lesbian ⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl

lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl

HIV IS
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW
⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl

OUR
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl

FIGHT
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl
lesbian⋅ bisexual⋅ queer⋅ WSW⋅ sexual minority woman⋅ butch⋅ femme⋅ dyke⋅ boi⋅ grrl


 



 HIV IS OUR FIGHT:
Discrimination against Sexual Minority Women,
LGBT Activism, and the AIDS Epidemic

An Activist Packet by Natalie Wittlin

Barnard College, Class of 2009
Co-President of Q, Barnard’s only group for LGBTQ students and allies

2

 AIDS and “The LGBT Community”

Some of the first reported cases of what became known as AIDS (Acquired Immune
Deficiency Syndrome) were seen in gay men. In the early 1980s, a wave of homophobia
and discrimination directed at gay men arose. AIDS was often referred to as “GRID”
(Gay-Related Immunodeficiency) (Treichler, 1999, p. 27). For these reasons, “the gay
community” has always been involved in the fight – or, rather, the fights - against AIDS
and the virus that causes it, HIV (Human Immunodeficiency Virus). Some of the earliest
AIDS-related LGBT activism was aimed at separating “gayness” from HIV and AIDS.
Such efforts were, and still are, intended to show that there is nothing wrong with being
gay - that sexual transmission from man-to-man is just one way of transmitting HIV and
that HIV can be transmitted from man-to-woman or woman-to-man, as well. These
campaigns explain that everyone is potentially at risk – that HIV is not (or not simply) a
“gay disease.”

Other educational campaigns have attempted to shift the emphasis of HIV discourse away
from identity and towards behavior, proclaiming, “It’s what you do, not who you are, that
puts you at risk” (Rankow, 1995). More recently, some organizations and groups have
been attempting to “reclaim” HIV. An advertisement sponsored by the Los Angeles Gay
and Lesbian Center stated: “HIV is a gay disease. Own it. End it.” (Bernstein, 2006).
Such campaigns are presumably premised on the understanding that discrimination and
stigma are related to behavior – that experiences of homophobia, alienation, and isolation
often make people more likely to engage in high-risk behavior. It is surprising, then, that
so little attention has been paid - by the medical world, the media, and “the LGBT
community” - to women who have sex with women in the AIDS Epidemic.

3

 It’s What We Do. It’s Who We Are.
Discrimination and Risk

A pamphlet put out by Duke University Medical Center states: “It’s what you do, not
who you are, that puts you at risk” for HIV. “Medically” speaking, this is accurate – and
it is important to recognize that your identity doesn’t directly put you at risk for HIV.
Exchanging “sexual fluids” (vaginal or penile) (Rankow, 1995) or blood puts you at risk.
That being said, it is imperative that we consider why certain people engage in high-risk
behaviors. To fully understand why certain people are more likely than others to engage
in high-risk behaviors, we must consider not only behavior and identity but also “status”
(Young, Friedman, Case, Asencio, & Clatts 2000). Young et al. (2000), in their review
of research on women who have sex with women (WSW) injection drug users (IDUs)
and HIV, explain, “We treat WSW as a ‘status’ because same-sex activity is itself a
marginalized behavior and may expose women to particular kinds of stigma and
vulnerabilities” (p. 501).

Being lesbians, bisexuals, queer women, and women who have sex with women does not
increase our risk for HIV. However, the way many women who have sex with women
are treated because of their sexual identity or behavior does increase their risk for HIV.
Studies have demonstrated that, in certain contexts, being a sexual minority woman is a
“risk factor” for HIV transmission. This is because the treatment that sexual minority
women receive because of their status as sexual minority women can put them at risk for
HIV, especially when they are already in potentially risky situations. One group of
women for whom sexual minority status increases risk for HIV transmission is injection
drug using women who have sex with women.

