Tag Archives: Duke

Avoiding the White Savior Industrial Complex

26 Feb

The premise of the “White Savior Complex” is derived from the scenario in which individuals who exercise certain privileges–race, class, education, etc.–invade the spaces of certain groups or communities that are culturally different from their own with the intention of uplifting or “saving” members belonging to the groups they are invading. (“White” is really semantics to describe “saviors” from high-income/developed communities).

Those with privilege often wrongly deem the communities they approach as “oppressed”, or otherwise lacking access to certain rights or liberties , and in desperate “need” of help. From desiring to “rescue” sex workers to wanting to “liberate” oppressed women in the Middle-East, the White Savior Complex is a flawed mentality, and the intrusion of those with privilege into perceived “oppressed” or “disempowered” communities is often coupled with a desire for self-promotion that is justified with misguided altruism and harmful ally-ship.

Savior complexes, while perhaps partially fueled by a desire to do good in society, are callous displays of privilege that reinforce social hierarchies. “Saving” implies that certain communities are above others, and only groups with access to certain privileges embody the efficacy to empower those who are labeled disadvantaged or in “need” of help. Broadcasting the perceived struggles of another group in a showcase of pictures from mission trips and research projects can be both insensitive and exploitive to many communities.  “Look at these oppressed and impoverished brown/black women and children from the global south that I helped save”.

Saviorship of those who voluntarily enter the sex industry is a current topic of public spectacle that has generated a community-wide response. The hashtag #NotYourRescueProject was started by twitter activists to express discontent over sex work-related savior mentalities and reject the jarring notion that all sex workers are unhappy in their profession and do not wish to participate.

In 2012, Teju Cole,  a writer for the Atlantic, published a series of tweets on the White Savior Industrial Complex 

Yesterday, I published a series of my own tweets on “Being a Good Ally & Avoiding the White Savior Complex” . I’ve embedded the full composition of tweets into my post below:

You can absolutely have the best intentions and still hurt groups that you wish to advocate on behalf of. How CAN you be a good ally to the groups you are advocating on behalf of?

Your mentality matters. The premise of all savior complexes lie in self-promotion or seeking public approval and praise rather than true social justice advocacy.

Be mindful of the fact that if you are in a position where you feel like you have the ability to “save” or “empower” oppressed/minority/disempowered groups, you are demonstrating your position of privilege and, in fact, reinforcing social hierarchies.

One great way to know how you can help is by listening and asking groups you are allied with how they would like for you to become involved. By listening and taking into account the words of others, you demonstrate a genuine interest, and you will likely be called upon when your support is needed.

Email me: rachel.safeek@duke.edu

Twitter: @RachSafeek

 

#FightStigma Campaign

25 Jan


#FightStigma is an anti-stigma campaign that was launched by the Duke University group, Know Your Status, to encourage HIV testing and combat stigma around HIV.

Due to an expressed interest in the #FightStigma t-shirts from the Twitter community, we are working on having more t-shirts made for anyone who is interested in participating in the campaign. Follow the #FightStigma campaign on Twitter for more information about HIV testing, HIV facts, and updates on #FigthStigma t-shirts.

FightStigma Campaign

Rachel Safeek and Jasmine Cross, KYS Co-Directors "Fight Stigma" image

Rachel Safeek and Jasmine Cross, 2012-2013 KYS Co-Directors “Fight Stigma” image

Free HIV Testing at Duke every Monday!

Free HIV Testing at Duke every Monday!

Rachel and Victoria of #FightStigma Campaign

Rachel and Victoria of #FightStigma Campaign

Jasmine and Rachel, KYS Co-Directors 2012-2013

Jasmine and Rachel, KYS Co-Directors 2012-2013

 

Daniel and Li of the #FightStigma Campaign, 2013-2014 Co-Directors of Know Your Status

Daniel and Li of the #FightStigma Campaign, 2013-2014 Co-Directors of Know Your Status

"Fight Stigma" Campaign

“Fight Stigma” Campaign

#FightStigma would like to thank Shayan Asadi for his amazing photography skills

 

Forever Duke (Welcome #Duke2018)

13 Dec


Yesterday, 797 early decision applicants were notified of their acceptances to the Duke University Class of 2018.

