Jose Antonio Vargas
Washington Post Staff Writer
Monday, August 4, 2003 2:49 PM
She tested positive for HIV in October, infected by the man she had married the year before.
He hadn't told her that he was HIV-positive and that he slept with men. She got pregnant. They got married. And, at 26 months old, their daughter died from HIV complications.
"If only he told me he preferred men over women. If only he came out with it. We could have been just friends," says the 50-year-old social worker, who lives in Southeast Washington and is black. The woman, who asked not to be named out of concern for her privacy, sits in her office for a moment, the only sound a light summer rain pattering at the windows, the near silence unnerving. Then the demure woman suddenly contorts in a minute-long tirade: "I'm very angry, I'm very hurt. . . . This is someone who killed my child. . . . I want revenge. I mean, I've wanted revenge. . . . . Should I kill him? Sue him?"
She collects herself, and with half a smile edging back onto her face, she asks, "What can women do?"
The question is familiar to Patricia Nalls, who hears similar stories with numbing frequency. Three weeks ago, a 25-year-old woman was infected by her boyfriend, who then left her for a man. A week before, a 52-year-old woman found a pill, which turned out to be HIV medication, in the pocket of her boyfriend's pants. She hurried to a clinic to be tested. She is HIV-positive.
Nalls, 46, runs the Women's Collective, a nonprofit organization in Northwest for women living with HIV and AIDS in the Washington area and the only organization of its kind in the country, local and national health officials say. With the District ranking highest among major cities in the rate of new AIDS cases a year -- blacks account for 80 percent of those cases -- Nalls fears that there's a trend that has gone unnoticed: an increasing number of HIV-positive women, infected by their husbands or boyfriends, who come knocking at her office, unsure what to think, not knowing who to turn to.
Nalls said they haven't a clue that their men are on the "down low," an expression describing black men who have sex with other men -- some, if not most, having unprotected sex -- and never mentioning it to their female partners.
In a 2001 report by the Centers for Disease Control and Prevention, these men were identified as a major bridge for transmitting HIV to heterosexual women. They existed -- in E. Lynn Harris's best-selling books, in a poem by Essex Hemphill about men secretly having sex in the District's Meridian Hill Park -- long before the term down low became the subject of several newspaper and magazine articles.
Yet the women in these men's lives, in some cases the mothers of their children, have seldom been mentioned.
Carren Kirkland, HIV outreach coordinator for the D.C. CARE Consortium, an umbrella organization of AIDS groups, works with HIV-positive men and women. She deals with men who are on the down low regularly and is familiar with the pressures that keep them from telling the women in their lives. She said most of them are addicts and that some have sex with other men for drugs; some have sex with other men just for the sex; and some do it for both reasons.
The problem, Kirkland said, is that "then they go home and sleep with their girls."
On a recent Sunday, about 1:45 a.m., a 32-year-old restaurant worker who was at Secrets, a gay bar on Half Street SE, made his way outside. He said he read about the bar in the Washington Blade, a weekly gay newspaper, and decided to check it out. His girlfriend was away for the weekend -- where to, he didn't elaborate. This was only his second visit to Secrets, he said, adding that he had "fooled around" with guys twice before.
Is he gay? He wouldn't say. Is he bisexual? He wouldn't say.
"What she don't know won't hurt her," he said as he smoked a cigarette while fidgeting with a lighter. "I play safe. . . . It's all good. . . . She don't need to know nothing about it."
That mentality, said Ron Simmons, is pervasive in the black community, where the taboo topic of homosexuality, and anything else outside the heterosexual norm, clashes with the interlocking issues of race, religion and gender.
"What we're talking about goes beyond the individual," said Simmons, executive director of Us Helping Us, an organization for black gay and bisexual men in Southeast Washington. "Men and women in the black community are not equal. It's rooted in the book of Genesis: God made Eve from Adam's ribs. Black women, for the most part, don't question what their men are doing. They don't confront them. They are willing to put up with things that I, as a gay black man, would never put up with just to keep a man."
Worse, Simmons said, is the denial within his community. "Black people don't talk about homophobia -- not in our churches, not in our living rooms -- so you have men afraid to come out, fearful of telling their families what they're really about."