Numerous studies have shown that, of women IDUs, women who have sex with women
have higher rates of HIV and engage in higher rates of “high-risk” behaviors than women
who do not have sex with women. WSW IDUs, who tend to be women of color and are
often living in poverty, face multiple, interacting (Crenshaw, 1991) forms of
discrimination: homophobia from the communities they grew up in and IDU

4

communities; alienation from LGBT organizations concerned that drug users will taint
their public image; racism, sexism, classism, homophobia, ignorance, and hatred from
society at large. This discrimination can translate into higher risk for HIV in a number of
ways. For example, these women are sometimes denied clean needles by fellow women
IDUs. One researcher observed a woman IDU say “that dyke” after telling a fellow
woman IDU she didn’t have any clean needles (Young, Friedman, & Case, 2005, p. 111).
Also, constant subjection to discrimination leads many women to experience what
Elizabeth Arend refers to as “shame, discomfort...[and] crippling feelings of isolation and
emotional disempowerment” (Arend, 2005, p. 110). These feelings often engender
feelings of “hopelessness and resignation” (p. 112), which can translate into engagement
in high-risk behavior.

5

 Identity vs. Behavior vs. Status

What puts sexual minority women at risk for HIV is not identity but behavior and status
(which are often related)…

IDENTITY: This is how you define yourself. Your identity does not put you at risk for
HIV. Sexual identities include lesbian, bisexual, straight, queer, etc.

BEHAVIOR: This is what you do. HIV is transmitted through exchange of blood and
penile and vaginal fluids (Rankow, 1995). Any behaviors during which this exchange
occurs can put you at risk for HIV – regardless of how you identify. Straight women can
get HIV from other women, and lesbians get can HIV from men.

• Female-to-female sexual transmission is possible. There is a lower risk of

transmission with many sexual behaviors between two women than, for example,
with those between a man and a woman, but that doesn’t mean there is no risk (A.
Heath-Toby, personal communication, March 6, 2009).

STATUS: This is your position in society. It is how you are treated by your family,
peers, community, local organizations, public and private institutions, etc. Status is
perhaps the most overlooked determinant of HIV risk – or, more accurately,
vulnerability. As Alexander Irwin, Joyce Millen, and Dorothy Fallows explain in their
book Global AIDS: Myths and Facts, “Socioeconomic determinants…often lead people
to adopt ‘risky behaviors’ and render them vulnerable to HIV infection” (Irwin, Millen,
& Fallows, 2003, p. xxviii). Sexual minority women, particularly women of color, poor
women, and women who inject drugs, tend to be “multiply marginalized” (Young et al.,
2005) – facing a combination of homophobia, sexism, racism, and classism. As a result,
some sexual minority women frequently engage in high-risk behaviors.

6

 *
Studies have shown …

• Women who have sex with women (WSW) injection drug users (IDUs) have higher
rates of HIV incidence and prevalence than other women IDUs (Young et al., 2000).

• WSW IDUs have higher rates of high-risk sex with men than other women IDUs
(Friedman et al., 2003).

• WSW IDUs are more likely to engage in high-risk injecting (sharing needles or rinse
water, etc.) than other women IDUs (Friedman et al., 2003, p. 903-4).

• WSW IDUs are more likely to be homeless or institutionalized or to “receive most of

their income from selling sex” than other women IDUs (Friedman et al., 2003, p.
904).

• WSW IDUs are less likely than other women IDUs to talk about AIDS with their
injection drug using peers (and studies have shown that such conversations are
associated with a reduction in risk) (Young et al., 2000, p. 507-8).


































































*
Note that these findings are not true for all groups of WSW IDUs.

7

 Activism: What’s going on?

Unfortunately, very few organizations directly address the risks that women who have
sex with women face due to their status in society. More frequently, LGBT and AIDS
activism organizations address the difference between identity and behavior and note that
lesbians are at risk for HIV not because of their identity but because of their behavior
(which includes sex with men, injection drug use, etc.). Some organizations also address
the risk of woman-to-woman sexual transmission of HIV.

The Lesbian AIDS Project at Gay Men’s Health Crisis was founded with the goal of
bringing those women who are often left out of conversations about HIV and AIDS, but
who are affected by HIV and AIDS, to the forefront of the LGBT and AIDS movements.

