PART II: Prevention Education
The Reverend Dr. Nancy Carter is a freelance writer who lives in New York City. She founded The AIDS Education Project of the New York Annual Conference of the United Methodist Church in 1986 and was its coordinator until December, 31, 1990. Dr. Carter has been a member of the Women and AIDS Project of the New York State Division for Women since its inception in 1985. She is the author of numerous published articles on the HIV/AIDS epidemic.
Women as a group remain dangerously uninformed about safer sex practices and how AIDS is transmitted. According to the federal Centers for Disease Control (CDC), most HIV-positive women have been unable to identify any risk for their infection. This fact is very disturbing. "If women continue to be unaware of their risks, and recent trends continue, thousands of women will die prematurely each year."[1]
The Need for Culturally Sensitive Education
Women must be given information relevant to their cultural, economic, educational, and religious background. For instance, AIDS education approaches which work with gay white men may not be appropriate to Spanish-speaking Caribbean women, as one female AIDS education worker in New York City discovered during the earlier days of the epidemic. A film she showed produced by a community-based AIDS organization shocked and embarrassed the women. In another case, a video made for New York public schools featured, in its first version, white upper middle class school girls and gave no role models for males taking responsibility for safer sex. The film had little relevance for African-American and Latina young women. It also failed to stress mutual decision making by both females and males.
Not enough has been done in targeting educational materials to women at risk. Some pamphlets are college reading level. Some use correct grammar when slang words would be best understood by an intended audience. Other pamphlets are translated from English to another language. Too often, information in these materials is irrelevant because it is translated literally without a solid understanding of the cultural heritage of a community or certain problems women from a community may encounter when confronted with sexual decision-making. One of the most difficult groups to reach has been intravenous drug users. In the past few years, more pamphlets have been produced by the groups to which they are addressed therefore increasing their effectiveness. In some communities, pamphlets are of little use; one-to-one contact works better on creative approaches such as street theater and concerts.
Information alone will not change behavior for women or men. A variety of educational approaches, including the use of role plays, interactional games, audiovisual aids, and informal and moral peer support groups increase the possibility of change of behavior. I will always remember a creative talk by Beverly Henley, who was then a community coordinator with the Bedford Stuyvesant AIDS Education and Outreach Program in Brooklyn, NY, at a conference on "Minority Women and AIDS," in New York City in 1987. She brought a grocery bag of vegetables and noted that men often claimed that condoms did not fit when women suggested using them. Then she began to put condoms on different vegetables, starting with a puny looking small squash, moving to a cucumber, and ending up with a giant zucchini. "You see," she said. "They fit all sizes." We were laughing and also getting the unforgettable point of the demonstration.
Linking changes to values a person or a group already holds will increase effectiveness, as groups like the Gay Men's Health Crisis discovered early in the AIDS pandemic. If a women feels as if her values or her lifestyle are under attack, she will be less likely to respond positively. I believe that church safer sex educational programs, if they are both non-judgmental and communicate values which women can positively link to their Christian or other spiritual traditions, can be more effective in changing behavior for women who attend churches and/or are participants in 12-step groups. For many women, spirituality is an important part of their life which should not be ignored in safer sex education. Later in this paper, I will share a model of a "spirituality of safer sex" seminar that I did on a retreat with clients of the Upper Room AIDS Ministry in New York City.
Education is most effective when it is done where women are--at home, in church, in beauty parlors, in crack dens, in shelters for battered women, in prison, in hospital prenatal clinics, in shelters for homeless women--rather than expecting women to come to a place where education is offered. "What women need is 'user-friendly' research which will provide them with a practical means of protecting themselves from unwanted future intercourse with infected men" [and women].[2]
The Impact of Sexism and Sexual Violence
Prevention for women does not involve their simply knowing safer
sex techniques. Societal ills which oppress women in general
must be addressed. AIDS education campaigns have been
"repeatedly criticized... for proceeding on the naive and false
assumption that women [can] exercise more influence over sexual
practices than [is] actually the case.... Women at the bottom of
the socio-economic ladder often [do] not enjoy even the most
basic human rights."[3]
When they decide to protect themselves sexually, some women must
deal with the possibility of the difficult and/or dangerous
consequences of their partner's responses to their assertive
decisions. For example, some women are from cultures where women
have never been permitted sexual empowerment. At the least, men
may be taken aback at a women's assertiveness.
Men may verbally demean the woman suggesting that she is being
promiscuous and therefore wants him to wear a condom. Men may
consider a condom to be unmanly. Some men tell women who suggest
safer sex to move out, which would leave the women with no way to
support themselves or their children. Often these women will
choose to have unprotected sex and risk future illness rather
than present hunger and homelessness. Most, if not all, abusive
situations which have been reported involve male violence;
however women can also abuse female partners.
Women from all over the globe suffer from the consequences of the
oppression of sexism, even in so-called "developed" countries.
..."their rights to safer sex [are] socially unrecognized and
thus uninformed. ...the mere suggestion that their partners use
a condom often [leads] to personal rejection or even violence.