Such men, Nalls said, sometimes use women as a front. "They bring women to the company Christmas parties. They introduce them to their families. But the women are just that -- a front," she said. "And when everything comes spiraling down, when these women find out what's really going on, they can't help but feel used. They beat themselves up. They ask, 'Did he really care about me? Was everything just a lie?' "
The Rev. Herbert B. Chambers, a pastor for 16 years at Young's Memorial Church of Christ Holiness in Southeast Washington, disputes what he called the "myth of the homophobic black church." Some churches may not address homosexuality openly, he said, but they do understand that the men and women who are "involved in the gay life" are their brothers and sisters, their sons and daughters.
"I don't think all churches are publicly going to say that they endorse that alternative lifestyle, but I do think we have no fear of men and women who choose that life. . . . Put it this way: I may not accept his lifestyle, but that doesn't mean I don't care for him or love him. Most of us are awakening to the idea that gay men and women are a part of us. They're of our flesh," Chambers said.
He meets HIV-infected women, mostly mothers, through an AIDS housing and care program formed in 1992 with four other SE churches, and voiced his concern about the reluctance, by both men and women, he said, to use protection when having sex.
"What's happening to these women is a major problem," Chambers said. "We all need to be involved in trying to help them."
Nationwide, about 75 percent of newly infected women contract the disease through sexual contact and the rest through intravenous drug use, according to the CDC. Those percentages closely parallel the District's, said Guy Weston, director of data and research of the District's HIV/AIDS Administration.
In the District, adult women accounted for 33 percent of all AIDS cases in 2001, the latest year for which figures were available, Weston said. That percentage has increased more than 400 percent since 1981, when AIDS was first reported. Adult women represented 7.2 percent of AIDS cases in the District that year, and 11 percent in 1990. They are now the fastest-growing population at risk to HIV and AIDS, Weston said.
And although local health agencies have targeted men on the down low in their HIV prevention efforts, urging them to have safe sex, some question why almost nothing is being done to reach out to the women they infect and to call attention to their problems.
"There is a lack of open dialogue, and this side of the story of how black women are getting HIV hasn't been adequately addressed," said Carole Bernard, spokeswoman for the D.C.-based National AIDS Minority Council. Bernard said black women are the new face of the HIV epidemic in the District and in the country. "It makes it very hard for women to protect themselves when they don't fully know the sexual behavior of their partners. With the information that's out there, I'm not sure if it's clear enough for women to understand what's going on."
The disconnect was clear in May 2001. "If you have sex more ways than most folks, call the down low line," said the last sentence of a local, 60-second public service announcement on National Public Radio that aired in the District then.
"Men on the down low knew exactly what that meant," said Simmons of Us Helping Us, which produced the announcement with funding from the CDC. It received 614 phone calls in 2002, he said, mostly from men.
And women? "Other than making them mindful that their men are fooling around, what else can they do?" Simmons asked.
At the very least, these men are responsible for telling their female partners about their sexual behavior, said Eve Mokotoff, chief of HIV/AIDS epidemiology at the Michigan Department of Community Health. But many of the men deny their actions, she said.
"What's happening to these women is tragic, and it's not only specific to Washington, D.C.," Mokotoff said.
Women, in turn, need to empower and educate themselves -- they need to make sure they're having safe sex, said Nalls, who has been HIV-positive for 16 years. She was infected by her husband, who didn't sleep with men but had used intravenous drugs. "Protection is the answer here. It is sad and unfortunate that our society still doesn't embrace and accept homosexuality. But until then, what happens? Women cannot be the brunt of all of this. Men know how to put on a condom, and they need to be honest. Women need to ask questions, and they need to be careful."
A 27-year-old Southern Maryland resident tested positive for HIV after dating her boyfriend -- "an average working-class guy, not too personable, though he came across as a very good person," she said -- for six months. Though he never said he was bisexual, she said he believes that he is. It wasn't until she lay in a hospital bed at Shady Grove, running a high fever and suffering from severe flu, that he told her he was HIV-positive. That was 1997.
The woman, who spoke on the condition of anonymity, works in health care. "He knew what I did for a living. He knew I have to get tested every six months. He knew I'd find out. Why didn't he just tell me?"
She says she has nothing against gay or bisexual men; she has friends who are. "What I take issue with is that I wasn't given a choice. I didn't know. How could I know? I feel like someone has put a death sentence on me. He doesn't have the right to do that."