On Nov. 5, a Dallas jury sentenced Larry Dunn to 40 years in prison for killing his girlfriend, Cicely Bolden. Dunn stabbed Bolden in her bed a week after she disclosed that she was HIV-positive, then used her status as his defense. “She killed me, so I killed her,” he said while confessing to police. According to Dunn, the two had had unprotected sex multiple times before her disclosure. He killed Bolden in September of 2012 and has not yet tested positive.
The U.S. network of HIV-positive women (PWN-USA), a national organization for women living with HIV, has dedicated a new report to Bolden. Her murder brought to light a number of issues facing the 300,000 women in this country who live with HIV, including their disproportionate experience of violence at the hands of romantic partners. Bolden, 28, put a face on a population that bears the brunt of the epidemic: African-American women who account for two-thirds of new HIV cases among women in the U.S.
Bolden’s murder also brought to light a taboo but obvious subject: despite their lack of representation in pop culture or even in the medical literature, women living with HIV do, in fact, have sex. While HIV-positive men seem to have internalized the idea that they can continue enjoying vibrant sex lives, women are generally treated as if they are asexual, according to Naina Khanna, one of the report’s authors and executive director of the organization.
“It’s commonly understood that gay men with HIV are having sex,” Khanna said. “There’s a whole culture around, ‘Are you bare backing?’ ‘Are you serosorting?’” Conversations about not using condoms or choosing partners based on HIV status are common on gay blogs and dating sites. Doctors, nurses, case managers and social workers who support these men’s health know to ask such questions, and are able to better serve them.
But similar conversations are not happening among HIV-positive women, which is why PWN-USA released its landmark survey assessing “the state of sexual and reproductive health and rights for women living with HIV in the U.S.” The study is based on questionnaires crafted by the research team that were then completed by HIV-positive women around the U.S.
Among their findings:
· 69 percent of respondents had been sexually assaulted, compared to 20 percent of all U.S. women.
· 72 percent of respondents had experienced intimate partner violence, compared to a quarter of all U.S. women.
· Fewer than half of respondents said that a healthcare provider had told them that the chance for transmitting the virus is very low when the amount of HIV in the bloodstream is low, a core tenet of the treatment as prevention approach to encouraging people living with HIV to adhere to their medications.
· 39 percent reported wanting children in the future, but the women themselves — not their healthcare providers — are more likely to initiate conversations about fertility and reproductive options.
· Nearly two-thirds of respondents said they had a poor perception of their bodies after receiving their diagnosis. In written responses, they frequently described themselves as “dirty,” “diseased,” “ugly” and “unwanted.”