Prevention Work Revolves Around Conversation

“Instead of lecturing at people about what they should and shouldn’t do, we have holistic conversations about other things that don’t just focus on surface issues.”

Nikki Fernandes | HIV Testing and Prevention Program Coordinator

As I’ve gained more and more experience in the HIV prevention field, I’ve realized how much prevention work revolves around conversation. We often think that prevention work is straightforward: educate people about their options to protect themselves and others through different methods and expect them to access those services or resources. What we tend to overshadow is the importance of addressing barriers to access, including stigma, embarrassment, and fear, as well as more structural barriers such as transportation, work day hours, disabilities, etc. Having conversations with people brings these issues to light and gives me a larger understanding of how to go about addressing them - whether it be through breaking down those barriers or just the acknowledgement that they exist and are valid.

Each session with a client, discussion during a presentation, or engagement with someone during outreach is personalized and individualized. Instead of lecturing at people about what they should and shouldn’t do, we have holistic conversations about other things that don’t just focus on surface issues. We talk about communication, whether it be how to describe what is going on with their bodies or how to talk to their partners about decisions they make together and worries that they have. I talk to people about sensitive subjects and how to approach those subjects in situations that might be uncomfortable. Some examples are feeling shame, addressing or coping with violent situations, and stigmatizing language, actions, or ideas. I don’t know these people personally, but I am outside of their social circles. Discussing these topics with someone who has a more objective and non-judgemental stance causes them to respond well and feel comfortable. Often times in the field we don’t see conversations as the work, but it is key to let people open up to you in order to help or guide them in any way they may need.

Also, conversations have to be holistic. By holistic I mean not just HIV-related because in reality, HIV is often just a symptom of multiple other structural and societal factors. Factors such as poverty, substance abuse, violence, racism, discrimination and bias, and mass incarceration all intersect in different ways that contribute to increased risk for the acquisition and transmission of HIV and other STIs. Talking with our clients and participants about their broader situations builds trust. That trust goes an incredibly long way and extends to their communities. Things that I think may be the best for a client might be different from what they feel are the best options for themselves, and building that relationship to support their decisions and validate their feelings about a situation or decision is the most client-centered thing that we can do.

I also learn so much about the community by talking with my clients and their fellow community members. They teach me slang, give me insight into how their community perceives issues as well as how they address them, where people socialize and share resources, and the historical context that explains how and why a community is facing barriers to living healthy lives. They also teach me the appropriate and compassionate ways to engage with their communities. Understanding all these aspects of the community and its members paves the way for doing HIV prevention work - it is a framework to work within that comes directly from the community, as it rightly should. Collaboration to do prevention work starts with conversation with the community to ask how do they want us to be of service to them.

“Things that I think may be the best for a client might be different from what they feel are the best options for themselves...”