Archive for March, 2009

Safer sex in the gay and biwomen’s Worcester community

Wednesday, March 25th, 2009

The other night on outreach duty at a local gay nightclub, as I was filling up the condom bucket in the ladies bathroom, a young woman came in, took a dental dam out and asked “when the hell will I ever need this?”

I told her that dental dams, squares of latex of polyurethane meant to cover someone’s vagina or anus during oral sex, are good for avoiding coming in contact with blood and vaginal fluids. Those fluids can spread HIV from an HIV positive person to someone who is HIV negative.

At this point, she appeared kind of worried, asking me, “Do you think I could have an STD?” I told her that no one can tell for sure just by looking, but that anyone who is sexually active should get tested for Sexually Transmitted Diseases and HIV regularly.  

Just then, another woman, who seemed to know her, came into the bathroom and told me “If I have to use one of those things (meaning dental dams), I’m not going there (meaning, sex with that woman).” Then they both left.

The conversation made me reflect on my own experiences in the gay and bi women’s community here in Worcester. I’m from this city, and I realized that I’ve never once been intimate with a woman who pulled out a dental dam, or said anything about safe sex. Actually, as women having sex with women, we mostly assumed that the sex was automatically safe. We thought there was no need for a dental dam or any other kind of protection- WE certainly weren’t going to get HIV. I had heard vaguely about herpes and HPV… but I thought these were things that happened to straight girls.

In fact, I realized, I had never even heard of a dental dam before starting work with AIDS Project Worcester.

I shared these experiences with a friend from out of town, who looked shocked. My friend told me about growing up in the D.C. area, where it was apparently considered very rude to have sex with a woman in the gay and bi community without using gloves and a dental dam at least. The idea seemed to be that one just assumed that it was safe sex, or no go, and that safe sex was the only acceptable way to have sex in that community. The conversation really made an impression on me – it was so different from what I see and experience here in Worcester.

The reality is, even if you are a woman who only has sex with other women, you are at risk for HIV and STDS like syphilis, chlamydia or gonorrhea if you come in contact with another person’s blood or vaginal fluids. Getting gonorrhea of the throat from oral sex is a REAL RISK, and it REALLY HAPPENS. Some STDS, like HPV (the virus that causes genital warts) and herpes can be contracted just from skin to skin contact. The best way to avoid getting HIV or an STD is to use barrier methods- like dams or gloves, for example. And, if you are having unprotected sex, getting tested regularly for HIV and STDs is your best bet.

Having said that, it seems apparent to me that here in Worcester, in the gay and bi women’s community, we don’t have a widespread culture of using barrier methods like dental dams. What do we need to do to change this? How can we be safer individually, and promote a culture of safe sex in our community?

These are the questions I’m asking myself… what you do think?

Posted by Cha Cha

Transgender people supported at AIDS Project Worcester

Tuesday, March 17th, 2009

I was recently asked why AIDS Project Worcester (APW) supports programming for transgender people at our agency. Part of APW’s mission is to provide services and support to communities that are at increased risk for HIV infection. Nationwide, transgender people are at extremely high risk for HIV/AIDS, even higher than other populations that are most often identified as being negatively impacted by HIV infection such as injection drug users (IDU). Below I’ve outlined why this problem exists and what we can all do to fight this epidemic among transpeople.
The Grim Reality
Transgender people face harsh stigma and discrimination in our society. This fact has been carefully documented by numerous community assessments that have been conducted across the United States for more than ten years now. For example, a community assessment survey conducted in San Francisco found that 60% of transgender respondents were unable to find regular employment and more than half of respondents had recently experienced homelessness. I can report similar problems for Worcester’s transgender population based on my own experience serving this community. Transpeople in Worcester are often underemployed or unemployed and/or facing homelessness due to discrimination based on their transgender status. When people are marginalized in this way they may turn to underground economies, like sex work, or alcohol and drugs to cope with stress which puts them at increased risk for HIV infection. Sadly, neither Worcester or the state of Massachusetts provides explicit anti-discrimination protection for transgender or gender variant people despite the apparent need.
Another symptom of anti-trans stigma in our society is rampant violence against transpeople. For example, every month throughout the world two transgender people are murdered because of who they are. Community surveys have also found high rates of reported sexual abuse among transgender populations. For example, one community survey conducted in San Francisco found that about 55% of transmen (FTM) and 68% of transwomen (MTF) had been forced to have sex at least once.
The high incidence of HIV infection among transgender populations has also been well-documented for over ten years. A recent analysis of twenty-two studies conducted across the country found that about 30% of transwomen (MTF) tested HIV+ during surveys while about 12% of transwomen (MTF) reported being HIV infected during interviews. Despite the clear need for more data and community interventions, our federal government has yet to conduct national studies to find out more about the prevalence of HIV infection amongst transpeople.
Transgender communities have been advocating for better HIV/AIDS services for several years, but the response at state and federal levels has been slow and faltering. During the Romney administration in our own state, the scantly funded state-wide transgender health program was cut. That means that right now there is currently no one charged with advocating for health and social services for transpeople within our state’s health and human services infrastructure. Massachusetts’ HIV/AIDS data for transgender people are currently documented under the category of men who have sex with men (MSM). This is inappropriate for two reasons: transwomen (MTF), who are often at highest risk for HIV infection in this population, are NOT men and should not be classified as men and the data for transpeople within the MSM category is not broken down in terms of numbers of transwomen (MTF) or transmen (FTM) who are infected or receive services. Federal authorities use a similar mechanism for tracking HIV/AIDS data for transpeople in that they are simply lumped into the MSM category. Also, there are currently no federally-supported HIV prevention interventions that are specific to the needs and experiences of transgender people.
What We Can Do
Support legislation that protects transgender and gender variant people from discrimination. In Massachusetts, a bill entitled “An act relative to gender discrimination and hate crimes” has been re-introduced and would provide transpeople with protection from discrimination across the state. Please call or write your state representatives and encourage them to support this vital piece of legislation. For more information about this legislation or how to talk to your representatives, check out: http://www.masstpc.org/legislation/callinghelp.shtml.
Help make your workplace safe for transgender staff and customers. Encourage your employer to adopt an anti-discrimination policy that includes “gender identity and expression”. Provide transgender sensitivity and culturally competency trainings for your employees and coworkers. Provide unisex or gender neutral bathrooms, showers, and/or changing rooms whenever possible. Encourage your place of employment to purchase health care insurance that covers transgender-related health care.
Advocate for improved trans-related health research and services. Transpeople are a part of our communities and our nation and their lives are worth protecting! Engage in dialogue with Massachusetts public health and human services authorities and push for better inclusion of transpeople in programming related to recovery from violence, hate crimes, substance abuse, suicide prevention, and HIV/AIDS. Take the Centers for Disease Control (CDC) and other federal authorities to task and ask them why they continue to neglect the HIV epidemic that is raging amongst transgender populations across our nation. State and federal health authorities are accountable to US, the public, and they must provide appropriate services to ALL of us.
Jesse Pack