As a recent graduate of Duke and volunteer interviewer for undergraduate admission, I have the opportunity to regularly talk about my Duke experiences with prospective students. The impact that Duke has made on my life and career goals is ineffable, and with each conversation I have about Duke, I grow even more nostalgic. And so, I dedicate this post to my alma mater, the greatest place on earth.

A very warm welcome to the Class of 2018, the new members of the Duke community! Remain open-minded and embrace all of the new opportunities that Duke has to offer. You are in for the best four years of your life. #ForeverDuke

Duke Graduation 2013

Standing Inside the Duke Chapel–Duke Graduation (May 2013)

Duke 2013 Graduation

Duke 2013 Graduation

Duke Chapel

In front of Duke Chapel with Brynne (December 2011)

Duke Chapel Homecoming Weekend

Posing in front of Duke chapel during homecoming weekend #ForeverDuke

Forever Duke

Best friend of four years #Pegram #ForeverDuke

–Rachel Safeek

HIV as a Human Rights Issue: Intersection of Gender, Race, and Violence

10 Nov


 

I Care about HIV/AIDS because...

I Care about HIV/AIDS because…

Why should people care about HIV if they are not personally affected by the disease, or if they do not know of anyone who is personally affected? I’ll tell you why: HIV is a human rights issue. 
One of the things that I love about my job is that when I’m discussing HIV prevention, I’m never just restricting my conversations to talking about HIV. I talk about STD concerns, general sexual and reproductive health, issues of consent for sexual activity, and finally issues related to power dynamics within relationships.
Here is one thing many people don’t realize, at least not consciously: condom use is all about negotiation. Okay, logically, to prevent the sexual transmission of HIV (and other STD’s), one should engage in all sexual or intimate encounters using condoms. That makes sense.
What if no condom is available at the moment? Or how about if your partner doesn’t want to use condoms? Okay, let’s focus for a second on the latter: Your partner is pressuring you into not using condoms.

There’s that classic line:

“You’re on birth control, and I don’t have anything (read: Sexually Transmitted Disease)….and neither do you. Why do we need to use condoms?”

If your partner doesn’t want to use condoms when you do, then logic tells us to just kick him/her to the curb. But unfortunately, logic cannot always be applied to instances of sex or intimacy. Beyond the emotional attachment which may cause someone to abandon his or her preferences “out of love” for their significant other, there are a few other matters to consider: What if you are in a long-term relationship and your partner is upset or offended by your request to continue using condoms? What if he/she threatens to leave you if you go against his/her wishes. Or…..

What if your partner threatens to (or does) hit you for resisting his/her demands? Ultimately: HIV transmission is not as simple as someone forgetting to wear a condom or not having any condoms available. It’s not even JUST an issue of a lack of education around HIV or sexual health. It comes down to negotiation. It’s and issues of power dynamics: who has the power (or IS empowered) to demand that condoms are (or are NOT) used.

The Three-Way Shift

In the early 1980s, when HIV was first observed in the United States, it was considered a “gay disease” because it was primarily observed among young, Caucasian, homosexual men in the Los Angeles area. Almost thirty years later in 2013, there has been a three-way shift in the race, gender, and sexual orientation of the demographic group with the highest incidence rate of HIV: from Caucasian, homosexual, men in the 1980’s to African American, heterosexual women in present day.

That’s a pretty remarkable shift to consider. In just thirty years, a virus has completely changed its course to disproportionately affect an entirely different demographic. This was what initially drew me toward researching HIV and its relationship to women.

Reasons cited by scholars for this shift in HIV to targeting women, particularly African Americans, include the power dynamic between men and women engaging in heterosexual intimate/sexual relationships, particularly in relationships in which:

  1. Gender-based violence (GBV)/Intimate Partner Violence (IPV), including domestic violence, rape, and sexual assault, are involved
  2. Women are financially unstable/”economically vulnerable”
  3. Men in heterosexual relationships bear attitudes of dominance or patriarchy

Because condom use is a direct product of negotiation, the individual with more power has the greater efficacy to control whether or not condoms are used in a relationship. Below I discuss the three situations listed above and describe their relationship to power dynamics within heterosexual relationships, condom use negotiation, human rights issues, and HIV transmission.

