The AFIYA Center: La Cisha Crear and Marsha Jones

— Suzy Subways, Editor, Solidarity Project

November 2007 • Issue 7

*Activist Snapshots #3*

When La Cisha Crear and Marsha Jones heard about the Prevention Justice Mobilization, the Dallas activists knew they had to get involved. “Our vision was already based on an HIV prevention justice model,” Crear says. She and Jones haven’t yet quit their day jobs as prevention outreach counselors at Mosaic Family Services, but for the past several months, they’ve been building a new, community-based HIV prevention organization for women of color, called the AFIYA Center.

“I attended the SisterSong ‘Let’s Talk About Sex’ conference, where I was exposed to the reproductive justice model,” Crear says. “If you read Dorothy Roberts’ book, Killing the Black Body, you see that, for women of color, the struggle has always been for the right to control our own bodies. The mainstream reproductive rights movement elevates abortion above everything else, but for women of color it’s about the right to have or not have a child.” Crear is also a member of the All African People’s Revolutionary Party, a pan-African liberation organization that has member groups in Africa, Europe, North America, and the Caribbean. Jones graduated from the African American HIV University, a two-year intensive education and training program on HIV science, prevention education, presentation development, and community mobilization, along with three six-month internships.

La Cisha Crear (left) and Marsha Jones of the AFIYA Center in Dallas

The pair are putting their diverse backgrounds to work at a time when AIDS has become the leading cause of death among Black women ages 25 to 34, and women of African descent are 23 times more likely to have AIDS than white women. But their approach to prevention comes with a sense of thoughtful urgency that is not narrowly focused on the virus. “AFIYA is a Swahili word for health and wellness,” Crear explains. “Our approach is women’s total health and well being. We have clients for whom getting an HIV diagnosis may not be the worst thing that’s happened to them. Yesterday, that woman may have been on a three-year waiting list for housing and couldn’t get food stamps or transportation. If we can address those issues before someone becomes HIV positive, we may prevent them from becoming positive.”

It’s Bigger Than You and Me: Institutional Racism and Sexism

The AFIYA Center – and women’s AIDS organizations like SisterLove, Women Alive, and WORLD that paved the way for them – are up against deep-rooted systems of racism and sexism. A November 2006 National Minority AIDS Council (NMAC) report on AIDS and health disparities in Black America by Dr. Robert Fullilove of Columbia University’s Mailman School of Public Health reviews extensive data and observes that HIV rates in both urban and (mostly Southern) rural Black communities are “a function of the same set of forces that create residential segregation, the concentration of poverty in segregated communities and the geographical concentration of health disparities.”

SESA WO SUBAN “Transformation”

Dr. Adaora Adimora, associate professor of medicine at the University of North Carolina at Chapel Hill, digs even deeper for the structural roots of racism and its links to HIV risk. In a July 2006 Sexually Transmitted Diseases article titled “HIV and African Americans in the Southern United States: Sexual Networks and Social Context,” she and her colleagues report “extensive economic injustice and racial discrimination…such as preferential hiring and job advancement of whites, blacks’ inability to obtain mortgages, and academic tracking of black youth in schools.” This institutional racism was linked to HIV risk in several ways. Poverty and unemployment disrupt stable relationships, and discrimination can affect health planning and services. Looking at STD rates, the researchers found that “Southern counties with high syphilis rates tended to have worse race relations, with exclusion of minorities from positions of influence such as the county commission or board of health, lack of employment opportunities for minorities, lack of minority-owned businesses, and in some cases, evidence of systemic economic oppression.”

A 2004 survey of newly diagnosed HIV positive Black women in North Carolina co-authored by Adimora and published in the CDC’s MMWR Weekly found that the HIV positive women were more likely than HIV negative Black women to be unemployed. The primary reason reported by both negative and positive Black women for engaging in behaviors that put them at risk for HIV was “financial dependence on male partners.”

Researcher Adaora Adimora speaks at a 2006 congressional briefing held by amfAR.

This financial dependence may be a result of forces beyond Black women’s control, but in the meantime, women can take the power they do have. “We want to deconstruct sexual objectification and sexism in the media,” Crear says. “We want to offer women a healthy model, to value themselves and their bodies, so women can see themselves as complete and total beings, not seeking out men for the sake of completing themselves.”

The AFIYA Center plans to host multigenerational quilting parties, where mothers, daughters and grandmothers share their stories and insight. “Several generations ago, women had more self-love, because moms and grandmothers were passing down legacies,” Crear says. “Quilting has a certain significance in the African American community, as a folk art form that’s been used to record important dates and events, to pass down cultural history and heritage, and also as a liberatory tool by the Underground Railroad [to send messages]. We need to look beyond just telling people to use condoms, and teach women and girls to transform the way they deal with health and well being, the way they see themselves. Once they love themselves, they’ll take the precautions.”


None of Us Is Free Until Everyone Is: Prisons and HIV Risk in the Community

The way that HIV and prison are often talked about, one might think that men frequently get HIV in prison and spread it wildly to unsuspecting partners once they’re released. But that version of the story is not only false, it also hurts and stigmatizes the people being talked about. In the study most often cited, a 2006 CDC report on HIV transmission among Georgia inmates, 91% of positive male prisoners already had HIV before going to prison.

“The men coming out of prison are already feeling shamed and stigmatized, and they can’t talk about behavior that happened in prison,” Jones says. “They’re having to prove their manhood because they were in prison, they’re having to prove that they’re not gay, they’re having to prove things nobody should have to prove. We need a safe environment where men can have a conversation, without being judged, and walk away feeling good about themselves.”

The research shows that imprisonment increases HIV rates in the Black community in ways that are less often discussed. While less than a third of crack users in the United States are Black, more than 80% of federal crack defendants are Black due to racial profiling in law enforcement. Since 1986, sentencing guidelines have required a minimum of five years for first-offense possession of five grams of crack. These and other realities have created a situation in which more than one in four Black men are incarcerated during their lifetime.

Researcher Robert Fullilove

Their absence from the community leaves men outside with more dating options than women, who are in effect competing with each other for the available men. In the NMAC report, Robert Fullilove writes, “There is evidence that the loss of a significant number of men to prisons also affects the degree to which women will insist on condom use and other safe sexual behaviors on the part of their sexual partners.” A lower ratio of men to women has been shown to be associated with higher rates of teen pregnancy, syphilis, and gonorrhea.

The disruption in families and neighborhoods caused by incarceration rates can also harm a community’s ability to work together toward a common goal. “We’ve got to look at men and women being put in jail unjustly,” Jones says. “When people get out of prison, they need a way they can be gainfully employed. And convicted felons can’t get housing, so they get out of prison homeless. We have to look at social injustices.”

One thing Crear and Jones are tired of looking at is stories about the “down-low.” “That has just been a travesty,” Crear says. “Black men are being demonized once again.” Black women, even those who have only one or two lifetime heterosexual partners, face a disproportionate HIV risk, simply because of the disproportionate burden of HIV among Black men. But Jones says the solution is not to place blame within the community – it’s providing respectful, effective prevention for the entire community. “We need access to services like yearly exams and prevention education for both women and men before they become HIV positive.”

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Filed under African Americans, arts and culture, economic justice, gender, housing, prison, sex education, Solidarity Project, Southern United States, stigma, women

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