This situation... must be remedied before any real progress [is]
possible."[4] Women who insist on safer sex may need help in
finding a way out of an abusive situation that will at least care
for their basic needs of housing, food, clothing, income, and
school for their children.
Many women are vulnerable. For instance, homeless women are at
risk for rape and other abuse on the street and in shelters.
They need safe housing. Homeless teenage women often use
prostitution to gain income and may be drug addicted. They need
to get off the streets and be in a protected environment with
loving adults who can help them gain formal education and
employment. They also need to be guided to professional and peer
support resources which can assist in their recovery from the
physical, emotional, and sexual abuse which originally caused
them to run away (or to be "thrown away") and to become addicted
to drugs or alcohol.
"One worker from the New York City Health Department has
estimated that over 90 percent of the AIDS kids living on the
street would test positive for the AIDS antibody... They've been
physically abused, sexually abused, in and out of youth shelters,
and in and out of jail. They're black, white, Hispanic and
Asian... They're our kids."[5]
Rape, child molestation and incest have become even more
traumatic for women than ever before. In the past, victims of
rape have had to worry about unwanted pregnancy and infection
from venereal disease, but now they must be concerned about HIV.
Sometimes the problem of child sexual abuse and incest is ignored
in AIDS education of students. There are teenage women (and
younger female children) still living at home who are being
sexually and physically abused. These women need information
that the perpetrator is wrong and that they are not at fault for
the bad things which are happening to them. They also need to
know to whom they can go for help to stop the abuse and that they
will be supported in the aftermath of their report.
The Varied Needs of Different Communities of Women
There are many examples of women with varied needs. Prevention
education must take this reality into account. For instance,
women are dying of AIDS in prison, as are men. Words spoken by
Catherine O'Neill in 1987 are still valid;
Women are at risk for two reasons: their own IV drug use and
their sexual involvement with men who have an IV drug use
history. These women bear children who are also at risk. Women
who either are in or come in contact with the criminal justice
system are a population that is extremely difficult to reach. It
is a population that becomes a captive audience when the women
become incarcerated or a population that can be reached when
women come to visit the men in prison. We need to do preventive
education and counseling of women who are at risk, both those who
are incarcerated themselves and those who come in contact with
the criminal justice system by coming to visit or by constituting
the family to which the men return when they are released.[6]
Another group of women who are slighted in prevention education
are women who have sex with women. Educators must make clear
that women who sleep with women should be concerned about HIV.
Many lesbians believe that they do not have to worry about AIDS,
even those who have sex occasionally with men. In addition,
lesbians and bisexual women are not the only women who have sex
with women. Education must break through the denial of
heterosexual women who sometimes have sex with women. They need
to be aware of safer sex practices with women also. Including
education about women-to-woman sexual activity communicates that
the safety of women who sleep with women is important and that
women of all sexual orientations are persons of sacred worth.
Substance abuse and HIV is another concern in relation to
prevention education. Most substance abuse programs have been
designed by men for men. According to Janet Mitchell, M.D.,
M.P.H., of Harlem Hospital in New York City:
"Women do not respond well to the confrontational methods used
in drug programs, nor do they feel they belong in groups that
focus totally on the individual. Women are more family focused
and more often than men have sexual partners who are substance
users, so dealing with their own substance abuse is not
enough."[7]
She says that substance abuse treatment programs should, like
alcohol programs, include familial causes and the consequences of
substance abuse in their focus.
Another problem for women who want to quit taking drugs is the
lack of child care services. In the case of outpatient programs,
either the women can't come or they must bring their children
with them. Most residential programs require that women give up
their children to the care of relatives or foster parents while
they recover. Azimah Ehr, M.D., administrator of medical and
mental health services at Daytop Village, NY, says, "Most
pregnant addicted women are afraid to enter drug treatment
because they fear their babies may be taken away from them, which
may not necessarily be the case...."[8]
Finally it must be noted that women who have sex with men
consistently emphasize that their male partners be taught about
AIDS and safer sex. Clearly they are correct. Education should
not reinforce the archaic notion that only women are responsible
for the consequences of sexual behavior. Men must accept equal
responsibility for protecting themselves and their partners
against infection or accidental pregnancy. As men's attitudes
toward women change, fewer women will be emotionally, sexually,
and physically abused.
"At the present time, the only weapon against the disease is
prevention, and the only vaccine is education."[9]
This section has surveyed some concerns related to prevention
education for women. The next one will describe a number of
community education models for women.
The third section will explore the spirituality of safer sex and
ways the church can address situations which contribute to women
being vulnerable to infection with HIV. A resources list is
included at the end.
