a bunch of separate, easy-to-read chats about sexual health

The Real Talk.

Dee's texts stay lit. It all started after she volunteered at the local health center and spoke up on a friend's podcast. Now, her friends hit her up about all kinds of things: navigating specific STIs, supporting a friend, and the history behind why medical mistrust runs deep in our Black community. Through every reply and shift at the health center, Dee's started thinking that looking out for our health is how we look out for each other. Pick where to start.

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Priya just switched to a new insurance plan and had to pick a doctor, which somehow spiraled into this. she got Dee's number from her coworker Reese, who wouldn't stop talking about how straight Dee was with her.
new · results are in
P
ok results are back, I tested positive for chlamydia😳3:14 PM
D
how are you doing with that3:15 PM
P
honestly fine, kind of expected it after our last chat. they gave me a single dose of antibiotics3:16 PM
D
that's the standard treatment, and it works. wait 7 days after the dose before having sex again, even once you feel fine.3:17 PM
P
do I need to tell anyone, because i didn't tell the nurses all the names3:20 PM
D
yes, anyone you've had sex with in the last 60 days, so they can get tested and treated too. otherwise it just passes back and forth.3:21 PM
3 weeks earlier, before any of that
P
random question: chlamydia and gonorrhea. how would I even know if I had one10:23 PM
D
honestly, a lot of the time you wouldn't. that's the part nobody tells you.10:24 PM
D
both are bacterial, both spread through genital, anal, or oral contact, and both are asymptomatic in a big share of cases, especially in women, but plenty of men too.10:25 PM
P
so it just sits there10:29 PM
D
yep, which is exactly why "I feel fine" isn't the same as "I don't have anything."10:33 PM
P
random, but is this actually more common in some communities, or is that just a stereotype10:34 PM
D
per CDC's 2023 STI Surveillance report , nearly a third of all chlamydia & gonorrhea cases nationwide were among Black Americans, who make up about one in eight people in the country.10:36 PM
D
the CDC is explicit that this comes from unequal access to care, not individual behavior. Black Health has a rundown of low-cost testing options if cost or access is part of what's holding you back.10:37 PM
a little later
P
ok how do you even get tested for it1:41 AM
D
urine test or a swab, quick and not a big deal. a lot of clinics test for both at once. at least once a year if you're sexually active, and with any new partner.1:42 AM
Treated vs. untreated
caught early & treateda short course of antibiotics clears it, usually within a week. no lasting effects.
treated after a delaystill clears completely with antibiotics, but more time spent infectious means more time it could've been passed to a partner.
left untreatedcan spread upward and cause , a leading cause of infertility and chronic pelvic pain.
P
not gonna lie, it still feels like one more thing to manage on a list that's already too long😂1:43 AM
D
I get that, but flip it around: this is one of the few things this week that's fully up to you, nobody else's schedule. that's you taking care of you.1:45 AM
P
ok yeah I'm just gonna get tested at my next appointment1:46 AM
D
i love to hear it!1:47 AM
P
random but my friend mentioned something called DoxyPEP, like a pill you take after sex to prevent this stuff. is that a thing I should ask about1:48 AM
D
yeah, it's a dose of doxycycline taken within 72 hours after condomless sex, and it cuts the odds of chlamydia, gonorrhea, and syphilis substantially. But in the trial that tested DoxyPEP's effectiveness in cisgender women, it just didn't show the same benefit.1:49 AM
P
oh, so it's not really built for me then1:50 AM
D
not off the current evidence, no, but worth asking your doctor about regardless, just so you know where the science actually stands instead of going off a friend's summary.1:50 AM
Read 1:51 AM
Sources: CDC – About Chlamydia, CDC – About Gonorrhea, CDC – 2023 STI Surveillance, CDC – Doxy PEP Guidelines, and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Theo found a weird sore, panicked, googled it, and is now more confused than before. his roommate Malik gave him Dee's number about a year ago "just in case," and this is the first time he's actually used it.
new · bloodwork is back
T
bloodwork's back, it's syphilis, early stage they said1:02 PM
D
one shot of penicillin usually clears it at this point.1:05 PM
T
yeah they're scheduling the shot for tomorrow, guess I'm getting the needle after all😂1:09 PM
D
you will. one shot, sore arm for a day, done. then a follow-up blood test in a few months to confirm it's fully cleared.1:11 PM
a few weeks earlier, before any of that
T
ok I found this small painless sore on my privates and now I'm spiraling8:12 PM
D
when I was at the health center, there were a few people who came in with syphilis. if it's syphilis, the sore is called a chancre. don't panic, but do get it looked at.8:15 PM
T
wait it doesn't even hurt though, can it be serious8:17 PM
D
that's the trap: syphilis moves in stages. the sore heals on its own in a few weeks even untreated, so people think it's over. if it's still not treated, it can go quiet for years, then resurface decades later attacking the heart, brain, or nervous system.8:18 PM
T
so waiting it out is the worst possible thing to do8:23 PM
D
basically yeah. it's very treatable. it's just about catching it early.8:24 PM
Treated vs. untreated
treated earlya course of antibiotics, often a single shot in the early stage, cures it completely.
treated laterstill curable with antibiotics at almost any stage, but any damage already done to the heart, brain, or nerves by that point may not fully reverse.
left untreatedcan progress over years to damage the heart, brain, nerves, and other organs, and in rare cases can be fatal.
T
not gonna lie, "get a shot for an STI" makes me nervous for other reasons too, not just needles8:25 PM
D
syphilis specifically has an ugly history with medical trust because of the tuskegee experiment among others. there's a whole chat about that under if you want it.8:26 PM
T
does it actually hit some communities harder than others,8:28 PM
D
U.S. syphilis cases recently hit their highest total since 1950, and CDC surveillance data show Black Americans carry a disproportionate share of that rise. it tracks closely with access to prenatal care specifically, which is part of why newborn syphilis cases have climbed for over a decade straight.8:36 PM
D
but I also brought this up because people always act like their grandparents and great-grandparents didn't have sex or acquire infections.8:39 PM
T
actually, now that you mention it, I've also had this weird rash on my palms and the bottoms of my feet for like a week, and I've been more tired than usual😳8:43 PM
D
that's really useful to mention. a rash on the palms and soles, along with fatigue, swollen glands, or a low fever, kinda sounds like the second stage.8:47 PM
T
so it's already moved past the first stage8:50 PM
D
i'm not a doctor, which makes getting in this week actually urgent, not just a good idea. it's still very treatable at this stage.8:53 PM
Video thumbnail►watchSyphilis, explained
T
I don't want to be dramatic about this, but I also don't want to keep sitting on it out of embarrassment8:55 PM
D
whatever this turns out to be, the goal is just taking care of yourself, with or without any shame attached to how you got here. the shame doesn't protect you. the appointment does.❤️8:57 PM
T
ok. I'm calling the clinic first thing tomorrow to get seen this week8:59 PM
D
good, don't wait on this one. let me know how it goes.9:00 PM
Read 9:03 PM
Sources: CDC – About Syphilis, CDC – 2023 STI Surveillance, and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Sam's partner just casually mentioned being on PrEP, and Sam had no idea what that meant.
new · bloodwork is back
S
talked to my doctor, I'm finna start PrEP next week, they just needed some bloodwork first2:44 PM
D
that bloodwork before starting is normal. they're confirming you're HIV-negative first.2:47 PM
S
wait why that even matter if it's basically the same medication either way2:51 PM
D
because PrEP is only one or two drugs. if you were already positive, that's not enough to fully suppress the virus, and taking it that way can let the virus develop resistance to those exact drugs. that's why the test happens first, every time, no exceptions.2:54 PM
S
ok that actually make sense now2:55 PM
a few weeks earlier, before any of that
S
ok what even is PrEP, I been nodding along but I don't really know5:59 PM
D
it's a daily pill (or a periodic shot now too) that prevents HIV before exposure. taken consistently, it's extremely effective.6:01 PM
S
wait so people be taking medication to not get something they don't even have😂6:04 PM
D
exactly. prevention, like a vaccine, not treatment after the fact. people who want that extra layer of protection use it as a safety net alongside condoms, whatever their own reasons are for wanting it.6:06 PM
S
what if somebody don't take it regularly but got a specific scare, like a condom breaking6:10 PM
D
different situation, different tool: that's PEP, not PrEP. it's an emergency course started after one specific exposure, but only works within 72 hours. there's a whole if it's ever relevant.6:14 PM
S
ok but if somebody do get HIV, that's just... it, forever?6:15 PM
D
it stays in the body, yes, but daily antiretroviral medication can suppress it to undetectable levels.6:16 PM
D
and here's the part people don't know: undetectable means untransmittable. someone on effective treatment cannot pass HIV to a partner through sex. that's been confirmed by large studies, not a guess.6:19 PM
Treated vs. untreated
treated consistentlydaily medication keeps the virus suppressed. normal lifespan, and undetectable means it can't be sexually transmitted.
treated inconsistentlyskipping doses can let the virus rebound and raises the risk of the medication stopping working as well, so consistency matters almost as much as the medication itself.
left untreatedprogressively damages the immune system, eventually leading to AIDS.
S
ok that's really different from what I had pictured6:22 PM
D
most people are working off decades-old information.6:25 PM
S
this all feel real "young and dating" though, do any of it even apply once somebody older or married6:29 PM
D
all of it, actually, maybe more than people expect. married women and older women are some of the groups most likely to get diagnosed late, exactly because everyone assumes it doesn't apply to them. there's a whole if you want the fuller picture.6:33 PM
S
is PrEP something people actually know to ask for, or that vary a lot too6:34 PM
D
it varies a lot.6:35 PM
D
Black Americans accounted for about 38% of new HIV diagnoses in 2023 while being roughly 12% of the population, per CDC data compiled by HIV.gov, but only a fraction of Black people who could benefit from PrEP are actually on it. that gap is exactly why places like Black Health's HIV care directory exist, to make PrEP, testing, and ADAP easier to actually find.6:38 PM
D
PrEP has existed for a decade now, but only around 10% of women who could actually benefit from it have ever been prescribed it. that's not a personal failing on anyone's part, that's a system that hasn't caught up to putting this tool directly in women's hands.6:42 PM
D
and it's not just race that shapes where this lands, geography does too. the South alone accounts for more than half of all new HIV diagnoses nationwide, even though it's not half the country's population.6:43 PM
D
and those two things stack. of the ten states with the most HIV diagnoses among Black people specifically, seven are in the South, and Black people in rural areas tend to get diagnosed later than Black people in cities, meaning the virus goes unnoticed longer before treatment even starts.6:44 PM
Video thumbnail►watchWhy do Black women account for 57% of new HIV diagnoses but only 1% of PrEP users?
S
not to make this deep, but knowing all this actually changes how I feel about being with my partner, not just the medical part6:47 PM
D
once you're not quietly worrying in the back of your mind, you get to just be present with someone instead of running risk math mid-moment. good sex includes actually wanting to be there, and it's hard to want something fully while half your brain is on guard.6:51 PM
S
people always frame this stuff like it's only about fear though, never about wanting a good sex life6:54 PM
D
that framing is backwards, and it's part of why so many people tune it out. it's about protecting your ability to enjoy sex, feel desire, and be free with a partner without it costing you something later. that's a completely valid reason on its own, no fear required.6:58 PM
S
ok, I'm actually finna ask my doctor about PrEP at my next appointment instead of just nodding along next time it come up7:01 PM
D
good. bring it up directly, they'll know exactly what to do with that. practicing and prioritizing prevention like this isn't a big dramatic thing, it's just part of taking care of yourself.7:02 PM
Read 7:04 PM
Sources: CDC – About HIV, HIV.gov – U.S. Statistics, and Black Health – HIV Care.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Noah's condom broke last night with someone whose status he doesn't know, and he's been spiraling on the internet since 3am. his friend Kai texted him Dee's number half asleep and told him to stop googling and just ask.
N
ok this isn't hypothetical, the condom broke last night and I don't know this person's status and I've been googling for hours and now I'm actually panicking3:11 PM
D
ok, breathe. first question, and it actually matters a lot right now: how many hours ago was this?3:15 PM
N
like fourteen hours ago maybe3:16 PM
D
good, you're well inside the window that matters. there's a medication called PEP, post-exposure prophylaxis, that can prevent HIV after a specific exposure, but it only works if it's started within 72 hours, and earlier is significantly more effective than later.3:18 PM
N
wait, there's actually something I can take AFTER, not just before like PrEP?3:21 PM
D
different tool, same family.3:23 PM
D
PrEP is ongoing prevention before any exposure happens.3:25 PM
D
PEP is an emergency course you start after one specific exposure. it's about a month of daily medication, and it dramatically lowers the odds of that exposure turning into an actual infection.3:29 PM
N
where do I even get this, like today, right now3:33 PM
D
an ER, urgent care, or a sexual health clinic can all start it. time actually matters here, so don't wait around for a "better" appointment slot. calling ahead so they know to have it ready can save you time once you're there.3:37 PM
N
will they judge me for this3:38 PM
D
no, and even if one specific provider is weird about it, that's not a hill worth losing time over.3:40 PM
D
ERs deal with PEP requests constantly. this is routine to them even though it feels huge to you right now.3:44 PM
N
is this going to cost a fortune, I don't even know what my coverage looks like3:48 PM
D
PEP is usually covered by insurance, and most places that provide it also have assistance programs specifically for people without coverage, since the entire point is getting people started fast, not turning them away over cost. ask directly. they'll know the process.3:51 PM
Started early vs. started late
within 72 hours, ideally soonersignificantly reduces the risk of the exposure turning into an infection.
after 72 hoursPEP is no longer considered effective. the exposure has to be handled through monitoring and testing instead.
N
ok, what actually happens once I start it3:53 PM
D
28 days of daily medication, no skipping doses, then testing afterward to confirm your status. some short-term side effects like nausea or fatigue are common, but they're manageable and temporary.3:57 PM
N
and if I don't want to end up back here again, is there something for going forward4:00 PM
D
that's basically the door right into PrEP, the ongoing version of this, you can also ask for DoxyPEP. the tab has clinic finders and hotlines if you need somewhere to start calling.4:04 PM
N
I keep feeling like I did something wrong just by needing this4:07 PM
D
you didn't. condoms break, that's just physics, not a character flaw. noticing it, reaching out, and handling it is you taking care of yourself, nothing to feel small about.4:11 PM
N
ok. I'm calling right now instead of googling more4:13 PM
D
that's exactly the move. the googling was costing you time that actually matters here.4:15 PM
Read 4:16 PM
Sources: Black Health – PEP and Black Health – PrEP.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Riley's doctor brought up the HPV vaccine at a checkup, and Riley wasn't sure what to think. Riley's sister is friends with Nadia, who's the one who passed along Dee's number in the first place.
R
my doctor asked if I'd gotten the HPV vaccine and I kind of froze, I don't know much about it11:12 AM
D
HPV is the most common STI there is. most sexually active people get some strain of it at some point.11:14 AM
R
wait, MOST people?11:15 AM
D
yeah. Many strains clear on their own within a year or two with zero symptoms. the ones that matter are the higher-risk strains that don't clear. And you can't know what kind you have without testing.11:19 AM
R
what happens if those don't clear11:21 AM
D
over years, they can cause cell changes leading to cervical, anal, or throat cancers. pap smears can catch those changes long before they'd become dangerous.11:24 AM
Monitored vs. unmonitored
monitoredregular pap smears catch abnormal cell changes early. the vaccine also prevents infection from the highest-risk strains in the first place.
unmonitoredhigh-risk strains left unchecked for years can develop into cervical, anal, throat, or other cancers.
R
is this actually a bigger deal for some people than others11:27 AM
D
for cervical cancer specifically, yes. the CDC is direct about it: Black women are more likely to die from cervical cancer than white women, largely because of later diagnosis, not a more aggressive disease. Black Health's guide to cervical cancer in Black women breaks down exactly why, and what to push for at a screening.11:28 AM
R
ok honestly I've heard some scary stuff about the vaccine itself online though11:30 AM
D
fair to check that rather than take my word for it. it's covered in , since it comes up a lot.11:34 AM
R
honestly this one feels different, like it's more about me than about anyone I'm with11:37 AM
D
it is. this one's squarely about your own body and your own future, nobody else's status or say-so required.11:40 AM
R
ok, I'm still getting the vaccine either way, and I'll actually go read that chat after this instead of just guessing❤️11:42 AM
D
good combo, get the shot, then get informed on your own time.11:43 AM
Read 11:45 AM
Sources: CDC – About Genital HPV Infection, CDC – Cancer and African American People, and Black Health – Cervical Cancer in Black Women.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Jordan's new partner just disclosed a herpes diagnosis, and Jordan is trying to figure out what that actually means.
J
so someone I'm seeing just told me they have herpes. I don't want to overreact but I also don't know anything about it9:44 PM
D
that they told you is actually a really good sign. herpes is common and very manageable. it's just badly misunderstood.9:48 PM
J
ok wait break it down for me9:52 PM
D
two types: HSV-1 is usually oral (cold sores), HSV-2 is usually genital, but either can show up in either place. it spreads through skin-to-skin contact, sometimes without visible symptoms.9:56 PM
D
it stays in the body for life, but outbreaks are very manageable with antiviral medication, and a lot of people go long stretches, sometimes years, symptom-free.9:57 PM
J
is it dangerous, like actually10:01 PM
D
for most people, no. it's more of a nuisance than a health threat. the biggest harm it causes is usually the stigma (negative and unfair beliefs about people with STI/STD diagnoses), not the virus.10:05 PM
J
is it actually as common as you're making it sound, or are you just saying that to make me feel better10:06 PM
D
genuinely that common, and not evenly. per CDC's national health survey data, roughly a third of Black adults carry HSV-2, versus about 8% of white adults, a gap that comes down to who's more exposed within their own social networks, not anything about individual choices. Black Health has more on that if you want the numbers straight from them.10:08 PM
Managed vs. unmanaged
managedantiviral medication shortens and reduces outbreaks, and daily suppressive therapy can lower transmission risk.
unmanagedoutbreaks can be more frequent, and transmission risk to partners is higher.
J
ok that actually makes me feel a lot calmer10:09 PM
D
good. the fact that they told you upfront is the part worth focusing on.10:11 PM
J
honestly I was more worried about how I'd feel about myself than the virus itself😳10:15 PM
D
you gotta take it seriously without spiraling10:17 PM
J
ok, I think I'm gonna ask about antiviral options next time I'm at the doctor anyway, just so I actually understand what's available before I need it10:18 PM
D
smart, it's worth having that conversation before an outbreak, not during one.10:21 PM
Read 10:24 PM
Sources: CDC – About Genital Herpes and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Ava got a result back from a routine screening that she'd never even heard of before. her cousin Camille was the one who told her to just text Dee instead of panicking alone.
new · checking in
A
finished the antibiotics, everything cleared right up9:06 AM
D
good. any repeat symptoms, or genuinely done9:08 AM
A
genuinely done, and I told the person I was seeing9:09 AM
D
good on you. worth getting retested in about 3 months, trich can come right back if a partner wasn't treated too.9:12 AM
a couple weeks earlier, before any of that
A
so apparently I got "trichomoniasis" and I never even heard this word in my life4:13 PM
D
super common, just not talked about much. it's actually caused by a tiny parasite, not a bacteria or virus. it's trichomonas vaginalis, if you want the full name.4:14 PM
A
wait, a parasite? that sound so much worse than an infection😳4:16 PM