Gender-Based Violence (GBV)/Intimate Partner Violence (IPV) in Heterosexual Relationships

Julia Kim (2008) describes the most visible “manifestation of the unequal power balance between men and women is violence against women”, specifically, violence against an intimate partner. If violence or sexual assault is an impending threat for a woman while she is in a relationship, she may not feel empowered to demand condom use from her partner out of fear of physical or sexual abuse. GBV and IPV constrain of individual agency and consequently lead to issues with women’s health. Women are physically at risk of being hurt from being hit or sexually abused by their partner. Additionally, they are left scared and in a disempowered state, in which they are unable to defend their human rights and protect themselves from STI’s and HIV.

Currently, the intersection of gender-based violence, intimate partner violence and HIV prevention among women is an initiative that is being undertaken by the White House (see link below).

Financial Disempowerment/Economic Vulnerability of Women Engaging in Heterosexual Relationships

Demonstrated lack of financial security among  women characterizes another social factor that contributes to female disempowerment, and subsequent transmission of HIV. Oftentimes, women who are struggling financially may turn to men for financial support.  In many of these situations, financial dependence upon men, the “sole bread-winners” of the household, places women in vulnerable positions. Women who are poor, many of whom are minorities, may rely on their partners for housing, food, or other forms of financial support. As a result they may be pressured to submit to the sexual needs of their partner. Women are more likely to engage in risky sexual behaviors, such as unprotected sex, because they believe they owe their partners in exchange for money, food, and resources. These type of sexual transactions in exchange for money or other material goods, including housing, clothing, food, or even drugs predispose women to HIV and other STD’s.

Patriarchy/Structural Violence

A woman who engages in sexual relationships with a man who bears attitudes of superiority toward women may be pressured to submit to the needs of her partner, including forgoing condom use if her partner demands it . If a man asserts his dominance, as the male “head of the household”, a woman may have limited control over protecting her body during intimacy, leaving her in a position of little control. Women may unwillingly submit to the pressures of her partner out of fear that her partner will leave her or engage in affairs outside of their relationship. The “subordinate status of women”, particularly of minority women, directly influences the health-threatening decisions made by women in relationships and characterizes a violation of women’s rights (Farmer 2003).

Dr. Paul Farmer (2003) cites structural violence,  the historically adopted behaviors or attitudes, e.g. sexism, racism, or classism, “that conspire to constrain individual agency”, as a key contributor to health disparities. Sexism, racism, and classism deprive certain groups of their basic human rights, creating “inegalitarian social structures”. Sexist or patriarchal styles of thought establish a hierarchy and division of power between the sexes, in which men are afforded the power to make final decisions. As a result, women are denied their right to assert control over their bodies and their health.

References

Farmer, Paul. (2003). Pathologies of power: health, human rights, and the new war on the poor. Berkeley: University of California Press.

Farmer, Paul. (1996) Women, poverty, and AIDS : Sex, drugs, and structural violence In Simmons J. (Ed.), Monroe, Me. : Common Courage Press

Kim, Julia, Pronyk, Paul, Barnett, Tony, & Watts, Charles. (2008). Exploring the Role of Economic Empowerment in HIV prevention. AIDS Journal (2008) Volume 22. Lippincott Williams & Willkins.

As always, please feel free to email me. I limited much of my discussion for ease of reading, but I’m always open to questions/further discussion and reading.

–Rachel Safeek

Voluntary Female Sex Work vs. Sex Trafficking of Women

13 Oct



sex-workers-rights

@RachSafeek: Not all #sexworkers are products of sex #trafficking. There are women who enter sex work of their own volition.

