an informal case manager for youths in search of testing services or advice on accessing social welfare programs. She also facilitates workshops on creative writing and healthy relationships.
 
Linda Hamptlon smiles with teeth as she stands underneath Harlem United’s green and gold awning brimming with celebration. “Tomorrow I will be celebrating right here, 15 years,” says Hamptlon of the sobriety anniversary that Harlem United celebrates for residents on the third week of every month. She also has had a suppressed viral load for 14 years.

Hamptlon, who is known by her peers as “Nana,” is also the proud convener of the Narcotics Anonymous program held weekly at the organization. “I remember times when I was in the hotel… I never had to leave out of the hotel because they had all the drugs that I needed,” Hamptlon says. “Now I have all the love that I need.”

Monique Howell-Moree receives roaring applause. She has just given her HIV testimony at the International AIDS Conference in Washington, D.C., this past July. Howell-Moree is happily remarried with three sons, and has been empowered by her faith in God and by writing Living Inside My Skin of Silence.
 
She advises women in concurrent relationships to “get out of the denial state that their husband is not doing anything. Step up to the plate and communicate with your spouse.”
 
If women on the margins of society can find it within themselves to fight this epidemic, the least everyone else can do is follow SisterLove’s lead and share these often untold HIV stories. Diallo declares, “We will ensure that women are a part of the story that gets told when this epidemic is over.”
Linda Hamptlon

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