D
i know it sounds dramatic, but it's actually one of the most treatable STIs out there, it's the most common curable STI in the country.4:20 PM
D
it's cured with antibiotics: since 2021 the guidance for women is metronidazole, 500mg twice a day for 7 days, not the old one-time dose, that switch roughly halved how often it comes back at the follow-up test. partners/lovers can usually be treated with a single dose instead.4:22 PM
A
is this actually random, or it hit some people way more than others4:25 PM
D
it's one of the starkest gaps out there: national testing found 8.9% of Black women carry it, a big piece of why is structural, not behavioral, trich isn't even on the standard chlamydia/gonorrhea panel by default, so it goes undetected for years unless someone specifically asks for it by name.4:28 PM
A
how I even get it without noticing anything4:31 PM
D
about 70% of people with it get zero symptoms. when they do show up it's usually itching, discharge, or odor, but none of that is specific to trich, which is part of why you can't diagnose it from symptoms alone, only a lab test can confirm it. it's worth confirming which one you're actually dealing with.4:35 PM
Treated vs. untreated
treated, partner tooclears completely with a short course of antibiotics, straightforward and quick, and it stays gone.
treated, partner isn'tcan clear for you and still bounce right back if a partner isn't treated at the same time.
left untreatedraises the odds of infection by about 1.5x because of the inflammation it causes, and in pregnancy it's linked to preterm delivery and low birth weight.
A
ok good, I was picturing something way more intense than that4:36 PM
D
make sure any partners get treated too, or you can pass it right back and forth.4:37 PM
A
this whole thing kind of reminded me how little control I feel like I have over stuff like this sometimes4:41 PM
D
and this is actually a place where you do have real control, screening, treatment, and telling a partner are all things you get to decide and act on yourself.4:45 PM
A
ok, I'm texting my partner right now so they can get treated too instead of putting it off4:49 PM
D
that's the last piece, good call.4:53 PM
Read 4:55 PM
Sources: CDC – About STIs (Trichomoniasis) and Black Health – Trichomoniasis in Black Women.
Reach out to your doctor and ask for the trich test by name (a NAAT), since it's usually not on the standard panel. If you don't have a doctor or insurance, check out Black Health's directory of free and charitable clinics or a Planned Parenthood near you, or see . More options are in the .
Nadia's been having pelvic pain for weeks and finally brought it up at an appointment.
new · checking in
N
finished the antibiotics, the pain's actually gone10:11 AM
D
that's what catching it early looks like. any lingering symptoms, or genuinely gone10:14 AM
N
genuinely gone, and I already told my partner like we talked about10:17 AM
D
good. keep the follow-up appointment your doctor mentioned anyway, just to confirm it's fully cleared.10:21 AM
a few weeks earlier, before any of that
N
so my doctor said the pain I've been having might be "PID," pelvic inflammatory disease. I've never heard of that as its own thing7:23 PM
D
it's really common effect of untreated . the infection spreads upward into the uterus, fallopian tubes, or ovaries.7:24 PM
N
wait so it's not its own separate infection, it's a result of one I didn't know I had7:26 PM
D
exactly.some people get real pain and fever, others get such mild symptoms they don't think anything of it, which means it can go on longer than it should before anyone catches it.7:29 PM
N
can they just treat it now that we know7:31 PM
D
yes. antibiotics treat the active infection. the harder part is that they can't undo scarring that's already happened, which is why catching it early really matters.7:32 PM
N
is this connected to the same access stuff you mention with chlamydia and gonorrhea7:35 PM
D
directly, since PID is mostly a downstream consequence of those going untreated. that's also part of why ectopic pregnancy, one of the scarring risks, shows up disproportionately in Black women; Black Health's guide on ectopic pregnancy warning signs is worth bookmarking even if this doesn't go that far for you.7:36 PM
Treated early vs. treated late
caught earlyantibiotics clear the infection before it causes lasting damage to the reproductive organs.
caught late, or recurringscarring can lead to chronic pelvic pain, higher risk of ectopic pregnancy, and infertility.
N
I almost didn't mention the pain because it wasn't "bad enough" to bring up7:39 PM
D
that's the exact instinct to ignore next time. unexplained pelvic pain is always worth mentioning, even if it seems minor.7:42 PM
N
I think I minimized it because I didn't want to make a big deal out of my own body😭7:44 PM
D
your body gets to be a big deal to you. speaking up for it isn't dramatic, it's the whole basis of taking care of yourself, and it's how you keep the ability to make your own choices about your reproductive health later.7:47 PM
N
ok, I'm finishing the full antibiotic course this time, and I'm actually going to speak up next time something feels off instead of waiting it out7:49 PM
D
both parts matter: finishing the course, and not waiting for pain to feel "bad enough" next time.7:52 PM
Read 7:55 PM
Sources: CDC – About STIs (PID) and Black Health – Ectopic Pregnancy in Black Women.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Leah's about to travel abroad and her doctor brought up a hepatitis A/B vaccine, which got her wondering why hepatitis was even in a sexual health conversation. her travel buddy Simone made her promise she'd run it by Dee before the trip.
L
my doctor pushing a hepatitis vaccine before my trip. I thought hepatitis was a travel thing, not a sexual health thing?1:47 PM
D
it can be both, honestly, it depends which one. there are three main types that matter here: A, B, and C, and they spread pretty differently.1:49 PM
L
ok break it down for me1:53 PM
D
hepatitis A spreads through tiny amounts of fecal matter, often from contaminated food or water, but also through oral-anal contact during sex. it's short-term and most people recover fully.1:55 PM
D
hepatitis B spreads through blood and sexual fluids, so it's a much more direct STI. it can become chronic, meaning it sticks around for life and slowly damages the liver.1:57 PM
D
hepatitis C mostly spreads through blood-to-blood contact, shared needles being the biggest route, but it can also spread sexually, especially with other infections or rougher sex involved.2:01 PM
L
okay so maybe i shouldn't eat the booty like groceries, wait, chronic? like it don't go away?😂2:04 PM
D
for B and C, it can. a lot of adults clear hepatitis B on their own, but some don't, and untreated chronic infection with either B or C can lead to cirrhosis or liver cancer over years.2:05 PM
L
is chronic hepatitis B actually more common in some groups, or that's just something I'm imagining2:06 PM
D
not imagining it. per federal health data, the prevalence of chronic hepatitis B among Black Americans is more than six times what it is among white Americans, and Black Americans are also significantly more likely to die from viral hepatitis overall. the vaccine you're already getting before your trip covers exactly this.2:09 PM
Vaccinated vs. unvaccinated (A & B)
vaccinateda series of shots gives long-term, highly effective protection against hepatitis A and B. many people got this as kids without realizing it.
unvaccinatedfully exposed to both, with no way to know it happened until symptoms show up, sometimes weeks later, or not at all.
L
so is there a vaccine for hepatitis C too?2:13 PM
D
no, that's the one gap. no vaccine exists for C. the good news is it's actually curable now: a course of antiviral pills, usually 8 to 12 weeks, clears it in the vast majority of people. that's a huge shift from a decade or two ago.2:16 PM
L
how would I even know if I had B or C, is it a symptom to watch for2:18 PM
D
most people don't get obvious symptoms early on, which is exactly why it's not something you can rule out by feeling fine. it's a blood test, and it's one of the ones worth naming specifically when you're getting a full panel done.2:21 PM
L
it's kind of nice honestly, treating my health like it's worth planning around instead of just an afterthought before a trip2:25 PM
D
this stuff doesn't have to be reactive, and building it into your normal life, vaccines, testing, checkups, is its own kind of self-care.2:28 PM
L
ok I'm getting the vaccine before my trip either way, but sound like I should ask about the blood test too next time I'm at the doctor2:31 PM
D
exactly right on both counts. there's a whole if you want the exact wording.2:32 PM
Read 2:33 PM
Sources: CDC – About Hepatitis A, Hepatitis B, Hepatitis C, and HHS Office of Minority Health – Hepatitis and Black/African Americans.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Simone's been treated twice already for "probably chlamydia," but the same symptoms keep coming back, and the standard tests keep coming back negative.
S
ok this round three. burning, discharge, the whole thing. tested negative for chlamydia and gonorrhea both times before, but they treated me for it anyway and it always come right back10:19 AM
D
that specific pattern, symptoms with a negative standard result, is actually a clue on its own. there's something worth asking about by name: Mycoplasma genitalium, usually just called M. gen.10:21 AM
D
I'm just guessing but I learned about it last summer.10:24 AM
S
what the hell? i've never even heard of that and my doc didn't mention it.🔥10:26 AM
D
it's a bacteria that causes urethritis in men and cervicitis in women, symptom-wise it looks and feels a lot like chlamydia, but it's a completely separate organism that needs its own specific test.10:30 AM
S
so the tests I already took wouldn't even have caught this10:31 AM
D
right. a standard chlamydia and gonorrhea panel doesn't include it. it needs its own NAAT test, and not every clinic even offers it automatically, so sometimes you have to ask for it directly, by name.10:35 AM
Tested for the wrong thing vs. tested for M. gen specifically
tested specificallya targeted test confirms it, and treatment can actually be matched to what's really going on.
treated on assumptionrepeated rounds of the wrong antibiotic, symptoms keep coming back, and the actual cause never gets confirmed.
S
ok so why this isn't just part of the normal panel then, if it's this common a mix-up10:38 AM
D
current guidelines actually recommend against screening people who have no symptoms at all, mainly because of something else going on with this one: antibiotic resistance.10:39 AM
S
wait, resistance? like it don't respond to the usual antibiotics no more?10:40 AM
D
a large share of strains have become resistant to azithromycin, which used to be the automatic first choice. testing everyone regardless of symptoms risks pushing that resistance further. but with real, persistent symptoms like yours, targeted testing might be exactly what's called for.10:44 AM
S
ok so what actually treat it, if the usual antibiotic don't always work10:46 AM
D
guidance now usually calls for resistance testing alongside the diagnosis, so treatment gets matched to what will actually work for that specific case, often doxycycline first, then a different antibiotic depending on the results.10:50 AM
S
ok so when I call the doctor's office, I should just say the name instead of letting 'em guess again10:52 AM
what to actually say
"The symptoms keep coming back, can I be tested specifically for Mycoplasma genitalium, including resistance testing?"
D
that sentence alone can save you another round of guessing and another course of the wrong antibiotic.10:56 AM
Video thumbnail►watchMycoplasma genitalium (M. gen), explained
S
two rounds of being treated for the wrong thing kind of made me feel like I didn't have a say in my own care😭10:59 AM
D
you're not being difficult, you're the only one who knows this keeps coming back.11:00 AM
S
ok. I'm calling tomorrow and asking for that test by name instead of doing another round of guess-and-treat11:04 AM
D
good, that's the whole ask right there.11:08 AM
Read 11:10 AM
Sources: CDC – Mycoplasma genitalium and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Reese noticed a smell she's never had before and is spiraling a little before her appointment even happens. her coworker Priya swears by Dee for exactly this kind of spiral.
R
ok this embarrassing, but I been having this thin grayish discharge and a weird fishy smell for about a week. is that an STI😳10:57 AM
D
not embarrassing at all, and it's a really common question. that combination points to bacterial vaginosis, BV for short, and it's actually not classified as an STI.10:59 AM
R
wait, not an STI? then what is it then11:01 AM
D
it's a shift in the bacteria, not an infection from an outside source. a healthy vagina is dominated by lactobacilli, they keep things acidic and crowd out other bacteria.11:02 AM
D
BV happens when those protective bacteria drop and other bacteria, including one called gardnerella, take over.11:04 AM
R
so I didn't "catch" this from nobody11:08 AM
D
right, and it's not about hygiene either, you can't get it from toilet seats or pools, and washing more won't fix it. douching is one of the things that can trigger it. it happens in people who've never had sex too, though new or multiple partners are linked to it, and semen can shift your pH, which is part of why the smell is often stronger after sex.11:10 AM
R
is this actually more common for some people, or it hit everybody about the same11:14 AM
D
BV's actually the most common vaginal condition out there, roughly 29% of women have it at any given time, that traces back to differences in the vaginal microbiome itself, not anything about hygiene or behavior, so if you keep getting this, it's not something you're doing wrong.11:17 AM
R
ok my partner need to get treated too then?11:19 AM
D
yep. If it's a (cis)man, a big clinical trial found treating the male partner with an antibiotic pill plus a topical cream cut recurrence from 63% down to 35%. If it's a (cis) woman, it can pass back and forth, so treating both can help stop the cycle.11:21 AM
D
But either way, cis or trans, gay or straight, everyone should be tested and treated.11:22 AM
Treated vs. untreated
treated right awaya short course of antibiotics, usually metronidazole or clindamycin, clears it within about a week.
treated, but recurringmore than half of people see it come back within a year, a longer maintenance treatment can help break that cycle instead of just re-treating it each time.
left untreatedraises the risk of catching HIV by around 60% if you're exposed, plus other STIs and pelvic inflammatory disease, and more than doubles the risk of preterm birth if it happens during pregnancy.
R
wait, if I don't treat it, will it actually make me more likely to catch other stuff too?11:23 AM
D
yeah, that's the part that surprises people. one big analysis found BV raises the risk of acquiring HIV by around 60%, on top of raising the risk of other STIs and pelvic inflammatory disease. and in pregnancy it's linked to more than double the odds of preterm delivery.11:24 AM
D
Black women already face higher preterm birth rates, so this is one piece of that worth catching.11:26 AM
Video thumbnail►watchWhy are you a BV girlie?!?
R
ok so this isn't just a smell problem, it's actually worth treating properly11:30 AM
D
exactly, even though day to day it can feel pretty minor. and worth knowing too, a lot of people with BV don't get any symptoms at all, so a clinician actually testing you matters more than trying to self-diagnose off a smell or discharge.11:32 AM
R
how it actually get treated though11:34 AM
D
antibiotics, either metronidazole by mouth twice a day for a week, a gel used vaginally for five days, or a cream for a week. finish the whole course even if it clears up early, it typically does clear within about a week, though it's also one of the more common things to come back later.11:35 AM
R
wait, it come back a lot?11:38 AM
D
for a lot of people, yeah, more than half see it recur within a year. that's not a sign anyone did anything wrong, it's just how sensitive that bacterial balance can be. one thing that actually helps: stop douching completely, it's one of the clearest things tied to both getting it and it coming back.11:40 AM
D
for people who keep getting it, there's also a longer option which is an antibiotic course, then vaginal boric acid for a few weeks, then a gel a couple times a week after that. worth asking about if this keeps happening.11:43 AM
R
honestly I almost didn't say anything cause it felt embarrassing even to bring up11:45 AM
D
nothing about your own body needs to earn its way past embarrassment before you're allowed to take care of it. this is just maintenance, same as anything else on you that needs attention.11:48 AM
R
ok. I'm calling to get in this week instead of just hoping the smell go away on its own11:51 AM
D
good call, and it's worth mentioning the recurrence question while you're there too, just in case this turns out not to be a one-time thing.11:55 AM
Read 11:56 AM
Sources: CDC – About Bacterial Vaginosis and Black Health – Bacterial Vaginosis in Black Women.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Chris has a doctor's appointment tomorrow and wants to actually ask for testing this time instead of chickening out again. his gym partner Devon is the one who finally talked him into texting Dee.
new · results are in
C
panel came back, everything's negative9:58 AM
D
how'd it feel to actually ask this time10:02 AM
C
way less awkward than I built it up to be in my head10:06 AM
D
that's usually how it goes. same time next year, or sooner with any new partner.10:08 AM
the day before, before any of that
C
ok I have an appointment tomorrow and I want to ask for a full STI panel but I don't know how to bring it up without it being weird4:10 PM
D
it's a much smaller moment than it feels like in your head. you don't need a reason, a story, or a disclaimer.4:11 PM
what to actually say
"I'd like to get a full STI panel done, including HIV, as part of my routine care."
C
that's it? no context needed?4:15 PM
D
that's it. providers hear this constantly. one thing worth knowing though: "full panel" isn't a standardized single test, so it helps to name what you want included.4:17 PM
D
chlamydia, gonorrhea, syphilis, and HIV are the core ones. ask about and too if you want them covered. some providers only test for those if you specifically ask.4:18 PM
C
wait, if I just give a urine sample, does that cover all of that?4:20 PM
D
not automatically, and this is the part almost nobody tells you: a urine test only picks up infection in the urethra. chlamydia and gonorrhea4:22 PM
D
in the rectum or throat are separate infections that need a swab of those specific sites, and they're usually asymptomatic, so nothing tells you they're there.4:24 PM
C
gonorrhea in your throat is actually a thing?4:28 PM
D
very much so, and it's common. in one CDC surveillance study, more than 70% of extragenital gonorrhea and 85% of extragenital chlamydia turned up in people whose urine test at that same visit came back negative.4:29 PM
D
urine alone would've missed it completely. if you have anal or oral sex where you're the receiver, say that out loud and ask for those sites to be swabbed by name, it won't happen automatically.4:30 PM
C
what about herpes and HPV, should I ask for those specifically too4:33 PM
D
herpes blood tests aren't usually recommended unless you have symptoms, since they can be unreliable without an active outbreak.4:37 PM
D
HPV isn't a blood test at all; it shows up through pap smears and cervical screening on a normal schedule.4:38 PM
C
ok what if the doctor seems weird or judgmental about it4:39 PM
if you get pushback
"I'd like this to just be part of my regular checkups going forward, regardless of symptoms."
D
that sentence usually ends the conversation. it frames it as routine, the same way a breast exam or a diabetes screening is just routine, nobody treats those as an accusation. and if a provider is genuinely dismissive about it, that's worth finding a different provider over.4:41 PM
C
what if I don't want to go through insurance for this4:43 PM
D
totally valid. a lot of routine STI screening is actually covered with no copay under most insurance plans, but if you'd rather go around that entirely, free and low-cost clinics exist specifically for this. check the tab or try linkudmv.org (to search for local places).4:46 PM
C
one more thing, does this only really matter for people who are dating around, or does it still apply once someone's married or has kids4:47 PM
D
it still applies, fully, whether you're gay, straight, cisgender, transgender, bisexual, or pansexual, married or single, dating around or not. that assumption is actually a big part of why married people get diagnosed later on average. there's a about exactly that if you want it.4:48 PM
C
ok. I'm asking for all of it tomorrow, core four plus trich if symptoms come up, and hepatitis, no chickening out this time4:52 PM
D
that's the whole plan right there.4:53 PM
Read 4:54 PM
Sources: CDC – About STIs and Black Health – STI Testing for Black Adults: What the Panel Skips.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
A few weeks after that first conversation about PrEP, Sam texts again, this time it's not hypothetical.
S
hey. I got my results back. it's positive. I don't really know what to do with that right now, honestly5:27 PM
D
take a breath. this is a lot to process. it's okay if you're not okay right now.5:30 PM
D
practically, the first move is getting connected to a provider who specializes in HIV care, usually within the first week or two. they'll run baseline labs, viral load and a count of certain immune cells, just to see where things stand.5:34 PM
S
do I gotta wait a while before starting treatment. I just blanked a little after they told me I had it.5:38 PM
D
actually the opposite. current guidance is to start treatment as soon as possible after diagnosis, often the same day it's offered. that's a big shift from years ago, when people used to wait.5:40 PM
S
and that get me to undetectable eventually?5:43 PM
D
