Taking on HIV and AIDS in our Backyard

In Washington, D.C., close to 3 percent of the population is HIV-positive and minorities represent nearly 75 percent of the number of people living with HIV. EGPAF sat down with Nanah Fofanah, a Whitman-Walker Health community health educator, to discuss what it's like to be on the front line of the HIV epidemic in our nation’s capital.

Can you walk us through a typical session as community health educator?

The first part of the session is getting the HIV test done. The test that we conduct is called the Clearview test and the results are ready in 15 minutes. As we wait for the results, I explain the test to the clients, assess their risks, and use this time to talk about HIV. It’s a very brief and informative HIV 101 session.

The second part of the session is post-counseling. I always ask, “how do you feel about your results?" and "what's your plan?" I turn it back to the individual because ultimately, it’s their decision. You have to be your own advocate about your health.

Counseling is about pointing out the risk factors and discussing what you can do to decrease your risk. 

Do you help them come up with a plan of action?

Yes. I’m not telling people don’t have sex, but asking what do you think you can do to lower your risk. I've had some people say, "I'm going to use condoms from now on."  That's a bold statement; we try to figure out a plan that's more realistic, making sure they’re the ones making their decision and making sure that we’re the ones to help them.

The most important thing is that they know their results. I'm telling them things that may change their lives, and it's not always easy. It's really about making sure that when they leave they feel okay, that they know they're supported, and that they have options.

Statistically, we know that HIV prevalence rates are higher among minorities, can you see those disparities in your day-to-day interactions with patients? 

Based on our stats now, in 2012, 47 percent of Whitman-Walker clientele were black or African-American, 38 percent were Caucasian, and 15 percent didn’t want to identify. The rates are also high among men who have sex with men (MSM), especially African-American MSM.

How do you deal with people who are reluctant to get tested because of the stigma surrounding HIV/AIDS?

We’ve come a long way in terms of people being able to talk about HIV. Now we go to metro stations and talk about HIV; people come in and say, “We just started dating, we're getting tested.” It’s a conversation that’s being had more than it used to be. But there’s more that we can do.

Education is the cure to stigma.

When you don't know about HIV, fear becomes all you know. The more you know, the more you can combat it. You can't see somebody and say, “Oh, you have HIV.” A lot of our patients, we don't know their situations, you have no idea what happened to them or didn't happen, so we don’t make judgments. We just offer assistance and support.

I facilitate group counseling sessions with people who have been living with HIV for a long time. They explain that in the past, nobody wanted to talk to you or touch you. None of us would feel great if you were shunned because of something you have no control over. Because of stigma there are a lot of people living with HIV and they don’t even know it.

It’s about educating everyone and making it a safe place for conversation.
                                                                                                                                                          
What keeps you motivated?

I believe in empowerment, that’s what keeps me motivated and passionate. The more you know about yourself and your health, the more you can do for yourself and your community.

The hardest part of my job is that it all comes back to the patient. All you can do is hope that they take what you're giving them and that they know they can go to any testing center and get the information that they need.

I'm always encouraged when people ask for print-outs of their results. When people ask for their results, it means they need proof and that they’re going to show people their status. It means people are going to be talking about it.

What's the take away message that you try to leave with your clients?

When it comes to HIV counseling and treatment, it's so, so important that you meet someone where they are at that point in their life. The issues you all encounter globally are here too. We just don’t see them on the same scale.

It’s important for people to get tested, know your status, and to talk about these things. The more you talk about these things, the more it becomes less of a taboo.

Nanah Fofanah is a community health educator at Whitman-Walker Health.