February 18, 2020

So, I’ve Been Thinking: Getting Back to Basics

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So, I’ve been thinking about how the HIV landscape, and the HIV movement, have changed a lot and are still changing rapidly—and how Community Education Group has changed rapidly, too, over the last few years. Many of you will notice that we haven’t put out a newsletter in several years, and that we no longer do direct service in the District. We are positioned differently now: we do work in DC and West Virginia.

In order to be true to the mission we started out with 25+ years ago, and to fulfill our motto of building stronger, healthier communities, we’ve had to change and grow. We’ve had to take some of the skills we learned and some of the projects that worked successfully in African-American communities in the District, and apply those in white, rural America, in places like West Virginia, where race, class, and access play key roles in the ability of all communities to access services and resources.

We had more than 80 new HIV cases in the state of West Virginia in 2019, mainly among white people who inject drugs or have a secondary connection to PWID. This is an example of how America’s poor in Appalachia are often forgotten in our HIV prevention, care, and treatment strategies, even though they have much in common with black, urban communities experiencing similar barriers to access to care and treatment. I’ve been thinking about black women and PrEP. Our message can’t just be about getting black women prescriptions and getting them on PrEP; it also has to be about getting black women educated about PrEP, aware of, and understanding about PrEP – to be able to raise their hands and say, “I know what that is.”

We’ve got to do a better job with that and I think, in this case, doing a better job means getting back to basics. What’s old is new, and what’s new is old. And so much of what’s missing or needed in our work is a “back to the basics” model. When we look around at biomedical interventions, it’s easy to say, “U=U.” It’s easy to provide PrEP, and we hear messages about “PrEP for all,” but really, PrEP for who?

The poor can’t access it, and black women are often unaware of it, even if it’s free. But we also have to remember the people involved in these interventions.

How do we touch people?

How do we hold people?

How do we embrace communities, now, during some of the most trying times that I can honestly remember?

Add HIV on top of trying economic times and trying political times, with Substance Use Disorder in many communities, and if there’s no behavioral and social support to go along with that—to bring that person, that family, that community together and make them whole—the challenges will still always remain.

We can provide a pill to help end the epidemic, but can we heal the community? That’s the bigger challenge that lies ahead of us: healing. So, that’s what I’ve been thinking about – how do we heal what has created these schisms?

It’s not solely the underlying race, class, and gender schisms, but that is so much of it. In our work, we often don’t talk about the need to be mindful of one another and to take a moment to ask if our colleagues are okay…if we’re okay. Because we do hard work, and in this work, sometimes we see one another but we don’t see one another.

Again, we have to heal not just with a pill, not just with treatment, but with behavioral and social supports that we will need if we are to heal whole communities, whole towns. We often hear Millennials talk about being “disruptors,” but so many systems have been disrupted of late.

How do we heal those systems that have been disrupted? That’s our job, and if we’re in a hole, how can we do it? How can we heal those systems that are so fractured, if we’re fractured ourselves?

That’s what I’ve been thinking about.

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