for most people, yes, usually within a few months on treatment. once you're there, and staying on treatment, it's not passed to partners through sex. that's the .5:45 PM
S
honestly the hardest part right now isn't even the medical stuff, it's who to tell5:49 PM
D
there's no required order. it's usually about who you trust and who you'll need support from. current or future sexual partners are the one category where a lot of places have specific legal expectations around disclosure, so that part's worth actually looking into for where you live.5:51 PM
S
does where I live actually change any of this5:55 PM
D
more than people realize. the South carries the heaviest HIV burden in the country, more than half of all new diagnoses happen there, and access to specialized care and medication assistance programs varies a lot state to state.5:56 PM
D
some Southern states also still have laws that criminalize not disclosing your status to a partner, so it's genuinely worth learning your specific state's rules.6:00 PM
S
is it normal to just feel kind of numb about all this6:04 PM
D
completely normal. a lot of care programs have counselors or support groups built in specifically for this. you don't have to sort through the emotional side alone either.6:07 PM
Video thumbnail►watchPositive Voices S1E3 - Mental Health and HIV
S
ok. I think I'm gonna call about that provider today and just start with the medical stuff first, the rest can come after6:08 PM
D
that's a solid place to start. one step at a time, that's genuinely all this needs to be right now.6:10 PM
Read 6:12 PM
Sources: CDC – About HIV and Black Health – HIV Care.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Wendell has been on treatment a few months and finally admits something he's been sitting on.
W
not gonna front, it's hard to take my meds. and it's not because I forget10:18 AM
D
what's going on in those moments, if you don't mind me asking10:19 AM
W
opening the bottle puts me right back in that clinic room, hearing the word positive. some days I just can't bring myself to pick it up10:21 AM
D
ooh, I hear you. When that happens, the bottle isn't just medication to you, it's tied to the exact moment your world shifted. it's trauma memory doing what it does.10:24 AM
W
I just feel like I should be past it by now10:26 AM
D
there's no clock on this. plenty of people years into care have days where the bottle feels heavier than usual. you don't have to be "over it" to take care of yourself, and saying this out loud is already you taking control.10:29 AM
W
i try to treat it like information, not a mistake, when i skip a dose, but that doesn't work sometimes10:31 AM
D
what's usually happening around you?10:35 AM
W
mornings are the worst. that's when I got the call to come in, so the whole routine just feels heavy10:37 AM
D
that's a really important insight. have you ever thought about switching to a different time of day?10:38 AM
W
wait, I can actually do that?10:42 AM
D
it depends on your specific regimen, since some meds need food or have strict timing windows, so it's something to clear with your care team first. but switching to evening or bedtime works great for a lot of people. is that something you feel comfortable bringing up to your provider?10:46 AM
W
bedtime feels way more neutral. I could definitely handle that better10:48 AM
D
do you think you'd be able to send them a quick portal message tonight or give their nurse line a call? until you get a chance to connect with them, what is one thing you already do every single morning without fail?10:50 AM
W
make coffee. first thing, every day, no matter what10:52 AM
D
how would it feel to put the bottle right next to the coffee maker? anchoring it to something neutral that's already part of your morning might help. it won't erase the memory, but it pairs it with another part of your routine.10:56 AM
W
that actually feels doable11:00 AM
D
do you think you can start trying that tomorrow morning? take it one day at a time, and remember: if a dose, it's just data on what's working and what isn't, not a reason to throw away your progress.11:03 AM
W
yeah. coffee maker tomorrow, and I'll message my care team tonight. thanks.11:07 AM
Sources: HIV.gov – Taking Your HIV Medication Every Day, The Well Project – Adherence, and Help Stop the Virus – Treatment Adherence.
Reach out to your doctor if sticking to a treatment schedule feels hard right now, that's a normal part of care to bring up, not a failure to admit. More options are in the .
Mo's friend group has... a lot of opinions about why protection is "not necessary this time." Dee has heard them all.
M
i feel like we clean though, so condoms not even necessary1:28 PM
D
"clean" isn't really a real category. plenty of infections show zero symptoms, so "looking clean" tells you nothing. the only way to know is a test, not a vibe check.1:29 PM
M
she on the pill so we good1:32 PM
D
the pill prevents pregnancy. it does nothing against STIs. two separate jobs. you'd still want a barrier method for infection protection.1:33 PM
M
pulling out basically the same as a condom though1:36 PM
D
withdrawal is one of the least reliable pregnancy-prevention methods even done perfectly, and does nothing for STIs.1:40 PM
M
condoms be killing the mood though, not gonna lie😂1:44 PM
D
fumbling with a wrapper isn't smooth. but that's a logistics problem, not a reason to skip it,1:45 PM
M
I only ever had one partner, so I'm good1:49 PM
D
infections don't know about partner limits. if you've heard people say it only takes one time, they're right it only takes one time.1:52 PM
M
getting tested embarrassing, feels like you admitting to something1:55 PM
D
testing isn't a confession, it's a checkup. the only awkward version is finding out later you could've known earlier.1:56 PM
M
we exclusive so we don't even gotta worry about it no more"1:57 PM
D
the move is to both get tested, not just assume it. "we're official now" isn't a test result.1:59 PM
M
what if somebody ask why I'm getting tested when ain't nothing "wrong" with me2:00 PM
D
you don't owe anybody an explanation for taking care of yourself.2:01 PM
D
"I've got my reasons" is a complete sentence. testing regularly doesn't need a justification any more than a dentist visit does.2:04 PM
M
ok this actually helped, appreciate you for not being weird about it❤️2:07 PM
D
none of it should feel like a big deal. get tested, use protection, ask questions.2:08 PM
M
ok. I'm actually finna bring up getting tested together next time this excuse convo comes up, instead of just letting it slide again2:10 PM
D
that's exactly it. straightforward conversation, straightforward next step.2:13 PM
Read 2:14 PM
Sources: CDC – About STIs and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Mo circles back a few days later with something that's been sitting uncomfortably.
M
ok not gon' lie, the idea of taking medication or getting a shot for this makes me more nervous than the infection itself. and I don't think that's totally irrational either4:53 PM
D
it's not irrational at all. that wariness has real history behind it, and it deserves to be taken seriously instead of waved off.4:57 PM
D
the most direct example: for 40 years, U.S. public health researchers studied untreated syphilis in a group of Black men in Tuskegee, Alabama, and deliberately withheld treatment, including after penicillin became the standard cure, without ever telling the men what was being done to them.4:59 PM
M
wait that's actually horrifying, for real5:03 PM
D
it is. and it's not the only example. there's a long history of forced sterilizations targeting marginalized groups too. there's a whole chat on that under if you want the fuller picture.5:06 PM
D
and drugs like thalidomide caused severe birth defects before anyone caught it, because testing standards were nowhere near what they are now. if any of that makes you want proof before you trust something, that's a completely reasonable position.5:07 PM
but
D
here's the thing though: those exact scandals are why the rules changed. informed consent became a legal requirement, not a courtesy. independent review boards now have to approve any study involving people before it can start.5:16 PM
D
every drug sold today goes through years of staged testing before approval, then keeps being monitored for safety issues after it's on the market.5:18 PM
M
ok but specifically for STI treatment, how long that stuff actually been around5:22 PM
D
penicillin's been treating syphilis for about 80 years.5:23 PM
D
HIV antiretrovirals have been refined for over 25 years and are far gentler than early versions. the HPV vaccine has been tracked across hundreds of millions of doses worldwide.5:26 PM
D
none of that erases the history. it just means these specific treatments have a long, closely watched track record, different from "trust us."5:27 PM
D
D
and you're allowed to ask your provider what a medication does, what the actual side effect rates are, and what the alternatives are. a good provider expects that question.5:28 PM
M
ok. I think I needed the history part acknowledged before the reassurance was even gonna land at all5:31 PM
D
that's fair, and it's exactly why I didn't skip it.5:32 PM
M
ok, I think I'm finna just go ahead and get the vaccine now instead of putting it off cause I'm nervous5:34 PM
D
that's a good call, and you can still ask every question you want on the way in. the fear is usually about the needle or the appointment, not the outcome.5:35 PM
Read 5:37 PM
Sources: CDC – About STIs and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Mo's been thinking about why this all felt so hard to talk about in the first place.
M
ok random thought, why this whole thing feel so shameful before we started talking like this? like it felt actually dangerous to even bring up10:36 AM
D
because a lot of how this stuff gets talked about isn't really about health, it's about judgment. an infection gets treated like a verdict on someone's character instead of a medical event.10:39 AM
M
like that whole "clean" vs "dirty" talk10:43 AM
D
yep and moralism doesn't actually make anyone safer. it just makes people less likely to get tested, less likely to , and less likely to ask a doctor an honest question, because now there's shame riding on the answer.10:46 AM
M
so the shame itself become a public health problem then10:49 AM
D
pretty much. someone avoiding a test because they're scared of what it says about them ends up walking around untreated longer, which is worse for them and for anyone else involved.10:51 AM
M
ok so what's the actual alternative then10:52 AM
D
treat health decisions as practical, not moral report cards. needing a test, a treatment, or a hard conversation with a partner doesn't say anything about who you are. it's just maintenance.10:54 AM
M
that's honestly the whole reason I could even ask you any of this without feeling weird about it10:57 AM
D
none of this is one group's cross to bear, gay, straight, cisgender, transgender, bisexual, pansexual, the community is all of us, and that includes the responsibility to drop the judgment, not just the people judged.10:58 AM
Read 10:59 AM
Sources: CDC – About STIs and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Maya grew up in an abstinence-only sex ed program and feels weirdly guilty even asking Dee anything at all. her roommate Imani had to talk her into saving Dee's number, let alone using it.
M
ok this might sound dumb, but growing up I was taught abstinence is the only real way to protect yourself, and some part of me still believes that, so I feel weird even asking you all this1:23 PM
D
it's not dumb. Abstinence prevents pregnancy & STIs because you're not even putting yourself in sexual situations. But there are sexually transmitted infections that can pass from skin to skin contact.1:25 PM
M
wait, you're actually on board with abstinence?1:28 PM
D
the math is the math. no contact, no transmission. I'm not here to argue with that fact if that's genuinely the choice you want to make.1:32 PM
M
ok so what's actually different about talking to you then1:34 PM
D
the problem with abstinence-only teaching was never that it's inaccurate, it's that it stops there, like it's the only plan anyone's ever allowed to have. for most people, at some point in life, it isn't the plan they end up following.1:37 PM
M
so what's the alternative, exactly1:40 PM
D
it's not me telling you what you should do with your body. its making sure you know what you can do, whatever you actually decide, so you're never standing there with zero information because the one approach you were taught stopped applying.1:41 PM
What's accurate vs. what's often implied
the actual factabstinence is the only method with zero risk of STI transmission or pregnancy. that part is just true.
the harmful add-onimplying that anything short of abstinence isn't worth doing carefully, which leaves people with no real plan the moment abstinence isn't the path they're on.
M
ok that actually makes sense. I think I've been treating using a condom as basically admitting I'd already "failed" at the actual goal1:44 PM
D
i don't love it.1:45 PM
D
That turns a smart, protective decision into a moral defeat. testing, condoms, vaccines, honest conversations is just what taking care of yourself looks like in the world you're actually living in.1:46 PM
M
it's a lot to unlearn, honestly1:47 PM
D
it's worth remembering that having this much information, and this many real options, isn't something everyone's always had.1:49 PM
D
Black women fought hard, and paid real costs, for things like informed consent, access to contraception, and honest sex education to even exist as options at all. some of that's not ancient history either, it's the and chats, if you want the specifics.1:53 PM
M
so actually using that information now is kind of the point of all that fighting1:55 PM
D
exactly. the sacrifice was so people would get to choose, with real facts in hand, instead of being handed one option and told that was the whole conversation.1:59 PM
M
ok. I don't think I need to pick a side between "abstinence" and "not abstinence" the way I thought I did2:00 PM
D
you don't. you just need enough real information to make whatever choice is actually yours, and to change your mind later without that being a crisis if you do.2:04 PM
Read 2:07 PM
Sources: CDC – About STIs and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Imani's friend just told her she's HIV positive, and Imani's been replaying her own reaction ever since, worried she said the wrong things. her cousin Grace had given her Dee's number ages ago, and this is the first time she's actually needed it.
I
ok my friend just told me she's positive and I think I said something wrong because she got really quiet right after5:44 PM
D
first, she trusted you with something real. what did you say?5:47 PM
I
I asked how she got it, I don't even know why that was my first question5:49 PM
D
that's a common missteps, even from people who mean well. leading with "how" can land like an interrogation, or like you're sorting her into a category of blame.5:51 PM
I
so what should I have said instead5:54 PM
a solid first response
"thank you for telling me. how are you feeling, and is there anything you need from me right now?"
D
you should have acknowledged the trust it took, and centered her instead of your own shock.5:56 PM
I
I also said "I'm so sorry" like three times, which felt weird even as I was saying it5:58 PM
D
"I'm sorry" on repeat can start to sound like you're grieving someone, when for most people on treatment this is a manageable chronic condition, not a tragedy in progress.6:02 PM
Reactions that help vs. reactions that sting
tends to land wellasking what support looks like, following their lead on how big a deal to make it, keeping the same tone as before the conversation.
tends to stingasking how they got it, treating it as tragic news, going quiet and distant afterward, or immediately asking who else knows.
I
is it bad that I asked if she's on medication6:05 PM
D
not bad on its own, just depends on the spirit behind it. asked with care, it's a fine question. asked like you're assessing risk to yourself, it stops feeling like care and starts feeling like a screening.6:06 PM
I
honestly I think what she needed most in the moment was for me to not freeze up, and I kind of froze up6:08 PM
D
some people do the first time and it's very fixable after the fact. the real marker of a good reaction isn't the perfect first sentence, it's whether the friendship still feels normal a week later, a month later. And that you keep showing up.6:09 PM
I
last thing, can I tell our other friends so they can be supportive too6:10 PM
D
that one's not yours to decide. it's her health information. if she wants others to know, she'll tell them, or ask you to.6:13 PM
I
ok, I'm gonna check in with her tomorrow, just to see how she's doing, not to make a whole thing out of it6:17 PM
D
showing up normally afterward counts for more than getting the first conversation perfect.6:19 PM
I
I think I was scared this makes it "her problem" now and I don't know my part in it6:22 PM
D
it's not just her problem, and it never should be treated like one. ending stigma and ending this virus is work for all of us, negative and positive together, not something people living with HIV have to carry alone while everyone else stands back and watches.6:25 PM
Read 6:26 PM
Sources: CDC – About STIs and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Kai's been seeing someone new for a few weeks and wants to bring up protection before things go further.
K
ok this is new territory for me, how do I bring up condoms and testing with someone I've only been seeing a few weeks without making it this huge awkward moment10:54 AM
D
bring it up before things go further, not in the middle of it. said early and matter-of-fact, it barely registers as a big deal.10:57 AM
with a new partner
"before we go further, I want us both to get tested. that work for you?"
K
what if they get weird or offended about it10:59 AM
D
that reaction is actually useful information. someone worth being with treats this as normal. someone who gets defensive or guilt-trips you about it is telling you something important, early.11:02 AM
K
what if they say they were "just tested" a while back and don't want to do it again11:03 AM
D
"a while back" isn't the same as "recently," and a test only covers what was true up until that appointment. it can't speak for anything since. It's fair to ask when and for what.11:07 AM
K
how long should we actually wait on results before anything happens11:09 AM
D
most panels come back within a few days to two weeks depending on the clinic. using condoms in that window can help cover, if you choose not to wait.11:11 AM
K
ok that actually makes this feel way less like a big scary conversation11:14 AM
D
that's really all it is: a practical step, said plainly, early enough that it's just part of how you two start off. and it pays off later too, once you both actually know, you get to just be with each other instead of half-worrying in the back of your mind and managing risk in your head.11:18 AM
Read 11:19 AM
Sources: CDC – About STIs and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Kellen's been with their partner for three years and realizes they've never actually gotten tested together. their friend Jordan mentioned Dee a while back and said she doesn't lecture, she just answers.
K
separate question: me and my partner of three years honestly never actually got tested together. is it weird to bring that up now, out the blue2:28 PM
D
not weird at all, and it's more common than people admit. a lot of long-term couples, married or not, just never had the conversation because nothing "prompted" it.2:31 PM
New partner vs. long-term partner
new partnertest before or early on, use condoms until results are back, treat it as a baseline expectation for anyone new.
long-term or married partnereasy to assume exclusivity, or a marriage license, means no risk, so testing often just never happens. worth revisiting anytime status, habits, or the relationship structure changes.
K
how I even bring it up without it sounding like I think they cheated or something2:33 PM
with an established partner
"I realized we've never actually gotten tested together. can we make that a normal thing we do, no particular reason, just good maintenance?"
D
framing it as routine maintenance, not a response to suspicion, is what keeps it from landing as an accusation.2:34 PM
K
what if they get defensive anyway and take it personal2:37 PM
D
that can happen even with a gentle framing. if it does, naming the intent directly usually helps: "this isn't about trust, it's just something we've genuinely never done and should." And even if they choose not to, you still should because you want to.2:39 PM
K
last thing, how often a couple actually should be testing once they established2:42 PM
D
at least once a year as a baseline, and again anytime something changes: a new partner enters the picture for either of you or you stop using condoms.2:44 PM
Read 2:45 PM
Sources: CDC – About STIs and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Devon's been seeing someone for a few weeks and things are heading somewhere physical. He's never actually said any of this out loud to a partner before.
V
ok, things with this boi probably about to get physical and I realize I got no idea how to actually ask the stuff I'm supposed to ask. like the words feel weird in my mouth3:31 PM
D
most people never get taught the actual phrasing, just the vague idea that they should "communicate." let's just go through the real questions, one at a time.3:35 PM
the core one
"What's your STI status, and when's the last time you got tested?"
V
ain't "I'm clean" a normal enough answer to that though3:38 PM
D
it feels like one, but it doesn't actually tell you anything. "clean" isn't a test result. a real answer has a date and a list attached to it.3:40 PM
the follow-ups
"What were you actually tested for?" "What did the results say?" "Have you been with anyone since that test?"
D
a test is a snapshot of one moment, not a permanent status. anything that happened after that date isn't covered by it.3:42 PM
V
ok what if asking all that just kill the whole mood entirely3:43 PM
the easier way in
"do you want to get tested together before we go further?"
D
