ViiV RISK TO REASONS GRANTS: OUR “LOVE LETTER” TO BLACK WOMEN
Although Black women account for 61 percent of new HIV diagnoses among American women, PrEP uptake has been persistently low among in this population.1 This disparity can be contributed to the countless economic, access and cultural barriers that Black women face when it comes to accessing HIV treatment, prevention and care. Therefore, as we commemorate National Black HIV/AIDS Awareness Day on February 7, we are pleased to highlight our 2022 inaugural Risks to Reasons grantees. These are grantees who are working tirelessly in their communities to reach more than one million Black women with reasons for HIV prevention.
ViiV’s Risk to Reasons initiative is the country’s largest philanthropic investment dedicated to Black women’s needs, voices and leadership related to HIV. The initiative is designed to reframe and refocus HIV prevention and care for Black women by developing new messages, new messengers and new methods to increase awareness and action around HIV prevention.
The foundation of Risks to Reasons was born in 2016 when ViiV Healthcare launched Positive Action for Women, and our community partners emphasized the need to “reframe risk” when delivering HIV prevention messages to Black women. There was a need to share information in ways that would resonate with their lived experiences.
We convened a Black Women’s Working Group— a group of Black women living with and working in HIV—that met over a seven-month period. They discussed and developed approaches and messages that increase Black women’s awareness, knowledge, and use of HIV prevention and treatment strategies. A central insight that emerged from those convenings was that the “risk” framework in HIV prevention message was too often counterproductive and off-putting.
Over and over, we heard how terms like “at risk,” “high-risk,” “risk-factors” and “risky behaviors” were unspecific and stigmatizing, causing too many women to disassociate rather than reflect on their potential prevention needs. Black women with HIV prevention needs may face personal challenges like poverty and homelessness where they live, or experience intimate partner violence – realities rarely captured in campaign messages, questionnaires or intake materials in traditional HIV prevention campaigns.
ViiV set out to change the conversation around HIV prevention, transforming it from one based solely around risks to one based on reasons a women may have to consider the range of prevention options available. This evolution in conversation is especially relevant to Black women given their sexuality being policed and pathologized throughout history. We are now intentionally developing language and approaches that support Black women’s lifestyles and desires, while avoiding stigma, shame and re-traumatization.
In October 2022, we announced an $8 million grant program to put these insights into action by supporting 17 community programs focused on helping women access HIV care and prevention tools and training service providers to change the stigmatizing risk-based narrative surrounding HIV/AIDS. Day by day, city by city, one woman at a time, ViiV grantees are changing that reality by informing, inspiring and empowering Black women with a message of hope and love.
In St. Louis, the Community Wellness Project has made shifting the conversation away from “risk” a centerpiece of its advocacy work to help young Black women feel empowered.
“Why is it important for us not to use the word risk?” posed Oluwabukola Apata, a research and medical case manager at Community Wellness Project. “Because sexual behavior doesn’t exist in a silo. You have socioeconomic barriers and social determinants of health. You have low economic status and lack of access to education, lack of access to insurance and healthcare, and religious intersectionality to cultural upbringing… young females feel like they might not have all the tools that they need to effectively communicate their wants and needs without repercussions. There are a lot of barriers. So, it’s doing ourselves a huge disservice to focus on just risk.”
In New York City, the African Services Committee focuses on promoting HIV prevention messages among immigrants, refugees and asylees from across the African diaspora, where cultural attitudes can make discussions around HIV prevention a sensitive subject.
“We have active participants from the community who are active participants in our [HIV education] workshops who take this message into the community,” said program coordinator Mahlet Maru. “It could be in mosques, churches, hair salons or after-school programs where we find African women. Risk to Reasons has allowed us to reframe our message in a positive way in a population where there is a lot of stigma around sex in general.”
Advocates for Youth, a global organization based in Washington DC, aims to educate and counsel young Black women around HIV prevention. Their goal is to enlist and train community advocates to help spread the message of making HIV prevention and care more relevant and salient for Black women.
“When you really look at the Risk to Reasons framework, the reason is that you should care about yourself,” said Char’Lee Marie King, HIV campaigns manager at Advocates for Youth. “You should have the autonomy, your self-love should be so great, that you should want to access STI testing or know your status or your treatment options. Regardless of where we are in the spectrum, it’s OK, and there’s a community of other Black women behind you and rooting for you to be whole and live a quality and thriving life. You deserve it.”
