Feeling awkward and embarrassed while watching your parents fumble through a choppy monologue about “the birds and the bees” is a cringe- worthy childhood memory for many people. However, the discomfort of talking about sex and presenting sex as taboo or scandalous is not present in other cultures within our country.
Gayle Robinson, a professor in the Seattle University College of Nursing, had a very different experience with learning about sex in her formative years. Raised in rural Mississippi, Robinson’s community engaged in “intergenerational dialogues,” or IGDs. Robinson presented her research on the power of IGDs in Garrand on April 5.
“I grew up around this concept of people being able to help each other and talk you through things,” Robinson said.
Robinson saw how successful IGDs could be, so when she moved to Seattle and didn’t see those conversations happening, she wanted to incorporate the IGD method into mainstream forms of sex education.
Robinson discovered that in 1993, HIV/AIDS was the leading cause of death for African-American women ages 24-45. She discovered that African-American women still have much higher rates of HIV than women of any other ethnicity. African- Americans represent only 12 percent of the United States population, but constitute around 44 percent of HIV cases today.
Robinson speculated systemic reasons for this disparity, from economic to housing situations, and from education opportunities to stigmas to overall access.
“Your education level and your sense of poverty can change your whole world view about what is possible for you,” Robinson said. “And who you choose as a mate. Who you think you deserve, what you think you deserve, all can be influenced by just those dynamics.”
Through these unsettling discoveries, she saw an opportunity to implement her desire for more IGDs in order to lower HIV rates among African-American women.
“I’ve been away from home for a long time and I kept trying to figure out: How do you go home and make a difference with some of the research work that you do? And I began to make the connection between what was going on with HIV prevention,” Robinson said.
On top of creating healthier community conversations about sex, Robinson’s goal was to have more people get tested for HIV so those receiving positive diagnoses could get treatment at earlier stages.
“The risk is not knowing, so people need to get tested,” Robinson said. “Treatment does work. We have to find a way to get to communities that are more vulnerable.”
So, she returned to Mississippi and conducted a qualitative study which was comprised of interviews with 30 African-American women in the city of Forest. Ranging from ages 18-80, 93 percent of them had participated in IGDs; 56 percent were talking about sexual health; 43 percent were talking about HIV.
She had two main research questions: In what ways would IGDs be used for addressing sexual health and HIV prevention? And, what kind of topics would you include and not include in the topic?
Robinson emphasized the effect of chosen language in the success of these conversations.
“Saying ‘war on AIDS’ versus ‘response to AIDS’ matters. When you think about war, you think of someone who needs to be eliminated… We need to get people more involved in [discussing HIV], where it isn’t seen as taboo,” Robinson said.
The establishment of trust and comfort within the conversation’s setting is necessary to IGDs effectiveness. Robinson believes being able to normalize these conversations so that they can be discussed in casual settings in vital.
“Just having conversations at the dinner table, or while driving in the car, or anywhere,” Robinson said. “You don’t have to worry about having the right words, you just go into the dialogue and it’ll evolve but if you don’t do it, you won’t get practice.”
Seattle U senior nursing student Shika Kalevor attended Robinson’s event. She expressed frustration regarding dialogues about sexual health.
“I feel like we really don’t talk about [sex] enough,” Kalevor said.
The women Robinson talked to didn’t think any of the conversation about HIV should be censored, including contracting, testing, treatment and impact on your life.
“[This openness is necessary] to destigmatize and take some of the fear out of the discussion,” Robinson said.
Robinson is partnering with the licensed behavioral health agency, Sisters in Common, a community- oriented childcare organization that believes in having HIV-positive people held accountable by family and friends for taking their medicine and going to doctor appointments, for example.
“It’s as powerful, if not more powerful, than a doctor you go see for a few minutes in his office and he gives you a prescription,” JC Ephraim said, a Mental Health Specialist for Sisters in Common who attended Robinson’s event. “Some kind of dialogue is more supportive in terms of health and well being.”
Robinson will work with Sisters in Common to further pursue her goal of creating healthy and destigmatized conversations around sexual health within families and communities.
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