HIV, Lesbians and Little Boxes
August 21st, 2009
One of the many nerdy things that interest me is database design. I learned to make the most basic contact database in university and have been improvising my way through various PWN database challenges ever since. One exciting example from pretty early on is the question of the tick box. Databases are good at storing tick box information. For example, if woman X is interested in both cake decorating and field hockey, woman X will show up in database lists of both icing-spreaders and stick-wielders, as well as in lists of women who both spread and wield. For some reason, we have a much harder time with ticking multiple boxes in real life; we tend to want everyone to fit into neat little boxes and either/or categories. This seems to be where many people fall through the cracks in HIV prevention and care.
It’s widely presented that “lesbians can’t get HIV” and sure enough, there have been no recorded cases of woman-to-woman sexual transmission in the US. But it turns out that there are lots of women who identify as lesbians and are also living with HIV/AIDS. According to a hot-off-the-press (June 2009) report by the Women’s Institute of the Gay Men’s Health Crisis (GMHC) in New York, 14% of GMHC’s positive “female clients” in 2008 identified as lesbian or bisexual. Could it be because many women who tick the “have sex with women” box might also tick other boxes, given the chance?
Just like heterosexual women (and men for that matter), women who have sex with women (WSW), whether they consider themselves lesbian or not, engage in behaviours that transmit HIV. The vast majority of WSW who contract HIV do so by having unprotected sex with a man or by sharing needles to inject drugs. There are also high-risk activities in lesbian sex (anything that allows body fluids from one partner to enter the bloodstream of another). But it turns out many WSW (84% in one study) believe that they are at “zero risk” for HIV and other sexually transmitted infections (STIs). It seems that just as many doctors ignore sex between women altogether and don’t ask questions that would lead to proper prevention and care for at-risk women. The woman and doctor, and any number of other healthcare providers, are ticking the “lesbian” box and moving right along, assuming there is no risk.
For somebody who wants to see the world in black and white, perhaps it is easier to fit people into little boxes. It makes it easier to pass moral judgments, and some people just aren’t comfortable in their own skin unless they can do so. But HIV doesn’t really care if you’re a man or woman, black or white, gay or straight, or none of the above. It only cares about what you do, and all kinds of people regularly put themselves at risk for STIs and HIV (in fact, the vast majority of people will have unprotected vaginal or anal sex during their life). I agree with the GMHC’s statement that “a woman’s risk of contracting HIV is directly related to her experiences and behaviors, which cannot solely be determined by the use of labels commonly used to identify and individual’s sexuality and sexual identity”. So stop trying to fit us into little boxes!
-Miriam
This blog represents the ideas of individual writers, and does not necessarily reflect any formal stance taken by Positive Women's Network.
This was posted on Friday, August 21st, 2009 at 10:00 am and is filed under Body Health, HIV Prevention . Feel free to respond, or trackback.
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