The difference between human sex trafficking versus consensual and/or voluntary sex work among women is a topic that I’ve been meaning to address for a long time. Oftentimes, when I mention that I work with HIV prevention among Female Sex Workers (FSWs), many incorrectly assume that the women with whom I work are all victims of female sex trafficking.  Just this morning, I received an email from a fellow Duke graduate with a link to Nicholas Kristoff’s column about sex trafficking in the United States. The sender noted that I would likely appreciate the column  “because of the work [I] do with sex trafficking victims”.

Indeed, I value the article for the education that it reinforces to readers regarding sexual exploitation in the United States. However, I believe that an important piece of the story is missing, the part of the sex trade that includes the group that I DO work with: women/girls who choose to enter the profession “willingly”. (Note: I refer to “willingly” as such because I do acknowledge that it is debatable whether women who do enter the sex trade without being forced by a third party pimp or madam choose to do so 100% agreeably. Many who do choose to engage in sex work do so out of desperation or a lack of better options, including a lack of skills, resources, and education. These women, however, do not fall under the category of trafficked women, which is problematic, as I will discuss later in this post.)

In any case, global health students, researchers, and health care workers alike have responded to my work in a manner similar to my classmate’s, assuming I work solely with trafficked women. While directing attention to an important cause, they are simultaneously dismissing the value of work with women who voluntarily engage in the trade, an unintended effect.

Personal Experiences with Trafficking

Before delving into further discussion of consensual and voluntary sex work, I would like to first like to acknowledge that I do not wish, in any way, to alleviate the seriousness of human sex trafficking. We can all agree that the effects of unlawful human sex trafficking are damaging to the individual and society as a whole. Even Hollywood has made a supreme effort to portray the traumatizing and dehumanizing side effects of trafficking in films such as Taken (2008).

I myself have been the personal target of trafficking because of the work I do. On World AIDS Day 2011 (December 1), while leaving my workplace in Salvador, Brasil, I was grabbed by two individuals who attempted to force me into their vehicle. The two men were later identified as pimps. As an HIV researcher and activist, I am committed to decreasing stigma around HIV through prevention education and research. Eager to assist in the World AIDS Day festivities at my workplace, I stayed at work late into the evening, a dangerous decision which put my own life in jeopardy. Due to extreme luck and some willful attempts to fight back, I was able to escape the situation and run to the police, who were not much help and mostly likely involved…but police corruption in Brazil is another topic which I’ll reserve for future blog postings. In any case, having almost been forced into the trafficking system, I am without a doubt privy to the manner and degree to which sex trafficking is an issue of paramount concern and represents one of the highest and most inhumane human rights abuses.

From World AIDS Day 2011. Holding a red candle for HIV awareness and wearing a red ribbon HIV activism shirt

From World AIDS Day 2011. Holding a red candle for HIV awareness during a candle light vigil and wearing a red ribbon HIV activism shirt.

Sex trafficking is not the same as consensual Sex Work, but discourse should develop around each topic equally

Nevertheless, even with my own personal experiences with trafficking, I believe it is important to consider cases of women who are not forced or kidnapped and sold into the sex trade. There are a several reasons why I am against the singular portrayal of female sex workers as products of human sex trafficking:

First, I believe that assigning the title of “trafficked” to all women engaging in transactions of sex relegates women who voluntarily enter the profession, labeling them as “victims”. This is both an unfair and disempowering assumption. Many women, some of whom are highly educated and accomplished, willingly choose to enter the sex work trade. One rather famous case involves the Ivy League graduate who documented her experiences with prostitution.  Additionally, I have worked with many female sex workers in the past who noted that they were comfortable working in the sex trade. Sex work was their profession–their source of income. It was what they were comfortable with, and while perhaps they would not want their daughters to continue with the trade, they personally did not identify with feeling “used” or “victimized”. If anything, they were happy they could provide for themselves and their children. While the notion of “empowered” sex workers may not represent the overwhelming majority of sex workers in the United States or internationally, and while they certainly may not be the headlines for discussion around sex work, these women cannot be overlooked when engaging in discourse about sex work.