it turns the conversation into something you're doing together, and it sidesteps whether you trust their answer, since you'd both just know. safer sex is a journey, not just a one time test result.3:44 PM
the other conversation
V
ok separate topic, and this one feel even harder to bring up. pregnancy stuff, since it ain't something either of us even mentioned3:53 PM
D
that's the right instinct. the whole point is to have this conversation while you're both calm, not during an actual scare.3:55 PM
before anything happens
"How do you feel about the possibility of me getting pregnant after hooking up?" · "If it happened, what would we actually do?"
V
that second one feel like we'd be planning a whole future we ain't even agreed to3:59 PM
D
it's not a commitment, it's just a compatibility check. you're not deciding anything permanent, you're finding out if you're roughly on the same page before it's a live situation instead of a hypothetical one.4:00 PM
and then there's the clinic
V
ok unrelated but also uncomfortable: why the clinic need my full legal name and date of birth just to get tested. feel like way more than they need4:11 PM
D
a handful of results, chlamydia, gonorrhea, syphilis, and HIV among them, are legally required to be reported to the public health department when they come back positive. that's not optional for the clinic, it's how contact tracing and outbreak tracking work at all.4:14 PM
V
so my name and birthday going on some government list somewhere4:17 PM
D
name and date of birth mainly exist so your specific record doesn't get mixed up with someone else's, especially if you're ever tested at more than one place. age and basic demographics also help health departments track where and how something is actually spreading.4:19 PM
D
that information is protected by confidentiality law, it's used for public health tracking, not shared publicly or with, say, an employer.4:20 PM
V
that mean they gon' contact my partner directly and use my name?4:22 PM
D
the general practice is that a health department or the clinic itself reaches out to notify partners of possible exposure without naming who reported it. exact rules do vary by state and by clinic though, so it's worth just asking directly, "how does partner notification work here" before you test, so there's no surprise later.4:26 PM
V
ok. none of this is as scary as it felt five minutes ago4:29 PM
D
it rarely is, once it's actual questions instead of a vague dread. you don't have to ask all of these perfectly, or all at once. just asking any of them is already more than most people manage.4:33 PM
Read 4:34 PM
Sources: CDC – About STIs and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Malik keeps hearing the same explanation for HIV rates in the Black community and wants to know if it actually holds up. his cousin Jamal passed along Dee's number a few months back, and this is the question he's been sitting on since.
M
random but I keep hearing that closeted bisexual Black men on the "down low" are basically the reason HIV rates are so high in the Black community. is that actually true2:57 PM
D
it's one of the most repeated explanations out there, but it's also one of the most thoroughly researched and debunked. when scientists went looking for that specific connection, it kept not holding up.2:58 PM
M
debunked how, like what did they actually find3:02 PM
D
studies comparing men who identified as "on the down low" to bisexually active men who didn't found basically no difference between the two groups in condom use or HIV rates. identifying as DL specifically didn't predict riskier behavior.3:04 PM
M
ok but bisexual men do exist in the community, so isn't that at least part of the picture3:05 PM
D
CDC research put the share of Black men who report being bisexually active at around 2%, nowhere near large enough a group to explain a disparity affecting an entire population.3:07 PM
M
ok so how big is the actual disparity, numbers-wise3:08 PM
D
Keep in mind, stats can be jarring but they don't tell the whole story, we're talking about real people's lives.3:09 PM
D
Black Americans made up about 38% of new HIV diagnoses in 2023 while being roughly 12% of the population, per CDC data. for Black women specifically it's even starker: our diagnosis rate is about 11 times that of white women.3:10 PM
M
so if it's not that, what's actually driving the disparity3:12 PM
D
layered, structural stuff. economic and access barriers make consistent healthcare harder to reach for a lot of Black patients. testing itself actually cuts against the stereotype, though: Black adults are more likely to report ever having been tested for HIV than white or Hispanic adults, per CDC survey data, and that's genuinely lifesaving, since knowing your status early is what actually opens the door to treatment and prevention.3:15 PM
D
the harder part sometimes isn't the first test, it's staying on a routine schedule and getting linked to care fast after a positive result. gaps in follow-up and ongoing testing show up across every group, not one community, but they hit harder wherever the healthcare access is already thinner.3:16 PM
M
so you're saying - getting tested once doesn't mean someone's actually covered?3:20 PM
D
right, a single test is a start, not a finish line. plenty of people get diagnosed and then drift out of care, or never get linked to it in the first place, simply because follow-up doesn't become a routine. that gap is a much bigger driver of spread than anyone's secret life.3:24 PM
M
so basically the "down low" story gave people someone to blame instead of looking at access and testing gaps3:25 PM
D
it turns a systemic problem into a personal, moral one about specific men's private lives. and that framing does real damage: it adds stigma that makes men (everyone really) less likely to test or seek care, which just makes the actual problem worse.3:26 PM
M
ok so what do I actually do with all this3:28 PM
D
honestly, none of the blame game matters as much as what you personally do. it's not about your identity or a partner's identity. it's about consistent action, regardless of who you're with.3:32 PM
What PrEP covers vs. what it doesn't
what PrEP protects againstHIV specifically. taken consistently, it's highly effective at preventing transmission through fluids.
what it doesn't coverinfections spread through skin-to-skin contact, like herpes or HPV. PrEP does nothing for those.
M
so even if I'm on PrEP I still need condoms and testing on top of it3:35 PM
D
that's the real ideal, medication, condoms, and regular testing together, not one instead of the others. each one covers a gap the others don't. But there's more than one way to have safer sex.3:36 PM
M
that actually feels way more useful than arguing about who to blame3:40 PM
D
it puts control back in your hands instead of in a myth.3:41 PM
M
ok. I'm gonna go get tested and actually ask about PrEP for myself, instead of just knowing the facts about it3:42 PM
D
this isn't one group's fault or problem to fix. gay, straight, cisgender, transgender, bisexual, pansexual, whatever the mix, the community is all of us, and everyone has a part in protecting the community.3:43 PM
Read 3:46 PM
Sources: CDC – About STIs and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Marcus saw a comment online blaming bisexual men for rising HIV and STI numbers and couldn't let it go. his cousin Kai sent him Dee's number after the same argument nearly ruined a cookout.
M
Why shouldn't I blame bisexual men for HIV and STI rates going up?5:21 PM
D
Because the numbers track actual behavior, not identity. A bisexual man who tests regularly, knows his partners' status, and uses protection carries far less risk than a straight guy who has never been tested in his life.5:24 PM
M
But doesn't having partners of more than one gender just mean more risk?5:26 PM
D
Having multiple partners can increase exposure, sure, but that is true no matter who someone is attracted to. What actually moves the needle is testing frequency, barrier use, and honesty with partners, not the gender of who is on the list.5:28 PM
D
In fact, plenty of straight-identified men who have never been tested carry far more undetected risk than a bisexual man who gets screened every few months.5:30 PM
M
Okay, so who is actually driving the numbers then?5:34 PM
D
Mostly gaps in testing, lack of healthcare access, and lack of treatment. Blaming one specific group lets the real issue, which is people not knowing their status, go completely unaddressed.5:38 PM
D
If you want to see how media narratives push that exact "down-low" myth instead of addressing real healthcare gaps, check out 7 HIV/AIDS Myths We Need to Stop Believing. if you want to dig into it even more.5:42 PM
M
Okay, that actually makes sense. I had it backwards.5:43 PM
D
You are not the first, that is exactly the myth this stuff runs on. But once you look at the evidence, blaming does not solve anything. It just shifts responsibility onto someone else instead of addressing the reality that testing and care matter for all of us.5:47 PM
M
Honestly I just hear it all the time, from everybody, so I figured it had to be true.5:50 PM
D
You know how people say there's not enough funding for straight Black men and Black women? I've always wondered if the people pushing that narrative realize it could actually cost funding for our own communities, since the story only makes room for one group to be "at risk."5:51 PM
D
For years, since 1981, they've known HIV affected straight Black people, and we had to fight just to get women recognized as having AIDS at all, since the original case definition was built around gay men and left women's symptoms out of the picture entirely. community-led work has been pushing back on that ever since.5:53 PM
D
Let's stop blaming bi and gay men and start listening to people actually living with HIV about what can help end this virus.5:54 PM
Read 5:57 PM
Sources: CDC – HIV Basics, Diverse Elders / Defender Network – 7 HIV/AIDS Myths We Need to Stop Believing, and TheBodyPro – Health Equity Resources.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Terrence has been living with HIV for six years, diagnosed through heterosexual sex, no other risk factors. Malik mentioned Dee's number after their own conversation about the "down low" myth, and Terrence has had this message half-typed for weeks before finally sending it.
T
ok this is gonna sound weird but I've had this typed and deleted like five times.11:28 AM
T
Malik said you listen instead of assuming stuff, so here goes: I'm a straight Black man and I've been positive for six years, and it's still the loneliest part of my life11:31 AM
D
I'm glad you actually sent it this time. what's the loneliest part specifically, the diagnosis itself, or what came after11:33 AM
T
what came after... the second people find out, I can see them doing the math, trying to figure out the "real" story. nobody just believes "unprotected sex with a woman" is the whole answer11:34 AM
D
Once the "down low" narrative took over people started treating straight Black men with HIV as a contradiction instead of just a fact that's true about them.11:38 AM
D
heterosexual contact accounts for a real share of new HIV diagnoses in men, around 6 percent nationally in recent CDC data. small as a percentage, but that's still thousands of men every single year. the conversation just hasn't caught up to include them.11:59 AM
T
ok that actually helps. knowing it's a gap and not just me being isolated for no reason12:03 PM
D
some of the men who've felt this most have ended up being the ones who talk about it publicly now, specifically so the next guy doesn't feel like the only one in the room.12:07 PM
T
that's actually the direction I've been quietly thinking about. d I'm tired of quiet12:11 PM
Video thumbnail►watchA Black, Cis, Hetero Man with HIV? More Likely Than You Think.
D
being the person you needed six years ago, even for just one other guy who's sitting where you were, it's worth trying for.12:12 PM
D
but that's not a bar you have to clear for any of this to count. if it turns out you're not the person who ends up speaking on panels or running a group, that doesn't make the six years of loneliness less real,12:14 PM
T
what if I try and it turns out I'm just not built for being anybody's example12:17 PM
D
your feelings don't come with a performance requirement attached.12:18 PM
T
ok. I think I actually just needed someone to say the loneliness part was real before I could think about doing anything with it, either direction12:22 PM
D
let me know how it turns out, even if you decide not to do it12:23 PM
T
part of why the room felt so empty is nobody who's negative ever seemed to think HIV/AIDS was theirs to think about too. Then I remember that's kind of how I was before I was diagnosed.12:26 PM
D
that's the piece that's missing everywhere, not just for you. it's negative and positive people together, we can all play a role in prevention.12:27 PM
Read 12:29 PM
Sources: POZ – "Changing the HIV Narrative", TheBody.com, and HIV.gov / CDC statistics.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Camille's uncle brings up the same name every single time HIV comes up, and she's tired of not having a real answer for it. her coworker Zora is the one who told her Dee actually knows this stuff.
C
every time HIV come up around my uncle he say the same thing: "Magic Johnson beat it, they got a cure now, it ain't that serious no more." I never know what to say back5:09 PM
D
the frustrating part is Magic Johnson himself has spent over 30 years directly correcting it. he's said "I am not cured" in interviews going back to at least 2011, on the 20th anniversary of his diagnosis.5:12 PM
C
wait so what actually going on with him then5:16 PM
D
he's managed his HIV with daily antiretroviral therapy since 1991, the same category of medication anyone diagnosed with HIV can be prescribed. decades of consistently taking it is why his viral load stays undetectable.5:18 PM
C
so it ain't that he had special access nobody else got5:20 PM
D
the medication itself isn't exclusive to him at all. what took real privilege was being diagnosed early, in 1991, and having uninterrupted access and support to stay on treatment for over three decades straight without a single lapse. that consistency is genuinely harder for a lot of people to sustain without stable insurance or income.5:21 PM
but is there an actual cure
C
ok but I definitely seen headlines about people being "cured" of HIV, so that part ain't made up, right?5:28 PM
D
it's real, but it's much narrower than it sounds. as of the most recent count in early 2026, somewhere around 12 or 13 people worldwide have been functionally cured according to the iAS, ever, through a stem cell transplant.5:31 PM
C
ok that's still something though, why can't more people just get that done5:34 PM
D
because every single one of those people had a separate, life-threatening blood cancer, usually leukemia, that already required a bone marrow transplant just to survive the cancer. doctors used a donor with a rare genetic mutation that happens to also block HIV, so the HIV cure was essentially a side effect of surviving a brutal cancer treatment.5:36 PM
What the "cure" actually requires
what it isa last-resort cancer treatment, intense chemotherapy or radiation followed by a stem cell transplant from a donor with a specific rare mutation, that has occasionally cleared HIV as a bonus.
what it isn'ta treatment offered to someone who just has HIV. it carries serious risks, including a potentially fatal complication called graft-versus-host disease, and it isn't a real option without an unrelated fatal cancer diagnosis to justify the risk.
C
ok so basically don't nobody get to just go request this even if they wanted to5:39 PM
D
correct, it isn't a menu option, and having money or resources like Magic Johnson's doesn't change that. what actually is available to nearly anyone is daily antiretroviral therapy for treatment and PrEP for prevention, both of which are real, accessible, and increasingly reachable through places like Ryan White clinics and community health centers, regardless of income.5:40 PM
C
honestly that's not even the part that gets to me most. my little brother already be repeating it too, "I could just get on meds if anything happens," like it's nothing to even think about5:43 PM
D
the "no big deal" version skips right past everything that actually protects him first, testing, PrEP, using protection, and replaces all of it with "there's a pill for later," like his health isn't a priority but an afterthought5:45 PM
C
and my little sister isn't even sexually active yet, but she's sitting right there hearing all of it too5:49 PM
D
you're probably worried whatever she hears repeated enough before any of this is relevant to her is what she'll fall back on once it is. better she grows up with the real version than the myth.5:53 PM
C
ok. next time he bring up Magic Johnson I actually know what to say now, and I'm not letting my brother keep saying that around my sister either5:57 PM
D
not a lecture, just the actual facts, said plainly, for him and for them too.5:58 PM
Read 5:59 PM
Sources: PBS Frontline, aidsmap / CROI 2025, and POZ.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Jamal's grandmother forwarded him a video about a "healer" who supposedly cured Magic Johnson, and pulling on that thread leads somewhere a lot closer to home than he expected.
J
my grandma just sent me a video about some healer named Dr. Sebi who supposedly cured Magic Johnson with sea moss and some mineral called shilajit. is any of that real9:39 AM
D
no, and it's worth naming clearly. a version of that video went viral in December 2023. fact-checkers found zero credible evidence the two men ever even knew each other, and Johnson's health is on the record as being managed through daily antiretroviral therapy, full stop.9:43 AM
J
why would anyone make that up9:46 AM
D
these "natural cure" claims tend to specifically target people looking for hope, and Black communities have been a frequent target for them. the real danger isn't just that they're false, it's that believing one can talk someone into stopping medication that's actually keeping them healthy.9:48 AM
J
has something like this actually caused real harm before, not just an online rumor9:52 AM
D
yes, and some of that harm happened right here, not just overseas. this isn't only a story about one video and one healer, it's the newest version of a much older pattern: the Black community getting fed the wrong story about this disease from the very beginning.9:55 AM
J
what do you mean from the beginning9:59 AM
D
When AIDS first emerged in 1981, media framed it as a "white gay disease." The doctor who wrote the first CDC report later admitted omitting race was a mistake while his first 5 cases were white gay men, his very next patients included Black and Haitian men. Because race wasn't tracked early on, Black and Haitian communities were dangerously overlooked from the start.10:02 AM
J
so it wasn't actually just hitting one group, even at the very start10:03 AM
D
not even close, and that early mislabeling did real damage.10:06 AM
D
Black communities were told, implicitly and explicitly, that this was someone else's disease: a "gay" problem and eventually a "Haitian" problem, happening somewhere else, to other people. that made a lot of people slower to see themselves as part of the picture at all, slower to get tested, and slower to demand treatment, while the real numbers kept climbing the whole time.10:07 AM
J
so we were dying too, just not being talked about10:10 AM
D
the data caught up eventually. by 1986 the CDC was already documenting that Black and Hispanic Americans were being diagnosed with AIDS at several times the rate you'd expect from population size alone. by 1996, more new cases were occurring among Black Americans than any other racial or ethnic group. the story on the ground had never matched the headlines.10:13 AM
J
damn. that's a lot bigger than just one fake healer video10:17 AM
D
it is, and that's why the Sebi video isn't a one-off, it's just the latest shape of the same old problem: bad information convincing people in this community not to trust or use the treatment that actually works.10:18 AM
J
ok. I'm sending grandma something better than that video then10:20 AM
D
not a lecture, just the actual facts, said plainly, enough times that they start to stick.10:21 AM
Read 10:24 AM
Sources: PBS Frontline, "30 Years of AIDS in Black America", Harvard T.H. Chan School of Public Health, CDC MMWR, "AIDS among Blacks and Hispanics", and POZ.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Grace is 12 weeks pregnant with her second kid, married eleven years, and got a little defensive when her OB ordered a routine HIV test.
G
so my OB just ran an HIV test as part of my regular prenatal panel and I got weirdly defensive about it.2:23 PM
G
I've been married for eleven years, why would that even be a question2:24 PM
D
that reaction is really common, and it's also exactly the assumption that ends up hurting people.2:28 PM
D
HIV and STIs don't check anyone's relationship status. marriage doesn't create immunity, it just changes who someone might be exposed through, and only if nothing was ever missed before or during it.2:32 PM
G
ok but realistically, what are the odds for someone like me2:33 PM
D
married women, and women over 40, are actually one of the groups most likely to get diagnosed late, partly because providers and patients both assume they don't need to check and skip the conversation entirely.2:36 PM
G
wait, so being married can actually work against catching something early?2:40 PM
D
in a way, yeah. assumed safety leads to less testing, not more actual safety. that's not a knock on your marriage, it's just what happens when risk gets tied to identity instead of actual exposure history.2:43 PM
G
ok, so why is the prenatal test specifically non-negotiable then, more than some other routine tests2:44 PM
D
because if someone is HIV positive and pregnant, treatment during pregnancy lowers the chance of passing it to the baby to under 1 percent. left untreated, that risk is closer to 1 in 4. that's the entire reason it's standard on every prenatal panel now, regardless of how low-risk anyone assumes the situation is.2:47 PM
What marriage actually changes