Lesbian AIDS Project:

The Lesbian AIDS Project (LAP) was founded in 1992 (Schindler, 2002). Amber
Hollibaugh, who served as LAP’s first director (Schindler, 2002), explains in Lesbian
Denial and Lesbian Leadership in the Epidemic the purpose of the project: “LAP…is an
organizing project with two core ideas: lesbian HIV visibility and lesbian sexuality.
Lesbians at risk of or with HIV have been ‘the disappeared’ lesbians in our communities
for too long. Wrong class, wrong color, wrong desires, wrong histories. But these are
the women who need to become the center of the lesbian movement, not just the AIDS
movement” (1999, p. 209).

I met with Alicia Heath-Toby, Program Coordinator at LAP, to discuss the work that
LAP currently does and what my student group, Q, could be doing to help.

Alicia spoke at length about how the primary challenge to HIV prevention for at-risk
women who have sex with women is “invisibility.” She explained that rates of
transmission in women of color are increasing and that this probably has something to do
with lesbians and other WSW. Alicia noted that women who have sex with women,

8

particularly women of color, face discrimination, stigma, sexism, and heterosexism. The
main question she posed, and which LAP focuses its attention on, is: “What does it mean
to be invisible in a huge epidemic affecting the world?” She explained that being
“invisible” puts women at risk – that it makes them feel like they don’t matter and is
likely related to high rates of mental illness, suicide, drug use and high-risk behavior.

Alicia and I also discussed the barriers to frank discussion about sex with both women
and men and how these barriers create additional obstacles to fighting HIV among WSW.
She spoke about the shame many self-identified lesbians feel, for example, about having
sex with men. She also emphasized the need for candid conversations about behaviors,
like cunnilingus during menstruation or drug injection, that many people might find
disgusting. Alicia said that it is important, and indeed necessary, to have conversations
about HIV and sexuality together. When discussing the risk of transmission, she said,
many women “hear low and think no.” She emphasized that “low does not mean none” –
that women can transmit HIV to other women through sex and that self-identified
lesbians can have sex with men, inject drugs, and engage in other high-risk activities.

LAP’s main goal, Alicia told me, is to change social norms – in particular, those
surrounding WSW and HIV. Specifically, LAP challenges the assumption that “HIV is
not a problem for us.” When I asked her how Q could help, she said that the most
important thing to do is raise awareness or, as she put it, “keep making noise about it.”
She said that the ways students on college campuses will approach issues relating to
WSW and HIV, and the ways in which we can make a difference, are very different from
the ways that LAP approaches these issues and strives to make a difference – and that this
is a good thing. Alicia explained that there is “no one way” to make a difference and that
we must try out all strategies.

9

Advocates for Youth:
Advocates for Youth is a D.C.-based organization dedicated to promoting the health,
specifically the sexual health, of adolescents in the U.S. and abroad. It is designed to
empower teenagers to take charge of their own sexual health and to make healthy
choices. It also advocates for comprehensive sex education. While Advocates for Youth
is not specifically geared toward women who have sex with women, it is one of few
organizations that addresses the complex reasons why WSW (specifically young WSW)
are at risk for HIV and STIs. In a section of its website for women who think they
“might be lesbian,” Advocates for Youth presents a quote from one 17-year old who says,
“Despite the rumor that dykes are indestructible, I’m not taking any chances.”

This same section lists those behaviors that put lesbians at risk for HIV. The list includes
needle-sharing, unprotected vaginal intercourse, and oral sex. However, it fails to include
vagina-vagina contact. Also, while it says that “sharing needles” puts women at risk, it
advises, “Do not shoot up drugs” (rather than “never share needles if you do shoot up
drugs”).