"An Ounce of Prevention: A pound of Cure"
The World Health Organization (WHO) has identified five key areas
as a "framework for intervention." They are:
(1) Public policy initiatives in legislation, fiscal measures and
organizational changes to foster greater equity;
(2) Supportive environments which "make the healthier choice the
easier choice" through easy access to condoms and overall support
of non-risk behavior;
(3) Community action through self-help support groups, NGOs and
lobbyists to introduce needed legislation;
(4) Individual involvement to acquire information and skills
designed to protect oneself (e.g. "safer sex" workshops);
(5) Health services which integrate HIV/AIDS activities into
existing frameworks of maternal and child health care, family
planning and treatment of sexually transmitted diseases.[10] The
models which are described in the following pages will illustrate
different aspects of the framework WHO has proposed. A number
of these are grassroots responses.
South Carolina AIDS Education Network (SCAEN)
SCAEN is a grassroots organization which began in a unique way.
Traditionally women talk and share information while their hair
is being done. DiAna DiAna, an African-American woman, uses this
established form to educate the customers at her beauty salon,
"DiAna's Hair Ego." When she learned about AIDS, she became
concerned about educating herself and her community. She wrote
for whatever information she could get a hold of and began to
talk to the patrons of her beauty salon.
The variety of education she has offered through SCAEN developed
over time as she assessed the needs of the people of her
community through personal contact, trial and error. For
example, when she first put out condoms, women were too
embarrassed to take them; so she and volunteers gift wrapped them
like little Christmas presents. Then the women started picking
them up. She recognized the need of women to be comfortable with
condoms. So she began to hold safer sex parties she holds for
women, inventing a game in which two teams of women were each to
make up a list of as many different uses of condoms as they could
think of. She also uses other games and educational methods at
the parties.
Her story is told in the 30 minute film DiAna's Hair Ego, which
has been shown on PBX and is available in VHS format from some
AIDS education organizations. The video shows many more of the
SCAEN's activities. For instance, one of the members of SCAEN is
a singer and guitarist who writes songs about AIDS prevention.
DiAna DiAna and her volunteers have spoken to many women's groups
and children's and youth groups. They also did a video of
children asking their own questions about AIDS as an educational
tool for adults.
For more information about SCAEN write:
South Carolina AIDS Education Network
Suite 98, 2768 Decker Blvd.
Columbia, SC 29206
(803) 736-1171.
Project REACH (Woodhull Hospital, New York City)
One place to find women is at gynecological clinics. With
funding from the CDC, Woodhull Hospital has been running a
research project with an educational component, according to
Maria Ricardo, coordinator of the perinatal HIV transmission
prevention demonstration project at REACH. Project REACH has
been relating to women at Woodhull's GYN clinic. After
participating in an initial survey, the 273 women who were
interviewed were invited to come to some classes on pregnancy
planning and birth control and on preventing infection with HIV
and other sexually transmitted diseases (STDs). A monetary
incentive was offered for completion of the classes.
Some 150 women attended the classes, with about 100 finishing.
The classes began by asking what the women thought were healthy
sexual practices. Role plays were a part of the learning. One
involved negotiating with a partner to use a condom. For
another, each woman was handed a paper saying that she was HIV
negative and HIV positive and she asked to share what her
response would be to receiving that news.
The women, many of whom were neighbors, began to become a support
system for each other. One woman was able to share in class how
she had taken her niece out of her sister's home. Her sister's
boyfriend was sexually abusing the niece. The women became free
to talk about things which were touching their lives.
There was also a case management component to the project. A lot
of women had drug-related problems related to their own use,
their partner's use, or previous use. They were given assistance
in addressing these concerns.
A follow-up is planned. At the time of the interview (October
1991), it was not clear if the project would get the funding it
needs to determine whether or not the women had changed their
behavior as a result of the classes.
Columbian Red Cross (Bogota, Colombia)
Forty percent of the people in Colombia live in dire poverty,
many of them street children who face many problems: violence,
drug addiction, and sexual abuse. They, also along with beggars,
drug addicts, prostitutes, and homosexuals, must worry not only
about food and housing but about private death squads who do
"social clean-ups" (murder) of "undesirables." In 1989, 400
people were killed this way.
The Red Cross has a van, which is a place for children to come
and take a shower, get medical treatment, and chat. The staff
also does preventative health education including safer sex
education. According to Dr. Castro, the project's medical
doctor, "one of the main problems is trying to prevent the spread
of STDs is that child-size condoms are not available. No child
is going to sue a condom if it's always slipping off."
Living in such dire situations, children have sex with each other
as a source of comfort and are also exploited by adults. Adults
remove them from the streets, wash them and give them nice
clothes, and take them to a client. The child is given a small
part of the fee and is dumped back on the streets.
The project staff try to refer children to organizations which
can provide a home for them or more permanent care. One
organization is the Foundation for the Children of the Andes,
which tries to give children a family life. Elena, a fourteen-
year-old who had been on the streets for seven years and now
lives in one of the three houses run by the foundation, says "On
the streets nobody cares and you get abused. But here they look
after you like they were your own parents."[11]
For further information write:
Columbian Red Cross, Apartado AERO 11-10
Bogota, Colombia
Hospital Audiences, Inc. (New York City)
Founded in 1969, the purpose of Hospital Audiences, Inc., (HAI)
has been to provide individuals with access to the arts at
hospitals, nursing homes, mental health facilities, prisons and
other human services agencies. In the late 1980's it expanded
its audience to people in family and adult shelters and those
affected by AIDS/HIV.