still true after marriagetesting, prenatal screening, and honest conversations with a partner all still matter exactly as much as before.
the risky assumptiontreating marriage or parenthood as proof of safety, which is exactly the gap that leads to later diagnoses.
G
ok that actually reframes it a lot. it's not an accusation, it's just... good medicine2:48 PM
D
it's not only the HIV test. pap smears, STI screening, contraception counseling, postpartum checkups, none of that stops mattering once someone's married or becomes a mom. if anything it matters just as much, since pregnancy and birth open their own windows for things to get missed.2:49 PM
G
no one really talks about that part, reproductive health after you're already a mother2:52 PM
D
it gets treated like pregnancy is the finish line, when it's really just a different chapter. a lot of what came up when , and later , applies here too honestly. the same habits that make testing and disclosure easy to skip early on make them just as easy to skip once things settle into "married with kids."2:54 PM
G
i want to bring this up with my husband. we've genuinely never talked about getting tested together, we just got married, had kids, and never circled back2:56 PM
D
it doesn't have to be a big dramatic conversation, more like updating an old assumption.2:59 PM
D
Kellen's has some ideas for this.3:03 PM
G
ok. I think I've just been treating "married" like a finish line this whole time3:06 PM
D
it's not a finish line, it's just one more chapter where the same basic care still applies. and taking care of your own body doesn't stop being an act of self-respect because you've got a ring and a title now.3:08 PM
G
ok. I'm bringing this up with him this weekend, no big buildup, just "let's make this a normal thing we do"3:11 PM
D
that's exactly the right amount of deal to make out of it. none.3:15 PM
G
are there actual organizations already doing this work, not just individual doctors3:16 PM
D
yeah, a few worth saving, all focused specifically on Black maternal and reproductive health.3:20 PM
D
Black Mamas Matter Alliance is widely regarded as the gold standard for Black maternal health advocacy and research, centering Black mothers' voices in research, policy, and advocacy for systemic change at every level of government and healthcare.3:22 PM
D
Black Women's Health Imperative is the first national nonprofit dedicated solely to the health of Black women and girls, producing research, running programs, and fighting for policy that directly serves Black women's wellbeing for over 40 years.3:23 PM
D
National Birth Equity Collaborative builds data-driven solutions to reduce disparities in Black maternal and infant health, training providers, developing community programs, and holding health systems accountable.3:24 PM
D
SisterLove, Inc. addresses sexual health, HIV, and reproductive justice with a specific focus on communities in the South, where access to care is often most severely restricted.3:28 PM
D
The Afiya Center is the only reproductive justice organization in North Texas founded and directed by Black women, rooting direct services and community organizing in the specific needs of Black Texans.3:32 PM
G
ok, saving all of these3:34 PM
D
good, keep them close, not just for you.3:37 PM
Read 3:39 PM
Sources: CDC – About STIs and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Zora's been reading about medical history for a class project and texts Dee mid-research.
Z
ok so I'm learning that modern gynecology was basically built on experiments done on enslaved women and I need to talk about this with someone9:42 AM
D
yeah, it's foundational. in the 1840s, a physician named9:44 AM
D
J. Marion Sims performed dozens of experimental surgeries on enslaved women in Alabama, without anesthesia, to develop a fistula repair technique.9:48 AM
Z
without anesthesia? even though it existed?9:52 AM
D
even though it existed. he operated on the same few women repeatedly, one of them, Anarcha, over 30 times. their names were Anarcha, Betsey, and Lucy. he went on to be called "the father of modern gynecology." they were left out of that story for over a century.9:55 AM
Z
ok that's just the 1840s though, right? like it got better after that9:58 AM
D
in 1961, civil rights leader Fannie Lou Hamer went into a Mississippi hospital for a tumor removal and came out sterilized without her consent, a practice so common it was grimly nicknamed the "Mississippi appendectomy." she later said about six in ten Black women who used her local hospital left the same way.10:01 AM
Z
that's insane. did anything change because of it10:04 AM
D
it helped her become a national civil rights figure, but the practice itself kept going for another decade. in 1973, two Black sisters in Alabama, Minnie Lee, 12, and Mary Alice Relf, 14, were sterilized after a federally funded clinic tricked their mother, who couldn't read, into signing a consent form she thought was for birth control shots.10:07 AM
D
that case, Relf v. Weinberger, went to federal court, and it's a direct reason informed consent for sterilization is a legal requirement today, not a courtesy.10:11 AM
Z
ok so where does the "fighting for reproductive rights" part come in, past just surviving all this10:13 AM
D
in 1994, a group of Black women at a reproductive rights conference in Chicago felt like the mainstream movement, focused mostly on legal access to abortion, didn't speak to what they'd actually lived through. they wanted the right to have children safely counted just as much as the right not to.10:16 AM
D
so they coined a new term for it: reproductive justice. three years later that grew into SisterSong, still one of the largest reproductive justice organizations in the country.10:20 AM
Z
ok wait that actually reframes a lot of what we already talked about, the whole informed consent and review board thing10:24 AM
D
a lot of the protections that make it reasonable to trust modern care exist specifically because these women had to fight for them, at real cost. it's not separate history.10:25 AM
Z
it's a lot to sit with, honestly, all of it happening to women who didn't get a say10:27 AM
D
it is, and that's exactly why prevention and testing today matter as more than just medical steps. for Black women especially, choosing to get tested, choosing protection, choosing when and how to be honest with a doctor, generations before didn't get to have that kind of control.10:29 AM
Read 10:30 AM
Sources: CDC – About STIs and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Elijah's working on a project for Black history month and wants more names than the one everybody already knows. his classmate Nia is the one who told him to just text Dee instead of falling down a search engine hole.
E
doing a project on Black history and sexual health and I keep landing on the same one name for HIV, Magic Johnson. who else built this response, like on the ground?1:44 PM
D
a lot of people, and most of them never got his kind of spotlight.1:46 PM
D
the people building this response were fighting on two fronts: government neglect from the outside, and respectability politics from within our own communities.1:50 PM
D
grassroots organizers, trans pioneers, health workers, and everyday people built the actual infrastructure while pushing past stigma around sexuality, gender identity, drug use, and reproductive health.1:53 PM
organization builders & grassroots pioneers
E
start with the people who built the core organizations2:08 PM
D
Pernessa Seele is a good place to start. she's an immunologist who was floored by how silent Black churches stayed on AIDS.2:10 PM
D
so in 1989 she founded The Balm in Gilead, organizing congregations directly to force Black churches past respectability politics and into AIDS outreach.2:12 PM
D
Dázon Dixon Diallo founded SisterLove in Georgia, the first organization there focused on women living with or affected by HIV.2:14 PM
D
it grew into the first HIV and reproductive-justice organization for women in the entire South.2:15 PM
Video thumbnail►watchThe History of Black HIV in the South
D
Debra Fraser-Howze founded the National Black Leadership Commission on AIDS in 1987.2:17 PM
D
she also co-authored the Minority AIDS Initiative, which sent billions of federal dollars toward underserved communities.2:20 PM
D
and Dr. Rashidah Hassan, a Black Muslim nurse, founded BEBASHI, short for Blacks Educating Blacks about Sexual Health Issues, in Philadelphia.2:21 PM
D
on the faith side, Archbishop Carl Bean founded the Minority AIDS Project in Los Angeles, one of the earliest HIV/AIDS organizations run by and for people of color.2:24 PM
D
Bishop Rainey Cheeks did similar grassroots organizing out of Washington, D.C.2:26 PM
D
Keith Cyler co-founded Housing Works in New York City, pioneering harm reduction, housing, and healthcare advocacy for homeless people living with HIV.2:29 PM
D
Tori Cooper founded Advocates for Better Care in Atlanta and became the first Black trans woman appointed to the Presidential Advisory Council on HIV/AIDS.2:32 PM
D
Dee Dee Chamblee founded La Gender Inc. in Atlanta, providing housing, support, and HIV prevention specifically for Black trans women.2:34 PM
public advocacy & lived experience
E
what about people who were actually living with it publicly, not just running organizations2:42 PM
D
that's its own kind of pioneering, and it wasn't only about visibility, some of it was direct, hands-on care.2:46 PM
D
Miss Major Griffin-Gracy provided direct care, housing, and mutual aid for Black trans women living with HIV at the height of the epidemic.2:50 PM
D
Marsha P. Johnson joined ACT UP and organized care for homeless trans youth and sex workers living with HIV in New York City.2:52 PM
D
Hydeia Broadbent was born with HIV and started speaking publicly about it at age six, becoming one of the most recognized faces of pediatric HIV awareness until she died in 2024.2:56 PM
D
Rae Lewis-Thornton was one of the first Black women to speak openly and nationally about living with HIV, most famously in a widely read 1994 Essence cover story.2:59 PM
D
Marvelyn Brown, diagnosed at 19, became an international, youth-focused HIV author and speaker.3:02 PM
D
Sheryl Lee Ralph started the DIVA Foundation decades ago to raise awareness and fund resources through the arts.3:03 PM
D
Larry Bryant was diagnosed in 1986 at 19, a straight Black man from D.C. at a time when almost no one talked about straight men getting HIV at all.3:07 PM
D
he kept it secret for five years, then spent decades afterward as a national field organizer for Housing Works, one of the few public voices insisting that straight Black men belonged in this conversation too. there's a whole about what that same isolation still feels like today.3:10 PM
policy, everyday people & movement leaders
E
who pushed the broader policy and movement spaces9:13 PM
D
Phill Wilson was diagnosed in the early 1980s and founded the Black AIDS Institute in 1999.9:15 PM
D
he concluded AIDS outreach was aimed mostly at white gay communities while the disease was hitting Black communities even harder.9:17 PM
D
alongside Reggie Williams, he pushed the CDC to fund HIV prevention specifically for Black gay men, which led to the National Task Force on AIDS Prevention.9:18 PM
D
everyday people mattered here too. Craig G. Harris and Joseph Beam were both writers who pushed back on exclusion from inside the broader AIDS and gay rights movements.9:21 PM
D
Beam edited In the Life, the first anthology of writing by gay Black men, before dying of an HIV related illness in 1988.9:23 PM
D
Cornelius Baker spent decades afterward as a policy advocate, leading both Whitman-Walker Health and the National Association of People with AIDS.9:27 PM
D
and Dr. Beny Primm, one of the most respected Black voices in addiction medicine at the time, eventually shifted Black leadership toward supporting needle exchange as immediate triage. that shift is its own story.9:31 PM
the pushback wasn't only from outside
E
was all this pushing against, like, the CDC and the government not caring? or was it more complicated than that9:46 PM
D
more complicated, and this is the part people leave out.9:49 PM
D
Black communities were absolutely failed by a government that mostly ignored the epidemic until it was unavoidable.9:50 PM
D
but a lot of pioneers were also fighting judgment from inside their own communities, especially early on, over homosexuality, gender identity, and drug use.9:52 PM
D
the people first and hardest hit were groups plenty of respected Black institutions weren't ready to publicly stand behind.9:53 PM
E
what did that actually look like9:57 PM
D
one clear example: Harlem's 1986 needle exchange pilot, one of the most effective HIV prevention tools that existed.10:01 PM
D
it got blocked for roughly six years by opposition from Black leadership and clergy citing Tuskegee-era fears or straight up moral judgment.10:05 PM
D
even after Harlem came around, it still took decades for syringe service programs to be legally funded nationwide.10:06 PM
E
so how did any of that change10:07 PM
D
through direct, lived-experience advocacy. Dr. Beny Primm opposed needle exchange too.10:11 PM
D
until Phill Wilson, a Black gay man living with HIV himself, pushed back with a simple framing: the job right now is triage, keep people alive first, argue about the rest later.10:15 PM
D
Primm came around, and because of who he was, his shift helped move a lot of other Black leaders with him.10:19 PM
D
they also organized church congregations directly, the way Pernessa Seele did with pastors preaching AIDS as punishment.10:21 PM
D
once enough families in the pews were personally affected and tired of being judged, they'd pressure their own pastors to stop preaching condemnation. that's basically what happened, church by church.10:22 PM
E
does any of that respectability politics stuff still affect things now10:24 PM
D
yeah, quieter but still there.10:26 PM
D
who gets sympathy versus who gets blamed for their own diagnosis still shapes how openly people talk about status in their own families and churches.10:28 PM
D
it's a big reason outreach run by people who've actually lived with HIV, not just people delivering a script about it, tends to land better: they're not carrying that same judgment into the room.10:29 PM
E
and the famous names, Arthur Ashe, Alvin Ailey, people like that10:33 PM
D
Arthur Ashe disclosed his HIV status in 1992, after contracting it through a blood transfusion, and used the time he had left to raise awareness before he died in 1993.10:34 PM
D
Alvin Ailey, the choreographer, died from AIDS in 1989, and his death, along with later disclosures about it, helped make the epidemic's toll on the Black arts community visible.10:35 PM
E
so where does Magic Johnson fit into all this10:36 PM
D
Magic Johnson brought massive global visibility when he disclosed in 1991. but the point of all this is: one famous name held the spotlight, while an entire network built the actual ground response. there's a whole about what his story actually means and doesn't mean.10:38 PM
E
this is way more than I had. thank you10:40 PM
D
that's most of it right there: a whole layer of people who built the response Black communities actually had, while one name kept the spotlight. both things are true, and both are worth knowing.10:41 PM
Read 10:44 PM
Sources: Wikipedia, PBS Frontline, Milken Institute, Nursing Clio, LGBTQ Nation, WNYC Studios – Blindspot, amfAR, The AIDS Memorial, and GLAAD, and POZ.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Nia's noticed the same link at the bottom of basically every chat on here, and she's got history with the name.
N
ok I have to ask. every single chat on here ends with a link to Planned Parenthood.2:13 PM
N
I know their history, and I know what people say about them. why is this the one place you keep pointing people?2:17 PM
D
I know the history too, so let's actually go through it2:18 PM
N
start with Margaret Sanger then, since that's usually where this goes2:19 PM
D
Sanger associated with the eugenics movement, which was mainstream and respectable in progressive circles in the early 1900s, and that's a real and fair criticism of her. but the specific claim people usually mean by "Black genocide" is bigger than that: that Planned Parenthood was built, and still operates, to reduce the Black population on purpose.2:20 PM
D
that part doesn't hold up against the actual record. the "Negro Project" Sanger launched in 1939 to bring clinics into the segregated South was developed with, publicized by, and endorsed by Black leaders of the time, including W.E.B.2:23 PM
D
Du Bois, Mary McLeod Bethune, and Rev.2:25 PM
D
Adam Clayton Powell Jr., along with Black churches and Black newspapers. it existed because segregation had locked Black communities out of birth control access that white communities already had.2:29 PM
N
so Black leaders were actually involved in building it, not just having it done to them2:32 PM
D
exactly, and that matters, because the "genocide" framing tends to erase that Black women and Black leaders were active participants demanding this access, not passive targets of someone else's plan. that erasure shows up a lot in this history, actually. it's a big part of what too.2:34 PM
N
ok what about the newer version of this, the stat that like 79% of clinics are in Black or Hispanic neighborhoods2:35 PM
D
that specific number comes from an advocacy group called Protecting Black Life. When asked about methodology and numbers Protecting Black Life didn't respond.2:36 PM
D
What I do know is the same people who claim to be pro-life vote for policies and politicians that cut access to healthcare, social programs, funding for public schools, and want to overlook the Black maternal death rate. Despite years of evidence presented by Black people in the fields they claim to care about.2:39 PM
N
ok so then why do Black communities have higher rates of unintended pregnancy and abortion, if it's not that2:43 PM
D
the better-supported explanation is access, not intent: disparities in affordable contraception, comprehensive sex ed, and poverty all drive up unintended pregnancy rates first, and abortion rates follow from that. all of this is a downstream effect of unequal healthcare access, which is a real and serious problem, just not the one "genocide" is describing. that doesn't even touch the stigma many of us have around sex or abortion.2:46 PM
so, practically
N
ok so given all that messy history, why this specific place, out of everything2:57 PM
D
honestly, pragmatism.3:01 PM
D
Black women have always fought to control their own reproductive and sexual health, on their own terms. that fight was never about any one organization, it was about access itself.3:03 PM
D
Planned Parenthood is the one service found to reliably serve everyone nationally: all genders, and people whether or not they have insurance, on a sliding scale. cost is one of the biggest reasons people put off testing and care in the first place, and this was the option that didn't let cost be the reason someone skipped it.3:05 PM
D
But I included the linkudmv.org and BlackHealth.org for those who prefer not to use Planned Parenthood.3:06 PM
N
so it's not an endorsement of everything about their history, it's just what's actually reachable3:10 PM
D
being skeptical of institutions that have earned skepticism is reasonable, we went through a lot of that in too. skepticism and getting actual care aren't supposed to be opposites.3:13 PM
N
ok. I appreciate that you didn't just brush past the question3:14 PM
D
it deserved better than a brush-off. ask again anytime, about this or anything else here.3:15 PM
Read 3:16 PM
Sources: CDC – About STIs and Black Health.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you. More options are in the .
Sabrina found out she's HIV positive at her very first prenatal visit, and she's terrified she's already hurt her baby without even knowing it. her friend Grace, who's had her own share of scares navigating pregnancy, is the one who told her to text Dee before she goes back to her OB.
S
I don't even know how to say this.5:54 PM
S
I'm 9 weeks pregnant and I just found out I'm HIV positive at my first prenatal appointment. I don't know what they expected me to say.5:55 PM
D
finding out this way is a lot, and being scared right now doesn't mean anything's already gone wrong.5:58 PM
S
how do I even know if the baby has it. I'm so scared I already hurt the baby without knowing6:00 PM
D
the baby's status isn't decided at conception, it's mostly decided by what happens between now and delivery, and that part is very much still in your hands.6:04 PM
S
my doctor mentioned starting medication right away, is that actually safe for the baby6:07 PM
D
starting it as early as possible is exactly the right move. current antiretroviral medications are considered safe throughout pregnancy, and starting now gives your viral load the most time to come down before delivery, which is a big factor in whether the virus passes to the baby.6:09 PM
Treated during pregnancy vs. untreated
on treatment, viral load suppressedthe chance of passing HIV to the baby drops to under 1 percent.
untreatedthat risk climbs to roughly 1 in 4. this is the entire reason starting treatment early gets treated as urgent, not optional.
S
ok that number actually helps. what happens between now and the birth then6:13 PM
D
mostly consistency: taking the medication daily, and regular viral load checks throughout the pregnancy to track how well it's working. the goal is to get you to an undetectable viral load well before your due date.6:14 PM
S
what if it's not undetectable by the time I actually go into labor6:17 PM
D
that's exactly what the delivery plan is for. if your viral load is undetectable close to delivery, a vaginal birth is generally considered just as safe as it would be for anyone else. if it's still detectable, your doctor might recommend a scheduled C-section instead, and sometimes IV medication during labor, both of which meaningfully cut the risk of transmission during birth itself.6:21 PM
S
so there's already a plan either way, it's not just hoping for the best6:24 PM
D
exactly, there's a specific plan for both scenarios, and your doctor will know which one you're heading toward well ahead of your due date, not the day you show up in labor.6:28 PM
S
what happens with the baby right after birth6:30 PM