In 2001, Advocates for Youth put out a report called Young Women Who Have Sex with
Women: Falling through Cracks for Sexual Health Care. The report explains: “Health
educators often assume that young women who have sex with women (YWSW) are at
little or no risk for HIV, other sexually transmitted infections (STIs), and unintended
pregnancy when, in fact, risk behaviors and barriers to health care put YWSW at risk for
all three. Health care professionals and researchers often tell YWSW that they are ‘safe.’
Moreover, the sexual health needs of young women of color who have sex with women
go mostly unrecognized. YWSW need information and programs that specifically address
their complex needs and that encourage them to protect themselves” (Gilliam, 2001).
The report includes a wide range of information on how the health care system, and
society at large, puts YWSW at risk for HIV:

• Widely-circulated safer sex materials rarely explain how women should have safer
sex with women. Those materials with this information are often only available to
lesbian organizations that do not reach many YWSW (particularly women of color).
• Because of concerns about homophobia, many lesbians seek out medical care (or give

10

 all information necessary for proper medical care) less often than other women. Also,
sometimes health care providers inaccurately assume that lesbian-identified women
do not have sex with men.

The report recommends that programs that address HIV risk in YWSW broaden their
scope to address not only what most directly puts YWSW at risk but also what indirectly
puts them at risk. It discusses the high rates of mental illness, homelessness, and
substance abuse among LGBTQ youths. It also cites a study that found that lesbian and
bisexual-identified teenage women were more likely to have engaged in “commercial or
survival sex” than heterosexual-identified or questioning teenage women (Saewyc, 1999).
The report explains that many YWSW face a combination of “sexism, racism, and
homophobia from society as a whole, the white lesbian community, and their individual
communities of origin” (Gilliam, 2001).

Advocates for Youth hosts two websites called “MySistahs” and “YouthResource.”
MySistahs is a website specifically for young women of color. YouthResource is
specifically for LGBTQ youths. Both websites’ sections on HIV state: “HIV doesn't
discriminate. It doesn't care who you are - black, Latina, Native American, Asian,
straight, gay, lesbian, bisexual or transgender. Anyone can become infected with HIV,
the virus that causes AIDS, because it's not who you are but what you do that puts you at
risk for getting HIV. Only you can protect yourself from HIV.” While its goal is to
empower adolescents to protect themselves, this message is somewhat problematic. First
of all, while HIV does not itself discriminate, it is clear from the research described in the
report that discrimination puts people at risk for HIV. Additionally, while the message
“only you can protect yourself from HIV” might be helpful for teenagers, it is critical that
policy-makers and non-governmental organizations recognize that this message does not
give the full picture; policy and societal attitudes dictate, or at least influence, people’s
risk for HIV. Therefore, to protect people from HIV, we must target policies,
organizations, and widespread attitudes.

11

International Gay and Lesbian Human Rights Commission:
Very few organizations are specifically devoted to HIV and AIDS in women who have
sex with women. It is important to recognize that other organizations that address those
more general factors that put many WSW at risk for HIV are allies in this fight.

The International Gay and Lesbian Human Rights Commission is an organization

dedicated to protecting the basic human rights of all people throughout the world. In
particular, IGLHRC fights for those people “who experience discrimination or abuse on
the basis of their actual or perceived sexual orientation, gender identity or expression.”

IGLHRC understands that health is a basic human right and is aware of how homophobia
and other forms of discrimination function as violations of this right. Its website states:
“Due to stigma, people whose sexual orientation, gender identity or expression does not
conform to social norms often find themselves subject to discrimination that
compromises both their access to healthcare and their medical treatment. Stigma-based
discrimination is particularly evident in efforts to treat and prevent HIV/AIDS.”
IGLHRC, contrary to what its name might imply, also understands that – especially in
working internationally – many people who are affected by this sort of discrimination do
not identify as “gay” or “lesbian” (a factor that some LGBT organizations ignore).