With a grant from the van Ameringen Foundation, HAI developed a
workshop series which used storytelling to reach women at risk
for HIV, particularly those from Africa-American or Spanish-
speaking backgrounds. Storytelling offers a way to help women
explore difficult issues by using "characters" to act out
problems from a safe distance.
Stories from East Africa, the Caribbean, and the U.S. South were
used to form the basis to explore issues such as self-esteem,
sexual decision making, and familial expectations. In a two hour
session, women listened to stories told by English and/or Spanish
speaking storytellers and then were encouraged to develop their
own stories. The workshops were offered to hospital and
community-based clinics, outreach programs, and other agencies
for up to three months at each site.[12]
Empowerment (Thailand)
According to W.H.O. officials, Thailand has done more than any
other country in Southeast Asia to deal with AIDS. Its blood
supply is now considered safe, at least in the provincial
capitals. AIDS educational ads are run on television and radio.
The country is trying to make good quality condoms available. It
also welcomes the involvement of private agencies such as
Empower, an organization which works with prostitutes.
In Thailand, women usually become prostitutes because they need
money for themselves or their family (or their parents need
money). Poverty accelerates the amount of prostitution. Many
politicians, officials, and policeman invest in the sex trade and
benefit it. Some of the brothels are nationwide business. Thai
newspapers have suggested that certain politicians own some of
these chains.
Chantawipa Apisuk, who runs Empower, describes how young women
are recruited for brothels. Well-dressed agents come to villages
and offer parents between $160 and $800 as an "advance" on the
salary. The more beautiful the daughter, the more money they
offer. Sometimes they offer refrigerators, television sets, and
jewelry.
The women are then bonded to brothels like indentured servants
and must pay back their debt. They are like migrant farm
laborers in the U.S.--they must buy items at inflated prices from
the company store and lose wages when they don't work or are told
they are lazy or sloppy. Women are often trapped by lack of
money.
The sex trade owners usually do not allow the women to ask men to
wear condoms. If the women become infected with HIV, they are
liable to be sent home with nothing. Sometimes they go to a
rural brothel. Chantawipa Apisuk complains about people's
prejudices:
"People just want to talk about prostitutes and penalize them.
They don't want to talk about the profiteers." It's not the poor
who need to be controlled, she says, but the rich; not the women,
but the men. Changing women isn't difficult; they're ready to
change. Why not open factories instead of brothels and
bars?"[13]
The D.C. Women's Council on AIDS (Washington, D.C.)
The Council educates African-American and Hispanic women about
HIV/AIDS. Using the format of Tupperware parties, the council
holds events tailored to specific groups of women at women's
shelters, private homes, and beauty parlors. Party goers watch a
video, complete a personal risk assessment questionnaire, and
play games, including a safer-sex quiz and how to use a condom.
They are encouraged to ask questions and share sexual
experiences. The party atmosphere helps women to break down
inhibitions about discussing sex and to realize their rights and
responsibilities to insist on safer-sex. They receive "take-out"
boxes of safer-sex devices as party favors.
For more information, contact: Denise Rouse, D.C. Women's Council
on AIDS, (202) 387-4898 (address in Resources).
Women, Spirituality, and Safer Sex
Recent studies have shown that about one woman in three is
overtly (touched) sexually abused before she reaches 18. No
studies have been published about the number of women who have
experienced covert (non-touching) sexual abuse. In our society,
few, if any, women have escaped covert sexual abuse. As Pia
Mellody and others have shown, covert sexual abuse of children
can be as emotionally damaging as overly sexual abuse.
Some of the results of childhood sexual and other abuse are low
self-esteem, feelings of powerlessness, poor body image, and
addiction to chemicals and behaviors, such as alcohol, drugs,
food, shopping, and sex. A recent study of 30 intravenous drug
using women found that prior sexual and physical abuse was common
and urged that the resulting damage to self esteem be addressed
in HIV/AIDS risk reduction programs for female drug users. The
study said, "Damaged self esteem, linked to histories of abuse,
leaves many women believing they cannot control their lives or
bodies--especially in transactions with men involving drugs and
sex."14
I would extend the recommendations of this study further. I
believe issues of self esteem and abuse should be addressed in
all prevention education programs for women. Even if a woman is
not drug or alcohol addicted, a history of abuse can undercut her
ability to set safe sexual boundaries and therefore increase her
risk for HIV/AIDS.
Not only secular groups but the church can play a role in raising
the self esteem of women and addressing issues of abuse and
addiction. In addition, the church can do theological and
spiritual education. Doing appropriate prevention education in a
church setting can be difficult. A problem is that the church
has often, through sexism, discouraged women from loving
themselves as Jesus taught. At the extreme, some churches still
teach women are to obey their husbands. Such obedience can now
lead to infection with HIV.