D
the baby gets a course of preventive HIV medication for a few weeks after birth, and gets tested more than once over the following months, since a baby's own HIV test can't be fully relied on until some of the mother's antibodies clear their system. most babies born to mothers on effective treatment test negative throughout.6:31 PM
S
can I breastfeed, or is that automatically off the table now6:34 PM
D
this one's genuinely more nuanced. In the U.S., where clean water and formula are reliably accessible, the CDC has historically recommended formula feeding, since it removes any transmission risk through breast milk entirely. that said, newer research on sustained undetectable viral loads has shifted some of that guidance toward shared decision-making with your care team. it's a real conversation to have with your doctor directly,6:35 PM
S
honestly the medical stuff is starting to make sense, I think what's actually keeping me up is just the fear6:37 PM
D
that's completely fair, and it deserves its own space, separate from the logistics. this diagnosis landing in the middle of a pregnancy is a lot to carry at once, and you don't have to carry the emotional part of it alone either.6:41 PM
worth asking your OB directly
"Can you connect me with a perinatal HIV specialist, and is there a counselor or support group for pregnant women living with HIV?"
D
most major hospitals have a maternal-fetal medicine or perinatal HIV specialist who works alongside your regular OB for exactly this. and the National Perinatal HIV Hotline (1-888-448-8765) has clinicians on call around the clock specifically for pregnancy and HIV questions like this, free, and it's there for partners and family too if they want to understand what's happening.6:43 PM
S
ok. I think I needed to hear that this isn't already decided, that there's actually still a lot I can do here6:46 PM
D
there is, and you're already doing it: you got tested, you told your doctor, and you're asking the real questions instead of guessing alone. that's exactly what gives this baby the best odds.6:48 PM
Video thumbnail►watchSurviving Voices: HIV Lifetime & Long-Term Survivors
S
ok. I'm calling that hotline tonight, and I'm bringing a real list of questions to my next appointment instead of just nodding along scared6:50 PM
D
good. one appointment, one question at a time, and you don't have to hold any of this by yourself. remember Black women fought for a lot of these treatments.6:54 PM
S
is there anybody actually organized around this, specifically for Black moms, not just general pregnancy stuff6:56 PM
D
yes, a few worth having saved.6:59 PM
D
Black Mamas Matter Alliance is widely regarded as the gold standard for Black maternal health advocacy and research, centering Black mothers' voices in research, policy, and advocacy for systemic change at every level of government and healthcare.7:02 PM
D
Black Women's Health Imperative is the first national nonprofit dedicated solely to the health of Black women and girls, producing research, running programs, and fighting for policy that directly serves Black women's wellbeing for over 40 years.7:03 PM
D
National Birth Equity Collaborative builds data-driven solutions to reduce disparities in Black maternal and infant health, training providers, developing community programs, and holding health systems accountable.7:07 PM
D
SisterLove, Inc. addresses sexual health, HIV, and reproductive justice with a specific focus on communities in the South, where access to care is often most severely restricted, which matters a lot given everything you're already carrying.7:09 PM
D
The Afiya Center is the only reproductive justice organization in North Texas founded and directed by Black women, rooting direct services and community organizing in the specific needs of Black Texans.7:11 PM
Video thumbnail►watchLiving with HIV during pregnancy
S
ok, adding these to my list too7:15 PM
D
good, you shouldn't have to figure this out from scratch by yourself.7:19 PM
S
I keep thinking this baby's the one who has to deal with what I did wrong7:21 PM
D
your baby isn't inheriting a mistake. with treatment, transmission risk to the baby drops below 1%. and however this goes, ending stigma and ending this virus was never supposed to fall only on people who are positive, it's negative and positive people showing up for each other, together.7:24 PM
Read 7:26 PM
Sources: CDC – About HIV, HIV.gov – U.S. Statistics, and Black Health – HIV Care.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Owen's cousin Marcus told the family he's HIV positive last week, and Owen's been keeping his distance ever since without really examining why. Sam, who Owen vented to at a cookout, is the one who pushed Dee's number into his hand.
new · checking in
O
ok I called Marcus. read him basically what you helped me put together. he got quiet for a second, then said he figured something was off but appreciated me actually saying it instead of just letting it sit9:47 AM
D
naming it gives the other person somewhere to respond instead of just absorbing the distance silently and wondering.9:51 AM
O
talked to my mom too. she didn't say much at first, then admitted she didn't actually know how it spreads either, she was just scared and didn't want to ask. we're having Marcus over Sunday, same cups as everybody else9:52 AM
D
it's dope that you went from quietly managing the fear to actually asking the question of if you were being harmful to Marcus.9:54 AM
a few days earlier, before any of that
O
my cousin told the whole family he's HIV positive last week and I'm not gonna lie, I've been keeping my distance. used a different cup at my mom's house when he was over. felt bad about it but also didn't really want to sit with that feeling11:56 AM
D
appreciate you saying that plainly instead of dressing it up. why did you feel the need for a different cup, if you had to name it?12:00 PM
O
honestly? I don't fully know. some part of me just thinks it's contagious like that, sharing drinks, touching stuff he touched, being in a small room with him too long12:01 PM
D
good news! none of that spreads HIV. it doesn't survive well outside the body, and it isn't in saliva or sweat in any meaningful amount. sharing a cup, a doorknob, a bathroom, a hug, none of it transmits. the only real routes are specific bodily fluids in specific ways: blood, semen, vaginal fluid, breast milk, and it has to actually get into someone's bloodstream, not just touch their skin.12:02 PM
O
ok that's actually good to hear, but not gonna lie I also just kind of assumed it was, like, a certain kind of person's disease, and Marcus doesn't fit what I pictured, which honestly made it hit different12:04 PM
D
say more about what you pictured, since that assumption is doing a lot of the work here.12:08 PM
O
I don't know, like gay men, people using drugs, people sleeping around a lot. Marcus is married, got kids, goes to church every Sunday. it threw me12:12 PM
D
those stereotypes doing damage here.. it's wrong on the facts: Black Americans accounted for about 38% of new HIV diagnoses in 2023 while being roughly 12% of the population, and heterosexual contact is a transmission route in that number, not some rare exception.12:15 PM
D
married people, churchgoing people, people who look nothing like the picture in your head make up a real share of it. gay, straight, cisgender, transgender, bisexual, pansexual, this touches all of us.12:16 PM
D
and it's wrong on the ethics too, even for the people it does describe. nobody's HIV status is a verdict on their character, their choices, or who they sleep with. it's a virus, not a moral report card. have you ever noticed how for some people compassion is framed as failing to hold people accountable?12:17 PM
What you pictured vs. what the data says
the stereotypea narrow "certain kind of person," used, consciously or not, to decide who deserves distance and judgment.
the actual picturemarried people, parents, churchgoers, people of every orientation and background. HIV doesn't check any of that before it transmits, and treating it like it does just adds shame on top of a manageable medical condition.
O
ok so even if I get all that in my head, is he even, like, dangerous to be around day to day, married or not12:19 PM
D
if he's on treatment, and most people diagnosed today get started on it fast, there's a real chance he's already undetectable, meaning the virus is suppressed to levels standard tests can't even find. undetectable equals untransmittable, U=U for short.12:22 PM
D
it's been confirmed across large studies: someone with a sustained undetectable viral load cannot sexually transmit HIV to anyone12:24 PM
O
damn. so the different cup thing was doing actual nothing except being messed up12:26 PM
D
pretty much. stigma like that is exactly why people delay getting tested, delay telling their family, delay starting treatment, because they're bracing for precisely the reaction you just described.12:30 PM
D
Marcus told the whole family. that took something.12:31 PM
O
ok that hits different when you put it like that.12:34 PM
O
I think I need to actually say something to him, not just quietly act normal and hope he doesn't notice I was being weird12:38 PM
worth actually saying to Marcus
"hey, I want to own something. I was distant with you after you told the family, and it came from stuff I believed that wasn't true. I looked into it, I was wrong, and I'm sorry."
D
he almost certainly clocked the different cup. an apology that owns it does more than pretending it didn't happen.12:41 PM
O
last thing, my mom's been kind of doing the same distance thing, I want to say something to her too, but kind of feels like it's not my place.12:44 PM
D
you don't have to lecture her, just pass along the same facts that moved you: how it actually spreads, what undetectable means, and that Marcus telling y'all was an act of trust, not a warning label.12:48 PM
O
ok. calling Marcus tonight, and I'm bringing my mom into it too instead of letting her keep doing the same thing I was doing12:50 PM
D
good. noticing it in yourself and actually fixing it counts for a lot more than never having felt it in the first place.12:51 PM
O
it kind of felt like his diagnosis was his thing to manage alone and the rest of us just had to tolerate it12:53 PM
D
that's the shift, right there. ending stigma and ending this virus were never one person's job to carry, they're the same work, and it takes everybody, negative and positive alike, treating status as something ordinary instead of something to brace for.12:56 PM
D
you should check out this video about HIV and stigma, from Positive Voices.12:57 PM
Video thumbnail►watchHIV Stigma, Status & Behavior
Read 12:58 PM
Sources: CDC – About HIV, HIV.gov – U.S. Statistics, and CDC – U=U.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Yvonne, 65, just got her test results back after her doctor suggested a screening. She wasn't expecting this, and she wasn't expecting to be grieving and processing a diagnosis at the same time.
Y
I don't even know how to say this out loud to somebody. I'm 65 years old and I just found out I have two STIs. I didn't know it would be like this.10:02 AM
D
I'm really glad you reached out, Yvonne. this can happen to anybody, at any age, and getting this news doesn't say anything about who you are as a person.10:04 AM
Y
he was my brother's friend. after my brother passed, he was the one who kept checking on me, driving me to appointments, sitting with me. we got closer than I ever expected to. I thought I could trust him.10:08 AM
D
grief pulls people together in real ways.10:11 AM
Y
I didn't think he was sick. he looked healthy. he was in the gym all the time, ate better than I did.10:13 AM
D
that's one of the most common misunderstandings out there. most STIs don't show up on the outside at all. somebody can be in the gym every day, eating healthily, looking the picture of health, and still be carrying an infection they don't know about themselves.10:16 AM
Y
so he might not have even known either?10:17 AM
D
very possibly. a lot of these infections cause no symptoms at all, especially early on, so people can carry them for months or years without any sign something's wrong.10:19 AM
Y
part of me feels like I should've known better, at my age.10:39 AM
D
most people are working off outdated information no matter how old they are, and screenings for older adults are still not a routine part of most checkups, so a lot of this genuinely never gets said out loud to people your age. you did the right thing getting tested.10:42 AM
Y
I'm going to tell him. What if he doesn't know?10:44 AM
D
but letting a lover know is part of standard care, it protects him and anyone else. a lot of clinics can notify a partner for you without using your name, if you'd rather not have that conversation directly.10:47 AM
Y
this is going to sound strange, but I still miss my brother something awful. this whole thing is tangled up with missing him too.10:52 AM
D
that doesn't sound strange at all. check out this video called HIV After 50: The Hidden Crisis | Even Me: The Journey10:55 AM
Video thumbnail►watchHIV After 50: The Hidden Crisis | Even Me: The Journey
Y
thank you for not making me feel foolish about all this.10:58 AM
D
you're not foolish, you trusted someone your own family had trusted for years, that's a completely reasonable thing to have done. married and older women are actually some of the people most likely to get diagnosed late, partly because everyone, including women ourselves, assumes this stopped applying to us. there's a whole if you want it.11:02 AM
Y
I think I do want to read that one.11:04 AM
Read 11:05 AM
Sources: CDC – STDs and Planned Parenthood – STDs.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Harper keeps catching herself, and other people, saying things about STIs that land wrong, and wants Dee to quiz her so she can actually spot it in the moment instead of after.
H
this might sound weird but can you quiz me on something? I keep hearing stuff about STIs, from myself included honestly, and I genuinely can't always tell anymore what's just a comment and what's actually messed up6:02 PM
D
not weird at all, that's a great instinct to build. here's a list of things people actually say about STIs. check off any you've said yourself or heard someone else say, no judgment either way, then see where you land.6:04 PM
H
ready6:04 PM
Check any of these you've said yourself, or heard someone say around you.
You checked 0 of 8.
H
ok the "clean" one got me, I say that constantly and never once thought about what it implies about the alternative6:22 PM
D
that's exactly the kind of catch this is for. most stigma isn't a slur, it's small word choices repeated so often nobody questions them anymore.6:24 PM
H
honestly some of these feel harsh to call "stigma," like the "sleeping around" one, isn't that person just trying to warn someone or get them to be more careful?6:25 PM
D
I think that's true a lot of the time, honestly. most people saying this stuff aren't trying to be cruel, they genuinely want people to be safer, or they're trying to warn someone they care about.6:25 PM
D
but good intentions don't change what the words actually do. it still doesn't help, and it still makes people less likely to get tested, including the person saying it. if getting an STI sounds like a moral failure, admitting you might have one, even to yourself, gets a lot harder.6:26 PM
H
how do I actually catch myself doing it in the moment, not just after the fact like right now6:26 PM
D
one quick test: could you say the same sentence about a UTI or strep throat without it sounding harsh? if not, the harshness isn't coming from the biology, it's coming from the topic.6:28 PM
H
that's a genuinely useful gut check. I'm gonna catch myself with that one for a while6:29 PM
D
good. that's the whole point.6:31 PM
Read 6:32 PM
Sources: CDC – STI Stigma and Discrimination, UNAIDS – Words Matter: Language Guide, and American Sexual Health Association – STI Stigma.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Adarius works with formerly incarcerated men through a reentry program and keeps running into the same health questions, so he finally asks Dee directly.
new · picking back up
A
sorry for disappearing. Jerry, one of the incarcerated dudes I work with, told me he got it from needles. and I'm ashamed to say I didn't believe it, just figured he was too ashamed to admit it was from sex10:21 AM
D
What do you gain from thinking that, if needles are a way that HIV is spread?10:24 AM
D
testing matters, but the real shift is regular checkups and staying on meds. framing it around taking ownership is how we protect ourselves, our people, and our communities.10:29 AM
A
that framing hits way different. handling your business sounds like responsibility and ownership.10:31 AM
D
exactly. reconnecting someone to care fast after release and getting them to handle their business isn't a side detail. it's protecting actual lives.10:35 AM
A
wait, what does partner concurrency actually mean, break that down for me.10:38 AM
D
overlapping partners during the same stretch of time, instead of one relationship ending before the next starts.10:41 AM
A
how does that change how a virus spreads?10:46 AM
D
when people have one partner at a time, it's like a wall that slows a virus down. when partners overlap, that wall is gone. everyone is exposed at the same time, so a single line turns into a web, and a virus can spread a lot faster.10:47 AM
D
one thing though: having one partner doesn't automatically mean you're safe. if either of you already has an STI, it can still pass between you, and a lot of STIs have no symptoms. one partner only protects you if you've both been tested and you're both only with each other.10:50 AM
D
when mass incarceration takes a lot of men out of a community, overlapping relationships start to feel more normal. women also have less power to ask for one partner only, or to ask their partner to get tested.10:53 AM
A
I've definitely taken advantage of that situation myself.10:58 AM
a couple days earlier, before any of that
A
keep meaning to ask you this, does incarceration actually have something to do with HIV rates? I'm taking that training class next month, but I'm curious now.2:57 PM
D
yes, it's structural. people who are incarcerated have HIV at about 5 to 7 times the rate of people who aren't.2:59 PM
A
wait, why would being locked up itself do that?3:02 PM
D
a few things stack on top of each other. Black Americans are 13% of the population but 44% of people in prison, which concentrates HIV in targeted communities.3:05 PM
D
inside, sexual assault, unsterile tattooing, and shared needles all raise the risk, and condoms are banned in most facilities.3:06 PM
D
needles are the one people underestimate. White people account for the largest share (44%) of HIV diagnoses tied to injection drug use, so it's easy to overlook how many straight Black people get HIV that way.3:07 PM
D
and the conditions don't help. overcrowding, stress, and malnutrition weaken the immune system, so people already living with HIV get sick more easily, and recent incarceration is linked to worse health outcomes.3:08 PM
A
is there a legal side to this too, or is it all social?3:35 PM
D
there's a huge legal layer. 38 states criminalize HIV exposure or non-disclosure: mostly in the South. UCLA research shows Black men are drastically overrepresented in these arrests, often without any transmission or intent required. it turns a health condition into a crime.3:37 PM
A
ok so this isn't two separate problems, mass incarceration and HIV. it's like one system hitting the same people twice?4:00 PM
D
that's the throughline most research lands on. the war on drugs, racially uneven policing, and medical disinvestment created both problems in the same communities. they share a root.4:10 PM
A
this is heavy, but it actually makes me glad I'm taking that training class. it makes the reentry work make more sense, like why we'll need to push testing so hard with guys coming home.4:15 PM
A
nm4:19 PM
Sources: HIV Law and Policy – Prisons and Jails, Prison Policy Initiative – Racial and Ethnic Disparities, IAPAC – People in Jails and Prisons fact sheet, BMC Public Health, 2007 article on condoms in US jails and prisons, CDC – HIV Diagnoses, Deaths, and Prevalence: 2025 Update, CDC – Association of Recent Incarceration and Health Outcomes Among HIV-infected Adults, Colorado Department of Public Health and Environment – STI and HIV Resource Center, The Lancet Infectious Diseases (via PMC), 2018 systematic review, and the Williams Institute at UCLA.
Reach out to your doctor to schedule an appointment. If you don't have a doctor or insurance, check out Black Health's STD testing resources or a Planned Parenthood near you, or see . More options are in the .
Dee's been sitting with an idea for a while: a campaign built to reach straight Black folks specifically, since most testing campaigns still picture someone else entirely. She pulls Sabrina, Chris, Ava, and Terrence into one thread to pressure-test it before it goes anywhere else.
D
ok pulling y'all into one thread bc I need real reactions, not just "this is nice" 😅7:02 PM
D
context: most testing campaigns still picture the same narrow image of who's "at risk." straight Black folks who think "that's not me" barely get talked to at all, and that gap is part of why testing rates lag in exactly the group least likely to think it applies to them.7:03 PM
C
Chris: ok I'm listening, keep going7:04 PM
D
so there's already a campaign doing exactly this, called "I'm Him." I want to build off the same energy, just make sure it doesn't only land for men.7:05 PM
I'm Him campaign checklist posterone of their existing posters
I'm Him campaign poster: Straight Black men test tooanother one from the same campaign
I'm Him campaign poster: I'll never ask her to trust me with her healthand this one, relationship-focused
S
Sabrina: between me and Ava, that's the exact worry. "straight, black, male," where do we fit in that7:08 PM
A
Ava: right, women who feel fine and figure they're low risk skip testing constantly, and nobody's making a poster about us either7:09 PM
D
that's the whole reason I'm not trying to copy it word for word. I want to pull the energy, not the exact audience7:10 PM
I'm Him campaign poster
I'm Him

