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When Unprotected Sex Is No Longer Negotiable: A Note for World AIDS Day

12/01/2012 01:25 pm ET | Updated Jan 31, 2013

In recognition of World AIDS Day this December 1st, I am more than ecstatic for the premier of the upcoming documentary I'm Positive, which follows the lives of three young people living with HIV, and will air this Saturday on MTV. Blessed to be able to attend an advance screening of the film, my experience was only enhanced by the opportunity to meet the participants and learn more about their stories in depth. It goes without saying that I was struck by the early 20-something, African American woman in the film named Stephanie, who resonated with my own experience of being a young, educated, family oriented, and ambitious black woman in the age of HIV. As she told her story of making a choice that forever changed her life, it made me think.

Most of us as women, me included, have been there -- facing the decision whether to use protection during sex. As much as we do know about the risk of having unprotected sex, too many of us do not insist on using protection with our partners each and every time. Too many of us do not broach the conversation about using condoms or ways to remain protected with our partners for reasons that some may consider valid and others not so valid. In the last decade, for women of color, the consequence of engaging in unprotected sex has placed us disproportionately affected by HIV and AIDS, so much so that by 2006, HIV and AIDS-related conditions had become the leading cause of death for African American women aged 25 to 34.

As recently as 2009, black and Latina women accounted for 73 percent of the total number of new HIV infections among all women in the United States. Yet, black and Latina women combined only represent roughly 24 percent of the total U.S. female population. More specifically in 2009, estimated rates of new HIV infections for black women were more than fifteen times the rate for white women, and more than three times as high as that of Latina women. While these numbers are a slight improvement from the 2005 statistics released from the Centers for Disease Control and Prevention, they remain scary but true facts. What is scarier still are the stigma and fear that are able to silence conversations around black women and the very real rise of HIV infection that is most often contracted by engaging in high-risk heterosexual activity, namely unprotected sex. Instinctually my first question is "Why, knowing the risks, are we still having unprotected sex in 2012?"

Speaking for myself, the times I have chosen to engage in unprotected sex, in spite of knowing the risk, most often stemmed from a place in me that was rooted in fear. Not only feeling afraid this or that man would not like me or leave me if I did not have unprotected sex, I remember the paralyzing anxiety over broaching a conversation about using condoms with a partner with whom this discussion was already much overdue. I have had unprotected sex when I felt powerless, unworthy, and was willing to play Russian roulette with my existence in response to life's losses and disappointments. Feelings and relationship dynamics aside, today, I have a better understanding that my own experiences as an African American woman hardly scratches the surface of all the possible factors that are impacting the disproportionate rise of HIV infection in women of color.

According to a 2006 report from the National Minority AIDS Council, race and ethnicity, alone, are not risk factors for HIV infection. Poverty and other social and structural influences, including limited access to high-quality health care, are associated with higher HIV/AIDS occurrence among African Americans. Moreover, African American women at high risk for HIV have often sustained the brunt of racism, discrimination, poverty, and sexual abuse existing in our communities. Particularly, women who have experienced sexual abuse may be more likely than women with no abuse history to use drugs as a coping mechanism, have difficulty refusing unwanted sex, exchange sex for drugs, money or other needs, and/or engage in high-risk sexual activities. Such social determinants as these may all be influencing factors which contribute to a black women's decreased ability to protect herself against the devastation of HIV infection.

So asking the question why are we still having unprotected sex is a start, but does not quite consider the full equation. Certainly awareness of the risks does not innately bring about behavioral change. And not every case of women engaging in unprotected sex is by choice. The question I have today instead is "What can be done to give women of color the skills, tools, and resources they need to reduce their risk of becoming HIV positive?"

From my own journey to realizing that having unprotected sex is not a risk I am willing to take, I do not believe there is a cut and dry answer to this question. However, I do believe there is a common factor that must exist if we are to begin to shift the tide dramatically.

Each of us as women, teens, and girls must reach a point where we feel empowered from within to insist on using protection each and every time. Empowered to speak up, to start the conversation about using condoms or other methods, whereby engaging in unprotected sex is no longer negotiable. For every reason that we may be engaging in unprotected sex, empowering one another as a pathway to behavior change is not the only solution, but it is a key component to fundamentally transform the how and why we see the rise of HIV infection disproportionately affecting women of color. In the same vein that an empowered woman is more likely to insist on using protection, she is more likely to get tested, seek out high-quality health care, and take the next right action to continue to protect herself and others.

In Stephanie, empowering one another is exactly what I saw in her willingness to openly and honestly share her story as an HIV positive woman of color. It was but a privilege to meet her and all those who contributed to the development of such a powerful film. Where unprotected sex is no longer negotiable on this World AIDS Day, everyone is encouraged, from all walks of life, to get tested, know your status, be educated, use protection and act to get treatment immediately. The spread of HIV does not have to continue, but we all must do our part.