This Black HIV/AIDS Day, the dialog about HIV will inevitably flip to “threat.” For Black girls in America, this phrase has turn out to be a heavy, suffocating cloak.
It’s statistically true — Black girls accounted for 50% of recent HIV diagnoses amongst cisgender girls, regardless of making up solely about 14% of the feminine inhabitants. Right here in Maryland, the truth is much more concentrated. The state is a essential entrance on this struggle, being house to 3 Ending the HIV Epidemic precedence jurisdictions: Baltimore Metropolis, Prince George’s County, and Montgomery County. In 2022, Black folks accounted for 70% of all new HIV diagnoses in Maryland, with an estimated 1 in 96 Black girls within the state dwelling with HIV.
Worry Has Failed Black Ladies
Black girls are endlessly advised (immediately and not directly) that we’re “in danger,” “susceptible,” and “disproportionately impacted.” However fearmongering has not made us safer, and this language of deficit has failed us on so many ranges. We’ve been advised what not to do and who to not be. It frames prevention as a burden and intercourse as a menace.
It’s time to strategy prevention and security by a dialog that’s centered not on concern, however on pleasure, company, and pleasure.
What if Prevention Began With Pleasure?
This was the main focus of my doctoral analysis on the Johns Hopkins College of Nursing. My research, SHINE (Sexual Well being, Inclusivity, Nurturance & Fairness), was born from frustration after observing this persistent and dangerous sample. I listened to Black girls throughout Maryland and located that even when girls are conscious of the “dangers” they nonetheless confronted essential gaps not simply in entry to providers, however in entry to conversations that affirm their complete selves, that make it secure to ask questions that additional their proper to a wholesome and pleasurable intercourse life.
So what if, as a substitute of asking, “How will we cut back your threat?” we requested, “How will we assist your pleasure and pleasure?”
That is the guts of a pleasure-based framework for sexual well being. It reframes the dialog from hazard to need, from prevention as a chore to prevention as a device for empowerment. It’s an strategy that acknowledges that for Black girls, as for all folks, intercourse can and ought to be a supply of enjoyment, connection, and intimacy.
The H in HIV Stands for Human
This isn’t radical — it’s an strategy to care and prevention that facilities the entire individual, as a result of the H in HIV stands for human. It means integrating HIV prevention seamlessly into broader sexual and reproductive well being conversations. A girl searching for contraception, a prenatal check-up, or a routine examination ought to be capable to talk about HIV prevention choices on the identical time in an affirming, non-judgmental approach. So we should cease siloing HIV as a illness of “threat” and begin treating it as an built-in a part of sexual wellness.
Prevention Has Modified. Our Language Should, Too
This shift in mindset is completely timed with revolutions in our biomedical toolkit. Beforehand a day by day tablet, PrEP (Pre-Publicity Prophylaxis) is now obtainable as a long-acting injectable, and it’s a game-changer. As an injection each two months and even twice a 12 months, it uncouples prevention from the day by day act, from the necessity to carry a tablet bottle, from a accomplice’s potential disapproval, or from the disruption of a second of intimacy.
This can be a piece of reproductive justice that girls ought to be made conscious of and may be capable to entry with out stigma. It’s a device that works silently within the background, permitting girls to give attention to the current, their pleasure, their accomplice, their pleasure, and their bodily autonomy. It is without doubt one of the strongest instruments we’ve got to maximise each sexual well being and sexual pleasure.
Pleasure Is A part of the Path to Ending the Epidemic
On this Black HIV/AIDS Day, our path ahead have to be totally different from our previous. We can’t lecture our method to the tip of this epidemic. We should hear, innovate, and affirm. We should dismantle the stigma that the deficit mannequin created and construct one thing new instead: sexual healthcare that sees Black girls not as vectors of dangers, however as architects of their very own pleasure and well-being.
Ending the HIV epidemic continues to be doable, however solely once we as Black girls lastly determine to worth our pleasure in prevention.
Brenice Duroseau, MSN, FNP-C, RNC-OB, AAHIVS, is a household nurse practitioner and newly minted Ph.D. graduate from the Johns Hopkins College of Nursing. Her work facilities on advancing sexual and reproductive well being fairness for Black girls and underserved communities. With greater than a decade of expertise in girls’s well being and infectious illnesses, she examines the social, political, and structural forces that drive persistent disparities, and develops culturally responsive, justice-driven interventions that strengthen autonomy, entry, and compassionate care.
