White Girls Don’t Get AIDS
by Laura Jones
“In 1998, the most
common cause of AIDS among women was heterosexual exposure
to HIV, followed by the use of injection drugs. A large percentage
of women who became infected heterosexually did so through
sexual contact with injection-drug users. For this reason,
reducing the HIV infection rate among women will require combating
substance abuse as well as reducing HIV risk behaviors.î HIV
Frontline, Issue 40, Jul/Aug 2000.
Last time I checked, the
Centers for Disease Control estimated that there were between
120,000 and 160,000 women and adolescent girls in the United
States living with HIV infection, including those who already
had an AIDS diagnosis. From 1985 to 1998, the proportion of
reported AIDS cases in women and adolescent girls rose from
7% to 23%. 77% of these reported AIDS cases are in African
American and Latina women and girls, who account for less
than 25% of the U.S. female population.
These figures are unacceptable.
But what is also unacceptable are the numbers that are missing—namely
the other 75% of the female population, who I’ll wager aren’t
doing so well either, but don’t know it yet. Remember: if
you don’t get tested, you don’t know you have HIV. If you
don’t think you can get HIV, you don’t get tested. Counties
with low numbers of actual diagnosed AIDS cases are not necessarily
counties with low rates of HIV infection—they’re just counties
that have fewer reasons for pulling their heads out of the
sand.
Given the state of health
in sub-Saharan Africa, Southeast Asia, and U.S. minority communities,
I’m not expecting anyone to open a vein and bleed for the
plight of white suburbia (though I do think more blood, and
certainly more money, should be shed for Americans of all
ages and races living in economically-depressed rural areas).
Money alone will not change the high level of denial that
saturates suburban and small-town culture. It won’t stop the
emphasis on keeping up “respectable appearances,î to not behave
like “trash,î that prevents open communication and dissemination
of much-needed educational materials. Some outer-city people
may have more financial resources at their disposal, but that
doesn’t mean they’re pouring it into HIV/AIDS prevention and
health services; it certainly doesn’t mean they’re any less
mired in the cultural propaganda that continuously reinforces
the notion that HIV/AIDS is something that happens to “other
people.î
Let me illustrate with a
story:
In 1994, I left the Twin
Cities—one of the nation’s bastions of liberal niceness, with
state-sponsored health coverage, an excellent network of community
clinics, and one of the highest literacy rates in the United
States. I left for a lot of reasons, but a big one was the
need to get away from a drug scene that was rapidly consuming
way too many of my peers. I’d moved there from Sioux Falls,
South Dakota in 1988, and started doing sexual health activism
in 1990. From then until the time I left, my social group
consisted largely of people like me: middle-class or rural
working-class young folk with at least a high-school diploma
and the opportunity to go to college; people between the ages
of 15 and 27 who had come to Minneapolis and St. Paul from
midwestern suburbs, small towns and farms. We weren’t all
white, but those of us who were not were often uncomfortably
“white-identifiedî—Koreans and Vietnamese adopted as children
by white parents, black youth who had grown up in mostly-white
towns, and others of mixed ethnicities who felt excluded by
their racial communities. Injection drugs—primarily heroin,
but also methamphetamine and cocaine—were all the rage at
the time, and while the “sceneî definitely supported such
self-destructive activities, drug use in general was new to
only a few of us. People looking for an escape valve without
leaving their neighborhood will choose the same options in
outer-city areas as they will in the inner city. My friends
got high a lot in the late ‘80s and first half of the ‘90s,
more and more often via the needle.
Oh yeah—we had sex a lot,
too. That was easy, and our crowd was right-on with same-sex
experiences as well. Not that most of us waited on that before
we got to the Big City either. For example, there was a very
popular telephone pole in downtown Sioux Falls where the interstate
truckers and other men of any age could post their sexual-partner
requests, complete with meeting times and places. Less sophisticated
than the options in larger cities, true; but my male friends
who knew they were queer didn’t have to wait until they were
18 and living elsewhere, and most of them didn’t. Neither
did us breeder kids, as the teen pregnancy rate did show.
How many HIV/AIDS outreach
programs do you think were targeting smalltown women between
the ages of 15 and 27 in the early 1990’s? Mainstream America
had only decided to worry about AIDS in 1985—do you think
we heard about HIV in “family lifeî class in places like Preston,
Iowa and Allouez, Michigan? In particular, how many I.V. drug
intervention programs do think targeted that demographic at
that time?
How many are targeting
them today?
In 1988, I graduated
from high school. In 1990, the city of Sioux Falls finally
overcame community opposition long enough to build a Planned
Parenthood. Positively Aware got started the same year residents
of the largest city in South Dakota gained access to birth
control methods from somewhere other than their family doctor’s
prescription pad.
Need I say more?
Even though most people nowadays
acknowledge that women of all ages and backgrounds have sex,
there’s still a lot of ignorance surrounding the high level
of I.V. drug use among women in general, and among certain
women’s partners. This was certainly true of my demographic,
even though many of us—or the people we dated—were in bands
where the popular look was pale, lanky, androgynous and sleepy.
Boys and girls so bony you wanted to drag them offstage and
feed them nourishing soups, if they could stay awake long
enough to eat them. My own long-term boyfriend was in one
of those bands, though they were definitely more healthy-looking
than most of their colleagues. He was also a bartender in
one of the most popular music venues in town, with constant
access to all the perks of said job: women, men, drugs, totally
justifiable reasons for rolling home in the wee morning hours
long after I’d gone to bed, etc. We’d been together so long
that we didn’t use condoms anymore.
My gut rolls over when I
think of how much trust I placed in him—trust that fortunately
was merited (either that or he really read all those outreach
pamphlets I kept stacked in his storage cabinet). Many, many
women I know weren’t that lucky.