Secondly, and related to the first reason, dismissing all women who engage in sex work as “trafficking victims” ignores the job-related risks of women who voluntarily engage in the profession. Women who engage in consensual transactions involving sex cannot be discounted when considering the needs and, more importantly, the RIGHTS of those involved in the trade. If all sex workers are readily labeled trafficking victims–or victims, in general–, those who have chosen to enter and remain in the trade willingly (or for lack of better options), will have their rights overlooked. The focus will be shifted mainly to helping women leave the profession. As I noted earlier, not every woman wants out. Many are comfortable with the work they do, and so, it is essential that women who do choose to remain in the trade are not denied their rights e.g. safer working conditions, protection from rape/sexual assault and gender-based violence, and addressing key health concerns, including prevention of STDs and HIV. Focusing on cases of female sex trafficking ONLY subtracts from the much needed attention that should be paid to public health and gender-related risks associated with women who are not being forced and sold into sex work by a third party pimp/madam.

Finally, and this is a more subtle yet very important point, focusing solely on sex trafficking ignores the reality of women who engage in casual transactions using sex. For this point, I refer back to the definition of sex work:

“Sex work is the exchange of sexual services, performances, or products for material compensation”

Considering this definition, an individual who has offered sex in exchange for food, money, or a place to stay has engaged in a transaction that is deemed sex work, even if he or she does not formally identify as a sex worker. Take, for example,–a situation that I have heard time and time again from the women I work with–the case of a young woman/girl who is homeless, lacks formal skills and education, and the support and resources that a family can provide. She may see sex work as her only option for money and choose to enter the trade, albeit out of desperation. Oftentimes, she is not being forced by a pimp or madam, which does not qualify her as a trafficking victim. And while she may have entered the trade out of desperation and circumstance, she is still voluntarily engaging in sex work for money, shelter, or food. An unfortunate situation, but for many women who do voluntarily engage in sex work, it can be a reliable source of income which some (NOT ALL) women may be comfortable with.

This is a more common occurrence than society is willing to accept. However, even if we do not always include these transactions as instances of “formal prostituting”, we must acknowledge the role that they play in leading women to officially entering the trade and the number of health risks that develop as a result of engaging in these types of desperate transactions. Women who engage in sexual encounters for goods for money out of their own volition (even if out of desperation), and in the absence of a third party pimp/madam or John who forcefully demands that a woman submit to prostitution, represent an under acknowledged group.

This sheds light on a need to uncover the greater issues at hand: Ultimately, female sex trafficking and female sex work (excluding cases of women who entered the trade voluntarily and not out of lack of other options) are two micro issues in a macro problem: gender disempowerment. Whether actively forced by a third party, e.g. a pimp/madam or a John, or voluntarily engaging in sex work out of desperation or lack of skills, education, and resources (forced out of circumstance), the macro issue at hand is the vulnerability of women in each situation.

We all recognize the dangers that are present for women who are kidnapped, trafficked, and sold into the trade. However, if we choose to focus solely on female sex workers who are the products of female sex trafficking, we are ignoring the macro issue of disempowerment among women who are compelled to enter the trade due to circumstance ( lack of skills, education, and a strong support system/resources). This disempowerment should be a topic that is capitalized upon and addressed via public policy, and it is often overlooked by the assumption that all women in the profession are forced in by pimps or madams, rather than also by circumstance or choice.

Finally, there are various other issues to consider with regards to sex worker rights and public health/human rights issues. For the purpose of this post, I have restricted my discussion to women. I did this on purpose to demonstrate the role that gender plays in increasing vulnerability among sex workers. Gender is continually cited as a factor which predisposes women to violence and disease transmission, two key topics that I choose to focus on with my research. I focused on female sex workers, given my extensive background working with this group and in an effort to highlight the particularly devastating effect that financial disempowerment, gender-based violence, and rape/sexual assault can have on women in the trade. However, it is also important to consider the situation of male or transgender sex workers.