As part of its “Africa Program,” which is based in Cape Town, South Africa, IGLHRC
published a 2007 report called Off the Map: How HIV/AIDS Programming is Failing
Same-Sex Practicing People in Africa. This report documents how ignorance,
discrimination, and threats of punishment and violence put people in many countries in
Africa who have sex with people of the same sex at risk for HIV. The report explains
that “same-sex practicing men and women are at increased risk of contracting HIV not
solely because of bio-sexual vulnerabilities, but as a result of an interlocking set of
human rights violations that prevent access to effective HIV prevention, voluntary
counseling and testing, treatment, and care…Same-sex practicing African women have
self-reported HIV seroprevalence rates substantially higher than one might expect. The
vulnerability of same-sex practicing men and women is not due to any biological

12

predisposition, but is the result of an interlocking set of human rights violations and
social inequalities that heighten HIV risk. Anti-gay discrimination is fueling the African
HIV/AIDS epidemic.” The report also lists a series of recommendations for how
governments and NGOs can help end these human rights violations and thus reduce HIV
transmission. This list includes the decriminalization of same-sex sex, the funding of
LGBT-inclusive HIV prevention and treatment programs, and the funding of studies that
examine HIV in women who have sex with women.

Discussion with Q, Barnard’s Group for LGBTQ Students and Allies:

I led an hour-long discussion with Q on HIV in “our community.” I started off the
discussion by asking everybody who “our community” consists of – in theory and reality.
I then asked the members of Q what conversations they have had about HIV in “our
community,” and in general, and whom these conversations have focused on. Next, I told
them about the research I had been doing on women who have sex with women and HIV.
We discussed whether and why addressing HIV should be priority for us and the best
ways to address HIV among lesbian, bisexual, queer, and other women who love, desire,
date, and have sex with women. While the group was particularly interested in the
logistics of woman-to-woman sexual transmission, we also discussed the social factors
that put certain WSW at risk for HIV and why addressing these factors should be a
priority for an LGBT and allied group like ours.

When discussing “our community,” some of the questions that arose were: Are allies part
of “our community?” What about people who aren’t out? People who are not involved
in official groups? These questions led to a conversation about why people do and don’t
come out and how, in many cases, it’s easier for people who are already in a position of
privilege to come out (versus people who are already facing discrimination). We also
spoke about the racial and socioeconomic makeup of LGBT movements since the 60s
and how, because these movements have so often been tied to universities, they have
been structurally skewed towards white, middle-class, educated people.

13

Next, we spoke about who conversations about HIV in “our community” tend to focus
on. Everyone agreed that these conversations generally focus on gay men. However, one
person noted that, more recently, women of color have begun to be included in such
conversations. A number of people mentioned that there has been a “media push” to
include everyone in conversations about HIV and to encourage people to focus on
“salient cues,” such as “unprotected sex” and “promiscuity.”

The general consensus was that there was little, if any, information “out there” on how
women can protect themselves from HIV while having sex with women. One person
spoke about how lesbians can get all STDs but tend not to think about it – and said there
needs to be more awareness about this. When someone mentioned that the media has
focused on the prevention message, “use condoms,” someone else immediately
interjected that this message is extremely unhelpful for women having sex with women.
She said, and everyone seemed to agree, that queer women lack established ways of
expressing a desire to use protection with other women.

At the end of the conversation, we turned our attention to why we should care about the
increased risk of HIV transmission for WSW IDUs. One student mentioned the
importance of “solidarity.” We talked about how, if our goal as activists is to fight
homophobia and discrimination and promote equality, the discrimination and inequality
that puts certain WSW at risk is definitely something we should care about. A number of
students also focused on how HIV is passed from person-to-person and from community-
to-community. They discussed how HIV in one group of people or community is not
something that can be fought in isolation. As one student said, “Less HIV in any
community is going to benefit everyone.”

14

 What are we fighting for?

As LGBT activists, we have had a variety of different experiences and we work on a

number of different specific projects. However, we are all committed to the same
fundamental goals: fighting discrimination and homophobia and achieving equality.
Discrimination can take on a number of different forms. It can be overt or subtle, legally
or otherwise sanctioned, large-scale or small-scale, targeted or pervasive, etc.

