Long focused on the gay community, the Columbus AIDS Task Force retools to reach an at-risk group not yet open to its message: African-American women.
Gladys is lying on her bed, staring at the wall and drowning in an oversized orange shirt. She barely notices when James, her boyfriend and the father of her baby, begins stroking her hair. She isn't sure whether to slap his hand away or close her eyes and accept his affection. Gladys is HIV positive and she blames James. How else could she have contracted the virus? The night she found out, she screamed over his denials and threw a baseball glove and baseballs at the pizza box he was using as a shield until he promised to get his own test. Now, days later, she rolls over to stare at him.
"You found out about your test, didn't you?" she asks.
Silence. James doesn't want to say. Gladys is up now and frantic, kneeling in her sheets.
"Tell me," she begs.
James looks away. "I don't want you to get upset again."
"Tell me." This time when Gladys says it, it's a demand.
The women who are gathered around the old television set, watching the Gladys-and-James soap opera, are suddenly incensed.
"Liar!" one yells at the screen.
"He's got it!" another insists.
Tanya Motley smiles. It doesn't matter that Gladys and James are mediocre actors in a mawkish, low-budget show that feels suspiciously like an after-school special for adults. All that matters is that these women-residents at the Maryhaven drug and alcohol treatment center-care.
Motley is a facilitator of the Sisters Informing Sisters on Topics about AIDS (SISTA) program. It's a Centers for Disease Control and Prevention project offered by the Columbus AIDS Task Force, where Motley is the African-American HIV prevention program coordinator. The title is a mouthful, but what it comes down to is this: Motley tells African-American women that they're at risk.
For decades, HIV and AIDS were viewed mostly as homosexual illnesses. Few outside of the gay community considered themselves at risk and national statistics largely supported their assumption. The first cases of AIDS were discovered in New York City and all of the victims were gay men. For the next 10 years, men who had sex with other men (or MSM as they are known by CDC experts) continued to outpace all other statistical groups in contracting the disease. The media mistakenly dubbed their diseases "gay cancer."
Hundreds of activist groups, including the Columbus AIDS Task Force, grew out of those numbers. Their mission was to seek out gay men, teach them safe-sex practices and encourage them to get tested. And in many instances, it worked. The number of HIV/AIDS cases among gay men dropped significantly in the 1990s. But the problem was, in focusing their efforts on MSM, activists were inadvertently ignoring other at-risk groups.
People who had received tainted blood through transfusions-before screening was required-and intravenous drug users who shared needles were also contracting AIDS in frightening numbers. And then, slowly and quietly, the CDC noticed the prevalence among black women creeping skyward. By 2005, 64 percent of all women living with HIV or AIDS were African-American. In Franklin County, the statistics were just as alarming. Of the 515 women living with HIV or AIDS in 2006, 349 of them were African-American.
But their cases were unlike those of their homosexual male peers-because the women were largely contracting the disease from domineering heterosexual partners who scoffed at fidelity and condom use, and because many of them didn't know where to turn for help.
In its more than two decades of activism, the Columbus AIDS Task Force has managed to reduce for gay men the uneasiness that often accompanies seeking its help. For many today, it isn't shameful to walk into the building on East Long Street and request an HIV test or counseling; it's smart.
"It's harder to reach African-American women," prevention program manager Anna Wuerth says, "especially for our organization, which historically served gay men. There's a stigma with coming to the Columbus AIDS Task Force-you see that a lot in the African-American community. We have to find a way to build a trust with them."
So instead of hoping that black women come to the task force, the task force has readjusted its philosophy and gone to them. Currently, Motley is targeting those who are rehabbing at Maryhaven or the city's female-centered residential treatment program, Amethyst, with the five-session SISTA program. The mostly impoverished residents of Maryhaven and Amethyst are among the most likely to be at risk and least likely to know their HIV status. Many of them do not have regular access to healthcare and medication (which can mean a faster progression to AIDS for those who are HIV positive) or the knowledge of how to protect themselves from contracting the virus. So the program is designed to teach participants about prevention: condom use, negotiating safer sex practices and developing more assertive communication skills. Motley opens each session with an ear-rattling reminder of her mission.
"SISTA love is?"
"SISTA love is?"
"SISTA love is?"
And while Motley has met with some success-she's educated about 110 women since the program's 2006 inception-she's also encountered a few frustrations. Though HIV testing is the ultimate goal of the program, it's not required and many women still skip the simple mouth swab at the end of the five weeks, afraid to know the answer. And some don't even attend the sessions voluntarily. It was the most difficult lesson Motley had to learn when she became a facilitator-she would never be able to reach everyone. In her last SISTA session at Maryhaven before Christmas, one woman slept in the corner, despite Motley's repeated pleas. "I'm challenged sometimes," she says. "I feel like I'm pulling teeth in some groups."
Finally, Motley worries that SISTA fails to hit an important slice of the task force's target audience: middle-class black women. "The programming is there, the community support isn't," Motley says. Even among her friends, whom she preaches to whenever she sees an opening, there is a feeling that they're not really at risk, an idea that HIV doesn't attack women in monogamous relationships with access to good healthcare. Though it might be less likely, it's not impossible. "Especially for women who think they're in a monogamous relationship," Motley says.
Still, reaching women who may not otherwise get tested, or even understand the risks, is paramount. So Motley spends hours among the residents of Maryhaven and Amethyst, drawing them in with enthusiasm (she sometimes throws her arms over her head and dances), straight talk ("HIV does not prepare you for the people who aren't going to love you") and the story of how AIDS shook her life.
Motley's brother was diagnosed with HIV in the 1990s. When others abandoned him out of fear or anger, Motley became his caretaker, driving him to the hospital when the disease began ravaging his body, spending sleepless nights at his bedside. It was his battle that inspired her to join the Columbus AIDS Task Force, and she tells the story to the women she teaches, not because it lends her credibility, but because it makes HIV and AIDS-just a vague idea for some-real.
"My brother always said, 'The virus lives with you; you are not the virus,' " she tells them.
Maybe it is the story of her brother. Maybe it is the tragic tale of Gladys and James playing out on the television (as it turns out, the women were right: James is positive). But in that last SISTA session before Christmas, Motley seems to touch something inside of the women. One raises her hand and asks, "Can I get tested?"
The woman was lying on the brown carpet, barefoot, during the session, alternately looking bored and interested, casually tossing out answers when Motley asked for participation.
"After Christmas," Motley tells her.
And then she smiles. One more sister is aware.
April Johnston is an associate editor for Columbus Monthly.