Congregations may have to do serious work on themselves in order
to address issues of spirituality, sexuality and safer sex. Most
churches have failed to instill a sense that sexuality is a good
gift of God. Church members often feel uncomfortable talking
about sex and dealing with sexuality. Spirituality (the good) is
set against sexuality (the bad) when, in reality, both are good
and interrelated.
Recently I was asked to talk about the spirituality of safer sex
in a workshop for 20 HIV positive African-American and Hispanic
men and women. Since I met with some of them beforehand, I knew
that all who would be present had grown up in Christian churches
and had some 12-step group experience. I also knew that the fact
that I was clergy would, for some participants, give my words
about spirituality and sexuality more authority than the average
lay person.
Though I had my own definitions of spirituality and sexuality, I
asked group members to share theirs without "crosstalk"
(commenting on the definitions of others). Because of their
struggles with dealing with recovery from chemicals and/or their
HIV status, many had insightful understanding and had grasped the
relationship between spirituality and sexuality. The women
related how their self esteem had improved through their recovery
work. They were now asserting their needs and not simply
focusing on their partners' needs. They were not putting
themselves at risk for more infection. They were feeling better
about themselves and liked it.
Then I read a definition of "spiritually centered sex":
Intimate sex connects us inwardly to our selves as well as to
another. We touch both spirit and soul.... How do you know if
sex is spiritually centered? For starters, it is not dependent
on being married, being heterosexual.... It is dependent on
feeling clear, honest, and in tune with yourself and having the
best interest of yourself and your partner at heart. It is not a
substitute for another need that is avoided or being kept
secret.[15]
This definition was well-received by the group, which felt
liberated by it. Obviously parts of it are rejected by many
church people and in the official statements of a number of
denominations. I believe this kind of judgmentalism harms the
self esteem of people and thus contributes to the spread of AIDS.
By the time I defined "safer sex" I knew we had already arrived
at an understanding of it. "Safer sex" is when we feel safe and
are safe with our partner, spiritually, emotionally, and
physically. In other words, "safer sex" in spiritual context is
more than techniques used to prevent HIV/STD infection. The
women seemed to especially resonate to this idea. For women
"safer sex" must include safety from current abuse and safety
from the triggering of memories of former abuse.
As a teaching device, I created a chart using the letters of the
words SAFER SEX to get across my point. It reinforced some of
the ideas which we had already shared as a group:
SAFER SEX IS:
Spiritually centered (mind, body, spirit are one) & satisfying
Accepts responsibility to protect self & others from AIDS & STDS
Feelings of love and care for self & partner
Engages our highest self and energizes us for respectful
Relationships
Self-esteem of self and partner is built up
Embraces the best interests of ourself and our partner
Xciting, xhilarating and xtatic.
The group especially liked the first and last lines, adding words
such as xtraordinary to the last line.
We ran out of time, so we were not able to talk about addictive
sex at length. A definition of addictive sex which has been
helpful to me follows:
"When sex is separated from love and care, it can become
addictive. Rather than bringing us close to someone, it becomes
a block to intimacy.... Addictive sex does not open up feelings
but is carried about in an attempt to hide them. Participants
are not alive and present to themselves to their partners. ...It
objectifies oneself and another person. It is skin touching skin
in search of 'high.'"[16]
Below is a chart I planned to discuss:
ADDICTIVE SEX IS:
Abusive and avoids true feelings
Distance is created between self, others, and God
Depressing, detrimental, and degrading
Irresponsible
Compulsive
Tears apart our senses of wholeness and troubles our spirit
Increases our frustration, anger, and hopelessness
Violates our self-esteem
Exploits others.
Secrets are kept
Empty and void of intimate feelings
Xternal satisfaction is sought, not internal love & wisdom.
Our whole society needs to be educated about spiritually
centered or healthy sexuality, which will, in turn, reduce the
rate of infection from STDs. Some of the guidelines we have
received from both church and society have been inadequate and
sometimes abominable. For instance, we laugh at the antics of
people like Al on "Quantum Leap" and Arnie Becker on "L.A. Law"
when the truth is they are in the grips of disease. We do not
recognize that sexual repression (called "sexual anorexia") is
also an addiction. Our image of sexual addiction is similar to
our image of alcoholism 50 years ago. (See resources.)
Introduction of the concept of sexual addiction can be
controversial, particularly with gay men and lesbian women who
have often been labeled "sex addicts" because of their
orientation. Care must be taken not to communicate this idea.
The group that I did this workshop with was appreciative. I
have no way of measuring long-term results. I share this model
in hope others may use some of it. I would also like to note that
I did not do this workshop in isolation. At the retreat, I also
led the worship services, a meditation workshop, and one of the
prayer times and designed all of these to affirm a healthy sense
of self: spirituality, emotionally, and physically.