When someone is imprisoned for same-sex sex, that is discrimination. When two people
are not allowed to marry because of their sexes, that is discrimination. When a doctor
assumes that you are only having sex with people of a certain sex, that is discrimination.
When an organization purporting to represent all LGBT people ignores the experiences of
women of color, that is discrimination. Homophobia fuels discrimination. Because it is
so widespread, it is often hard to notice. When ignorance and hatred are systemic, they
are often also invisible. Only by drawing attention to the homophobia that pervades our
society can we change it. We will know discrimination no longer exists not when it is not
explicitly, legally sanctioned but when all people are equal in reality – for example, when
women who have sex with women are no longer disproportionately affected by HIV and
AIDS.

15

 HIV Is Our Fight

But who are “we”? As one conversation with a college’s LGBT group demonstrates (and
many other conversations could), this is a complicated question. “The LGBT
Community” is not monolithic; rather, it is incredibly diverse. The issues faced by some
people within “our community” are very different from those faced by other people
within “our community.” However, as LGBT activists, we are dedicated to eliminating
homophobia and discrimination and to achieving equality for all people regardless of
sexual orientation, identity, and behavior and gender expression, presentation, and
identity.

Sexual orientation and gender expression do not exist in isolation from other social
factors. People of color, in many cases, are affected by discrimination “based on sexual
orientation” more than white people are. It is absolutely critical, then, that when we
define our mission as LGBT activists, we not limit ourselves to “specific” forms of
discrimination; we must recognize that our identities and backgrounds intersect, as do
different types of discrimination (Crenshaw, 1991).

In Lesbian Denial and Lesbian Leadership in the Epidemic, Amber Hollibaugh says,
“HIV makes a mockery of pretend unity and false sisterhood” (1999, p. 212). As women
who love, desire, date, and have sex with women and who identify as gay, lesbian,
bisexual, queer, straight, or whatever else, we must acknowledge that real unity and
sisterhood do not exist. We must understand why this is, and we must work towards
achieving them. As we fight for the rights of gay, lesbian, queer, bi, etc. women, we
must recognize that we do not represent all of these women. When we ask for the right to
marry, we must consider the fact that this is part of a fight for equality – and that the fight
against HIV in WSW is also a part of this fight. We must recognize that women who
have sex with women and inject drugs are put at risk for HIV because they have sex with
women. These are women like us in that they love women and have sex with women and
want the right to do so freely without facing repercussions of any kind. Many of them
experience repercussions and forms of discrimination that other women who love and

16

have sex with women do not. We must recognize both our similarities and differences
and work to achieve equality for all of us.

What you can do:

• Talk about it! Raising awareness is the first step in any activist project. While many
WSW face overt forms of discrimination, many too face more subtle, systemic forms
– which includes widespread ignorance and invisibility. Before we can effect any
large-scale change, or while we attempt to do so, we must effect more local change.
This means talking to your peers about how discrimination against people like us puts
many women at risk for HIV. This also means raising this issue to LGBT groups that
you are a part of.

• Educate yourself. Learn about what puts many WSW at risk for HIV. You can do
this through reading and through community service. Q is going to be volunteering
with the Needle Exchange Program at Harlem United. Work like this directly helps
people at risk for HIV and also helps us learn about the systems that puts people at
risk (which allows us to better understand how we can change these systems).

• Be observant and critical. If you are involved in LGBT or AIDS activism groups,
think about who you are working with. Ask yourself, “Who is included? Who is
excluded? How can we make our work more inclusive of all LGBTQ people? How
can we help those people who do not identify as LGBT (for a variety of reasons) but
face discrimination because of their sexual behavior or gender presentation?”

• Write a letter to your local (or global) LGBT or AIDS activism organization
explaining why women who have sex with women and are at risk for HIV should be a
priority.

17

Bibliography


Advocates for Youth: Rights. Respect. Responsibility.
http://www.advocatesforyouth.org/about/vision.htm

Arend, E.D. (2005). The politics of invisibility: Homophobia and low-income HIV-
positive women who haves sex with women. Journal of Homosexuality, 49(1),
97-122.

Bernstein, S. (2006). HIV aids embrace, and stun, audience. Los Angeles Times, A1.

