A Cocktail for Prevention

Passing out condoms didn't work. Neither did abstinence. Stemming HIV will require a combination of creative approaches.

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condom

Before we begin this discussion of HIV prevention, a few questions:

· More than a handful of studies show that any American adult who's made it past seventh grade knows how AIDS is transmitted and how to prevent it. So why do we still need to raise awareness about the disease?

· How many of us—for real now—wear condoms every time we have sex?

· How can a woman ask a man to wear a condom if that man's her husband and he's her only means of support? Or worse, he's violent, too?

· Or what if her husband's recently returned from prison? Asking him to wear a condom says, "I think you had sex with a man while you were inside, or worse, got raped." After all he's been through, what if that's something he's too ashamed to face?

· What's up with the down low? Are there really gangs of closeted, black gay men hooking up through the Internet for booty calls—then returning home to their wives or girlfriends? Or is this an E. Lynn Harris plot line—a terrible lie or at minimum, totally overblown?

· If the down low is simply magical realism, how are so many black women getting infected with HIV?

· How many men of color are too scared to tell anyone they have sexual feelings for men or are, in fact, gay? How many loved ones already know their brother-cousin-best friend-hair dresser-choir director is gay, love that person anyway, but don't know how to talk about sexuality?

· Why are we embarrassed to talk about sex and sexuality with our daughters and sons—even though the kids have seen every BET video and are reading Zane's books under the covers with a flashlight?

These are some of the many questions that come up in discussions of HIV prevention for African Americans. But because of our massive failure to understand the particulars of the epidemic in general, but especially in our community, no one really knows the answers. Or we don't wrestle with the issues and come up with them.