Actions Churches Can Take
In Focus Paper # 17, I suggested a number of ways churches could
help address concerns of women and HIV/AIDS. Following are a few
related to prevention education, including building self esteem
and addressing the problem of abuse.
1. Churches can open their doors to 12-step groups and refer
people to them. Many churches already have Alcoholics Anonymous
(AA) and Narcotics Anonymous (NA) meeting in their space.
There are other 12-step groups which focus on recovery of self-
esteem and dealing with root causes of self destructive behavior.
Two groups especially important for women and which also address
the sexism implicit in older 12-step groups are Survivors of
Incest Anonymous (SIA) and Incest Survivors Anonymous (ISA). SIA
has published particularly good resources on sexual abuse and
spirituality.
If no group exists to address issues of incest survivors,
individuals in your church can form one. Many models exist.
Note: A 12-step group affiliated with a national group such as
SIA must be independent of your church. You can also start a
local support group not based on the 12 steps which can either be
self-led or led by a professional (See resources.)
Sadly many churches have been afraid to open their doors to
groups for sex addicts. Three major 12-step groups which address
sexual addiction, Sex and Love Addicts Anonymous (SLAA), Sexual
Compulsives Anonymous (SCA), and Sex Addicts Anonymous (SAA) do
not label people or insist on monogamous heterosexual marriage as
the only form of healthy sexual expression.
Many members of your church could benefit from attending one of
these groups which, especially in the age of AIDS, are saving
lives.
2. Identify women leaders in your own church and involve them in
developing a program of prevention education for themselves.
These women may be "the grandmothers" of the church;
professionals such as nurses, doctors, social workers, and
therapists; members of United Methodist Women; and/or women
already infected with HIV or with family members infected with
HIV. These women may or may not have to first be educated about
HIV themselves.
3. Encourage church studies on sexuality for all ages.
Curriculum is available from Cokesbury and other sources.
4. Worship services and sermons can address issues of sexuality,
AIDS, self esteem, racism, sexism, homophobia, sexual abuse, and
domestic violence. Hold forums afterward. Put ways of following
up on these concerns in place. NOTES
[1] Women and AIDS: The Growing Crisis: Update," CDC
HIV\AIDS Prevention Newsletter, II, 1 (April 1991), p.2.
[2] World AIDS Day 1990: Focus on Women and AIDS (United
Nations, November 1990), p. 3.
[3] World AIDS Day 1990: Focus on Women and AIDS, p. 2.
[4] World AIDS Day 1990: Focus on Women and AIDS, p. 2.
[5] Trudee Able-Peterson, Report of the Public Hearing on
AIDS: Its Impact on Women, Children and Families, Summary of
Testimony, Friday, June 12, 1987 (New York State Division for
Women, 1987), p. 33.
[6] Report of the Public Hearing on AIDS . . . ., p. 11.
[7] "Women, Substance Abuse and HIV," Focus on AIDS in New
York State: A Newsletter of the New York State Department of
Health AIDS Institute (April 1991), p. 13.
[8] Focus on AIDS in New York State . . . ., p. 13.
[9] The Women and AIDS Network (WARN), "An AIDS Information
and Referral Clearinghouse for Women" (September 1987), p. 3
(unpublished paper).
[10] World AIDS Day 1990, p. 3.
[11] The source for this entire section is "Home from Home:
Helping Children on the Streets of Bogota," AIDS Action (August
1990), p. 5. Published by Appropriate Health Resources and
Technologies Action Group Ltd. (AHRTAG), 1 London Bridge Street,
London SE1 9SG, UK. (The names in the article have been
changed.)
[12] "Women, AIDS, Storytelling," hai news, Fall 1989, p. 5.
(Hospital Audiences, Inc., 220 West 42nd St., NY, NY 10036)
[13] Steven Wrlanger, "A Plague Awaits," New York Times
Magazine (July 14, 1991), p. 53. This article is the source for
all of the information on Thailand and Empower.
[14] "Sexual and Physical Abuse as Factors in Continued Risk
Behavior of Women IV Drug Users in a South Bronx Methadone
Clinic." Study by Dooley Worth, E. Drucker, K. Eric and A Pivnic
(Montefiore Medical Center/Albert Einstein College of Medicine,
Bronx, NY) Reported in AIDS Weekly (January 7, 1991).
[15] Charlotte Davis Kasl, Women, Sex and Addiction: A
Search for Love and Power (New York: Harper & Row, 1989), p. 9.
[16] Kasl, p. 10.
----------------------------------------------------------
RESOURCES: PRINTED RESOURCES ON WOMEN AND AIDS
ACT UP/New York Women and AIDS Book Group. WOMEN, AIDS AND
ACTIVISM. Boston: South End Press, 1990. $7.00 Paperback.
Contributors include DiAna DiAna, Ruth Rodriguez, Suki Teerada
Ports, and the Women of ACE (AIDS Counseling and Education
Program at Bedford Hills Correctional Facility).