Nobody's business but mine, and I still handled it.

Handling my business. All of it.
Get testedFind a clinic
the tone I'm chasing
D
this direction is closer to what I mean. calm, no drama, testing just filed under "stuff I already handle." that part can work for anybody7:11 PM
T
Terrence: the calm part is what gets me. most of what I've seen is either scary or pitying, this just reads like a grown person handling their business7:12 PM
C
Chris: keep the confidence, just widen who it's actually talking to7:14 PM
D
noted, confidence over caution, just don't make being a man the price of admission for that confidence7:15 PM
I'm Him campaign poster: I'd rather know than wondera reason-based direction, not fear-based
D
this one's my favorite honestly. reason-based, not fear-based, and it's not gendered at all, anybody with people counting on them gets this one7:16 PM
A
Ava: ok that one I actually love, that could be me in that photo just as easily7:18 PM
C
Chris: one more thing, no dramatic music, no clinical imagery, no "reveal" moment, keep it feeling like a real photo of a real person, not a PSA7:20 PM
D
already the rule, borrowing that straight from the original brief7:21 PM
T
Terrence: one thing I'd add: get people who actually live with this in the room when you test the versions. straight Black men are almost never in the picture, and it changes how the whole thing lands7:22 PM
D
gonna mock up 2 or 3 versions blending the "handling business" tone with reasons that aren't gender-specific, bring it back here before anybody outside this chat sees it7:24 PM
S
Sabrina: send it whenever, I'm invested now lol7:25 PM
A
Ava: same, this the most useful group chat I've been in all month 😂7:26 PM
T
Terrence: count me in for a review round too, whichever version you land on7:27 PM
D
y'all are the realest focus group I could ask for. thank you7:28 PM
Seen by everyone · 7:29 PM
Dee's saved list: actual places to get tested, ask questions, or talk to someone.