Women weren’t lucky in other
ways, too. Our gay friends knew and believed that safe sex
was hot sex (they’d seen that unsafe sex could leave you permanently
cold), but in the early ‘90s you didn’t even hear much about
women and AIDS. If you did, the women you heard about were
generally “drug addicts,î “homeless,î or “prostitutesî—which
we were not, since A) we only used drugs sometimes, and B)
we just had sex with the friends and friends-of-friends who
let us sleep on their couches and eat their food when we were
between jobs or too young to get an apartment. We didn’t do
it for actual money; we weren’t hookers or anything. Anyway,
we weren’t going to get AIDS because we came from towns, farm
counties, and suburbs, not big places like New York City.
Oh, we knew we could get it—in theory. But it didn’t really
sink in for a lot of us. And my girlfriends were no more skilled
than any other young women in negotiating condom use with
partners, despite our high literacy rate and liberal politics.
We could easily get our hands on a copy of “Our Bodies, Ourselvesî—and
that access to information is, unfortunately, still a privilege—but
that alone didn’t mean we were empowered enough to put what
we read into practice. I personally saw all too many of my
friends and aquaintences use and abuse the Unclean Way, and
based on the number of times I supported women friends during
home pregnancy tests and gave STD tutorials and referrals
to the area’s excellent low-cost clinics, I can say quite
honestly that there was safer-sex Trouble in our own little
River City.
But most of us were,
you know, white. And everyone knows white girls don’t get
HIV.
We were morons, is
what we were. But we didn’t have too many people telling us
otherwise—just like women today. In fact, a lot of healthcare
providers are more than happy to reinforce these stereotypes
for us. I know plenty of young women who have been told by
their doctor, gynecologist, or pre-natal care provider that
they’re “not at riskî for HIV, as though because they’re white
women who’ve had a few college-level courses they do nothing
in the sack but discuss “Beowulfî with their always-monogamous,
always-hetero, always-straightedge lover (note the singular
form: “niceî girls may have sex now, but we still never have
more than one partner at a time. We never do drugs either,
and we certainly never shoot up or let our boyfriends shoot
us up with communal syringes at after-hours parties. But you
knew that already). I know plenty of young women who “confessedî
to fictitious high-risk activities during pre-test counseling
because they’d been denied HIV tests so often that they knew
lying was the fastest—and sometimes only—way to get one. From
what I hear, this is still as true in 2000 as it was in 1990.
People from my background are always more than happy to believe
that the people they think are the least like them are definitely
at risk for all sorts of things, including HIV and AIDS. When
I visited my mother’s family in downstate Illinois this summer,
for example, they were so pleased to hear that I’m doing “good
workî for the “underservedî in the big city. They’d never
heard of the state STD and HIV hotline I work for, nor apparently
did they consider southern Illinois “underserved,î even though
any of them would have had to travel two counties over to
get services if they were HIV positive, or even had an embarrassing
infection.
As a friend of mine said
recently, “If 50% of youth live in large cities, where do
you think the other 50% live?î I can tell you this: they do
not live in places that provide them with the health information
and services they need, especially when it comes to HIV.
It’s true that many outer-city
kids lead comparitively more privileged lives than most inner
city youth (though not all do, especially youth from rural
boom-and-bust economic regions). Unfortunately, their “privilegesî
also include ignorance and isolation, along with hefty doses
of culturally-endorsed denial.
The risk factors my friends
and I engaged in 10 years ago haven’t dissipated; if anything,
they’ve increased. What hasn’t increased during that time
are services for non-city people with HIV/AIDS, or prevention
services for the next generation of rural and near rural kids.
There’s no needle exchange in Decatur, Illinois. There’s no
young-injectors HIV/AIDS awareness campaign in Clancy, Montana
(heck, there’s none in Chicago, either). And now that we all
know abstinence-only sex ed programs are the greatest things
since sliced bread and we can rest assured that all America’s
youth won’t even think about having sex until their mutually
heterosexual life-long monogamous marriages take place, there’s
really no need to even talk about these “issuesî anymore,
is there?
No, they’ll just do what
everyone before them has done: become infected, and then infect
others before they get into rehab or fall sick and find out
why. Because everyone knows AIDS only happens to gay men.
Or inner city Black and Latino women. Or those “backwardsî
people in Africa and Thailand. Or anywhere else but “here.î
I’m not in touch with most
of my old crowd anymore. Most of them are on the West Coast
now—Seattle, Portland, San Francisco—and hopefully they’re
doing better out there than they were the last time I saw
them. The ones I know of from the grapevine have mostly gone
through rehab or overdosed; there are quite a few successful
rehab stories, which is a great blessing. The one good friend
I still know from that time tested negative for HIV, though
she lost most of her cervix to aggressive treatment for early
cervical cancer at the age of 31 (we didn’t hear much about
HPV or other STDs either). The old “sceneî seems to have quieted
down as well, or maybe it just migrated west with a lot of
the scenesters.
Or maybe I’m just out of
the loop now, and it’s the same as it was a decade ago.
Because I don’t know where
they are, I don’t honestly know how many of the Old Crowd
came up HIV positive. Maybe the numbers are as small as we’re
led to believe. Maybe there weren’t enough of us infected
at that time to spread HIV within our circle of friends. Maybe
our communities were more insulated than we thought, or more
of us adapted our behavior before things got really bad. Maybe
we did get lucky. If not, those of us who never felt the need
to test should start figuring that out any day now, given
that 8-to-10-year incubation period. All I can say is we were
definitely “high-risk,î despite our age, race, gender and
background.
We were so much like women
and girls today, coming from the same backgrounds, the same
suburbs and small towns, and the same experiences.
Again: Need I say more?
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