Order from South End Press, 116 Saint Botolph St., Boston, MA
02115
AIDS PREVENTION MODEL: REACHING WOMEN AT RISK. For ordering
information contact NOVA Research Co., 4600 East-West Highway,
Suite 700, Bethesda, MD 20814. Phone (301) 986-1891.
Brown, Patricia D. and Adele K. Wilcox. WORSHIP RESOURCE FOR HIV
& AIDS MINISTRIES. New York: Health and Welfare Ministries
Program Department, GBGM, UMC, 1991. Order from the Service
Center, General Board of Global Ministries, 7820 Reading Road,
Caller No. 1800, Cincinnati, OH 45222-1800. Stock #1683, $2.50
plus postage.
Paleo, Lyn. LIVING WITH HIV: A GUIDE FOR WOMEN. 25 pp. booklet.
This booklet was written to address questions that women newly
diagnosed with HIV are likely to have. Bulk copies are 90 cents
each, plus $12 shipping for every 250 copies. A complementary
review copy can be obtained from Impact AIDS, 3692 18th St., San
Francisco, CA 94110. Phone (415)621-1730.
Roth, Paula, ed. ALCOHOL AND DRUGS ARE WOMEN'S ISSUES. Metuchen,
NJ: Scarecrow Press, 1991.
Russell, Letty, ed. THE CHURCH WITH AIDS: RENEWAL IN THE MIDST OF
CRISIS. Philadelphia: Westminster Press, 1990. $10.95 Order from
Cokesbury (800) 672-1789.
Watstein, Sarah Barbara and Robert Anthony Laurich. AIDS AND
WOMEN: A SOURCEBOOK. 160 pp. $36.50. Order from Oryx, 4041 N.
Central at Indian School Rd., Phoenix, AZ 85012-3397. Phone:
(800) 279-ORYX; Fax toll-free (800) 279-4663.
Woodruff, Geneva and Christopher Hanson. COMMUNITY SERVICE
DELIVERY FOR CHILDREN WITH HIV INFECTION AND ADVOCATES. $39.95
plus shipping and handling.
Provides guidelines for developing community-based, family
centered services for children with HIV infection and their
families. Available from South Shore Mental Health Center, 6 Fort
St., Quincy, MA 02169. For more information call Amy Katz at
(617) 847-1950.
BOOKS ON SEXUALITY, SEXUAL ETHICS, SEXUAL ADDICTION
Carnes, Patrick. DON'T CALL IT LOVE: RECOVERY FROM SEXUAL
ADDICTION. New York: Bantam Press, 1991.
With Kasl (see below), one of the best books out on sexual
addiction and sexual codependency based on a study of folk
recovering from these problems. Includes surveys, resources,
stages of recovery, and root causes of abuse.
Harrison, Beverly. "Sexuality and Social Policy" in MAKING THE
CONNECTIONS: ESSAYS IN FEMINIST SOCIAL ETHICS. Ed. by Carol S.
Robb. Boston: Beacon Press, 1985.
She says, "No sexual ethic will be adequate unless it
incorporates a full appreciation of the interstructuring of
social oppression.... The goal of a holistic and integrated
sexual ethic is to affirm sexual activity that enhances human
dignity, that entails self-and other-regarding respect and
genuine communication" (p. 90).
Heyward, Carter. TOUCHING OUR STRENGTH: THE EROTIC AS POWER AND
THE LOVE OF GOD. San Francisco: Harper & Row, 1989. There is
much in this book which impresses me and I use it often. I also
have problems with portions of the book, particularly her
concepts of sadomasochistic eroticism and her very brief mention
of sexual addiction.
Kasl, Charlotte Davis. WOMEN, SEX, AND ADDICTION: A RESEARCH FOR
LOVE AND POWER. 1989 rpt. New York: Harper & Row, 1990. This is
the book on sexual addiction and sexual codependency for women of
all sexual orientations. It is useful for non-addicted women too.
Contains a helpful chapter "Rx for the Culture" addressing
changes which need to be made in society to alleviate abuse of
women and children.
Nelson, James B. EMBODIMENT: AN APPROACH TO SEXUALITY AND
CHRISTIAN THEOLOGY. Minneapolis: Augsburg, 1978. A good basic
book on sexuality and Christian sexual ethics.
Schaef, Anne Wilson. ESCAPE FROM INTIMACY: UNTANGLING THE "LOVE"
ADDICTIONS: SEX, ROMANCE, RELATIONSHIPS. San Francisco, Harper &
Row, 1989. A short introduction to these "process addictions"
with definitions. For sexual addiction, she adapts a model in
Patrick Carnes' earlier book OUT OF THE SHADOWS. A level of
addiction which she includes is "repressive sexual addiction"
("acting in") in addition to "acting out" addictive activity.
This level includes "religious sexual obsession" and "sexual
anorexia." She addresses issues related to sexual addiction in
the church structure.