Get tested

CDC GetTested gettested.cdc.gov: searches by zip code for HIV, STI, and hepatitis testing sites near you, including free and low-cost options. Black Health: STD Testing blackhealth.org: testing information and screening resources geared specifically toward Black communities. Planned Parenthood clinic locator plannedparenthood.org: find a nearby health center for testing, treatment, and birth control, often on a sliding scale.

Talk to someone directly

CDC Info Line1-800-232-4636 (1-800-CDC-INFO): general HIV/STI information, 24/7.
Planned Parenthood Hotline1-800-230-7526 (1-800-230-PLAN): routes you to your nearest health center.
American Sexual Health Association (ASHA)1-919-361-8488: STI-specific information and referrals, weekdays.

Read more, at your own pace

CDC: Sexually Transmitted Infections cdc.gov/sti: plain-language fact sheets on every infection covered in these chats. American Sexual Health Association ashasexualhealth.org: deeper guides, including on herpes and HPV specifically. CDC: Viral Hepatitis cdc.gov/hepatitis: fact sheets on hepatitis A, B, and C, including vaccine info and where to get tested. SisterSong Women of Color Reproductive Justice Collective sistersong.net: the organization that grew out of the history covered in the "Black Women & Reproductive Rights" chat.

Resources for African Americans

The Black AIDS Institute blackaids.org: the only U.S. think tank focused exclusively on HIV and AIDS among African Americans. Greater Than AIDS greaterthan.org: a national outreach effort with community guides for spreading HIV/AIDS awareness, plus free promotional materials you can use locally. Magic Johnson Foundation magicjohnson.org: founded by Earvin "Magic" Johnson in 1991, supporting community based efforts on health in ethnically diverse urban communities, including HIV/AIDS awareness, treatment, and prevention. The Balm in Gilead balmingilead.org: founded by activist Pernessa Seele, this nonprofit helps faith based institutions promote good health and prevent disease throughout Black communities. SisterLove Inc. sisterlove.org: an Atlanta based nonprofit focused on HIV prevention, safer sex education, and self help, with a particular focus on women of color.

Resources for people living with HIV/AIDS

The Body thebody.com: a broad set of resources including a treatment tracker, a guide to FDA approved medications, and a large network of blogs from people living with the virus. Minority AIDS Project minorityaidsproject.org: founded in 1985 as the first community based HIV/AIDS group run by people of color, this Los Angeles organization provides housing and transportation assistance, case management, and mental health services. POZ poz.com: a national magazine for people living with HIV/AIDS, with sections for people newly diagnosed, the latest treatment news, and help finding assistance paying for medication.

One more thing

your local health department almost always runs a sexual health clinic too. searching "[your county] health department STI clinic" usually turns it up, and many are free or income-based.
and if you're pregnant, married, or both: routine prenatal panels include HIV and STI screening for a reason, and none of that stops applying just because the "getting tested" conversation feels aimed at single people. more on that in Grace's chat.

Check-in