Crenshaw, K.W. (1991). Mapping the margins: Intersectionality, identity politics, and
violence against women of color. Stanford Law Review, 43 (6), 1241-1299.

Des Jarlais, D.C., Friedman, S.R., Friedmann, P., Wenston, J., Sotheran, J.L. Choopanya,
K., et al. (1995). HIV/AIDS-related behavior change among injecting drug users
in different national settings. AIDS, 6, 611-617.

Friedman, S.R., Jose, B., Neaigus, A., Curtis, R., Deren, S., Des Jarlais, D.C., et al.
(1996). IDUs who are women who have sex with women may be at particularly
high risk for HIV. Presented at the 7th International Conference on the Reduction
of Drug Related Harm, Hobart, Australia, March 3-7.

Friedman, S.R., Ompad, D.C., Maslow, C., Young, R., Case, P., Hudson, S.M., et al.
(2003). HIV prevalence, risk behaviors, and high-risk sexual and injection
networks among young women injectors who have sex with women. American
Journal of Public Health, 93(6), 902-904.

Gilliam, J. (2001). Youth women who have sex with women: Falling through cracks for
sexual health care. Advocates for Youth.

Hollibaugh, A. (1999). Lesbian Denial and Lesbian Leadership in the Epidemic: Bravery
and Fear in the Construction of a Lesbian Geography of Risk. Durham, NC: Duke
University Press, 203-218.

I think I might be lesbian, now what do I do? A brochure by and for young women.
Advocates for Youth.
http://www.advocatesforyouth.org/youth/health/pamphlets/LESBIAN.HTM

International Gay and Lesbian Human Rights Commission: Human Rights for Everyone.
Everywhere: About Our Work.
http://www.iglhrc.org/cgibin/iowa/content/about/index.html

Irwin, A., Millen, J., & Fallows, D. (2003). Global Aids: Myths and Facts: Tools for
Fighting the AIDS Pandemic. South End Press, xxviii.

18

Johnson, C.A. (2007). Off the Map: How HIV/AIDS Programming is Failing Same-Sex
Practicing People in Africa. U.S.A.: International Gay and Lesbian Human
Rights Commission.

Kwakwa, H.A., & Ghobrial, M.W. (2003). Female-to-female transmission of Human

Immunodeficiency Virus. Clinical Infectious Diseases, 36, e40-41.

MySistahs: HIV and AIDS. http://www.mysistahs.org/health/HIV/index.htm

Rankow, L. (1995). What you need to know about…HIV/AIDS and other sexually
transmitted diseases (STDs) and safer sex for women with women. Adapted from
“Women’s Health Issues: Planning for Diversity.” Durham, NC: Women’s Health
Access, Duke University Medical Center.

Saewyc, E.M., Bearinger, L.H., Blum, R.W., & Resnick, M.D. (1999). Sexual
intercourse, abuse and pregnancy among adolescent women: Does sexual
orienation make a difference? Family Planning Perspectives, 31(3), 127-131.

Schindler, P. (Dec. 6, 2002). Lesbian AIDS Project at 10 Years. Gay City News.
http://gaycitynews.com/site/index.cfm?newsid=17003978&BRD=2729&PAG=46
1&dept_id=568864&rfi=8


Treichler, P. (1999). How to Have Theory in an Epidemic: Cultural Chronicles of AIDS.

Durham, NC: Duke University Press.

Young, R. (November, 2003). Sexualized surveillance of non gender-conforming women.

American Anthropological Association Annual Meeting, Chicago, IL.

Young, R.M., Friedman, S.R., & Case, P. (2005). Exploring and HIV paradox: An
ethnography of sexual minority women injectors. Journal of Lesbian Studies,
9(3), 103-116.

Young, R.M., Friedman, S.R., Case, P., Asencio, M.W., & Clatts, M. (2000). Women
injection drug users who have sex with women exhibit increased HIV infection
and risk behaviors. Journal of Drug Issues, 30(3), 499-524.

YouthResource: HIV doesn't discriminate.

http://www.youthresource.com/health/hiv/index.htm

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