SEX AND LOVE ADDICTS ANONYMOUS: THE BASIC TEXT FOR THE AUGUSTINE
FELLOWSHIP. Boston: The Augustine Fellowship, 1986. The "big
book" of SLAA, written by its male founder. It also includes
stories of others, some of them women and SLAA's reflections on
each of the 12 steps of the 12 steps as they relate to sexual
addiction. Order from The Augustine Fellowship, Sex and Love
Addicts Anonymous, Fellowship-Wide Services, Inc., P.O. Box 119,
New Town Branch, Boston, MA 02258.
BOOKS ON PHYSICAL AND SEXUAL ABUSE AND SELF-ESTEEM
Bass, Ellen and Laura Davis. THE COURAGE TO HEAL: A GUIDE TO
WOMEN SURVIVORS OF CHILD SEXUAL ABUSE. New York: Harper & Row,
1988. A must read book for survivors of sexual abuse, their
friends and loved ones, and professionals who relate to
survivors. There is a separate self-help workbook, which is used
by individuals and groups.
Bradshaw, John. HEALING THE SHAME THAT BINDS YOU. Deerfield
Beach, CA: Health Communications, Inc., 1988.
Distinguishes between healthy and toxic shame and how to overcome
toxic shame and improve self-esteem.
Burson, Malcolm, C., etc. al. Discerning the Call to Social
Ministry: An Alban Institute Case Study in Congregational
Outreach. New York: Alban Institute, 1990.
The story of St. James' Church, Old Town, ME addressing issues of
sexual and domestic violence.
Leehan, James. PASTORAL CARE FOR SURVIVORS OF FAMILY ABUSE.
Louisville, KY: Westminster/John Knox Press, 1989. Leehan Shows
how to recognize and understand abuse, examines biblical passages
often used to justify family violence, and suggests ways to help
professionals address abuse.
Mellody, Pia. FACING CODEPENDENCE: WHAT IT IS, WHERE IT COMES
FROM, HOW IT SABOTAGES OUR LIVES. San Francisco: Harper & Row,
1989. Contains helpful separate chapters on physical abuse,
sexual abuse, emotional abuse, intellectual abuse, and spiritual
abuse. There is a separate self-help workbook, which is used by
individuals and groups.
Pellauer, Mary D., Barbara Chester, and Jane Boyajian. SEXUAL
ASSAULT AND ABUSE: A HANDBOOK FOR CLERGY AND RELIGIOUS
PROFESSIONALS. San Francisco: Harper & Row 1987. This
collection of articles introduces religious professionals to the
physical, spiritual, and psychological consequences and related
issues of abuse.
Taylor, Mark Lloyd and Carmen Renee Berry. LOVING YOURSELF AS
YOUR NEIGHBOR: A RECOVERY GUIDE FOR CHRISTIANS ESCAPING BURNOUT &
CODEPENDENCY. San Francisco: Harper & Row, 1990. This book is
good for church group discussion on issues of self-esteem,
workaholism, and our images of God. It is a gentle way in to
addressing these issues for more conservative audiences.
ORGANIZATIONS
Center for Population Options, 1025 Vermont Ave., NW, Suite 210,
Washington, D.C. 20005. Phone: (202) 347-5700. Has factsheets
and resources such as "Adolescents, AIDS and HIV."
Childhope USA, 333 East 38th St., New York, NY 10015. Free
factsheets on "Street Children and AIDS/HIV" and "Streetgirls"
are available.
The D.C. Women's Council on AIDS, 725 8th St., SE, Washington,
D.C. 20003 Phone: (202) 544-8255. Dedicated to preventing the
spread of AIDS/HIV and to creating a network of support for women
affected by the virus.
National AIDS Hotline: (800) 342-2437 (English), (800) 344-7432
(Spanish), (800) 243-7889 (deaf).
The hotline is open 24 hours a day.
National AIDS Information Clearinghouse, P.O. Box 6003,
Rockville, MD 20850. Phone: (800) 458-5231; TTY/TDD (800) 243-
7012. Call M-F, 9:00am to 7:00pm EST. The clearinghouse keeps a
list of hundreds of organizations serving women and educational
items related to women in its database.
National Black Women's Health Project, 1237 Gordon St., SE,
Atlanta, GA 30310. Phone: (404) 753-0916. NBWHP addresses
vital health issues facing African-American women, including
HIV/AIDS.
National Hemophilia Foundation, the SOHO Building, 110 Greene
St., Suite 406, New York, NY 10012. Write for an order blank
which lists their resources, including a booklet WHAT WOMEN
SHOULD KNOW ABOUT HIV INFECTION, AIDS AND HEMOPHILIA.
Sisterlove: Women's AIDS Project, 1132 West Peachtree St., Room
111, Atlanta, GA 30309. Phone: (404) 872-0600; Fax: (404) 885-
6799. The project's goals are to instill education and
empowerment in women of color at risk.
Survivors of Incest Anonymous, Inc. (SIA), P.O.Box 21817,
Baltimore, MD 21222-6817. Phone: (301) 282-3400. Write for an
order blank and/or information on how to start a group.