Additionally, one must consider what is truly consensual sex work.  I mentioned that I have met some women who are truly content with their earning income through the sex trade, but what percentage of all sex workers do these cases account for? Furthermore, do young girls/women who express content with engaging in sex work really have the ability to engage in consensual transactions using sex? All very important questions to consider. In any case, these questions represent even more of a reason to consider all instances of sex work, despite only the “sexiest” and most shocking stories of sex work/trafficking which are often highlighted in the media.
Email me at rachel.safeek@duke.edu
–Rachel Safeek

HIV Prevention Among Female Sex Workers (Honors Thesis in Brasil)

15 Sep


In response to the number of requests I’ve gotten from current Duke students/study abroad students who are interested in reading about my work in Brazil with female sex workers, I’ve dedicated this post to focusing on the details of my research project.  If you are interested in my motivations for working with HIV prevention and sex workers, you can read more about my experiences in the field in one of my previous postings. And for those who are interested in the socio-cultural backdrop of the project, you can read here about why I selected Salvador (Bahia), Brazil as my site for undergraduate research and why the HIV/AIDS prevention model is so unique in Brazil.

Talking to one of the coordinators about disease prevention among Female Sex Workers

Talking to one of the coordinators about disease prevention among Female Sex Workers

I want to address the issue of culturally-competent community engagement briefly. For anyone who is working with marginalized groups, it is ALWAYS important to bear in mind that you should approach your research in the most non-intrusive way possible. You never want to come off as exploiting the persons with whom you are working for the benefit of your research and publications. Because Female Sex Workers (FSWs) are a marginalized and stigmatized group, many of the women with whom I worked were initially unwilling to participate in my project.  I was American, “over-privileged”, and it didn’t help that I had a rudimentary and “textbook” knowledge of Portuguese at the time of my first visit to the organization where I worked, O Projeto Força Feminina–The Female Force (Empowerment) Project (September 2011).

To overcome any cultural/linguistic barriers and earn the trust of the women at O Projeto Força Feminina, I dedicated the first few weeks of my project to establishing a relationship with the women. I taught basic English classes and engaged the women in belly dance and makeup classes (eyebrow threading), which they loved! It was truly a beautiful exchange of cross-cultural interests: I shared aspects of my Middle-Eastern culture. In exchange, the FSWs taught me some forms of Brazilian dance and helped me with my Portuguese. Ultimately, we established a firm sense of camaraderie that allowed them to trust me and have me interview them about their work and sexual behaviors. I also demonstrated my commitment to working with the group by returning to my project site again last summer (May-August 2012). While I will not be able to return to Salvador until next summer, I still maintain contact with many of the women at the organization.

Below is my finalized research abstract with some pictures from my time at O Projeto Força Feminina. Please email me at rachel.safeek@gmail.com with any questions.

“Who Cares about Us–We are Just Women of the Street”–Combating HIV Transmission and Gender Disempowerment among Female Sex Workers in Salvador, Brazil 
Authors: Rachel Safeek, Sherman James, Ph.D
Duke University 
ABSTRACT

BACKGROUND: While Brazil is lauded for its exemplary HIV prevention model, the majority of HIV prevention programs promote safe sex through education, ignoring the realities of gender disempowerement and inequality, which increase the susceptibility of female sex workers (FSWs) to instances of violence and disease. This paper analyzes factors associated with gender disempowerment and lack of condom use among FSWs in Salvador (Bahia), Brazil who engage in heterosexual interactions with male clients. An understanding of the sources of gender disempowerment is key to developing culturally-appropriate and effective policy interventions.

METHODS: Over a seven-month period, formal interviews were conducted with sixteen female sex workers and focus group discussions were conducted with 35 female sex workers at Projeto Força Feminina. The latter is an organization located in Pelourinho, the Historic District of Salvador, that works with FSWs to promote safe sexual practices and combat gender-based violence. Three life histories were also conducted with three of the sex workers. Additionally, Dr. Edivania Landim, the former head of the HIV/AIDS program of Bahia, was also interviewed.

RESULTS: Interviews and focus groups revealed that economic vulnerability (financial instability), drug use, and instances of gender-based violence (structural violence) and rape/sexual assault from police and clients disempower FSWs, increasing their susceptibility to the transmission of disease. In each case of disempowerment, the factors contributing to women’s decision to engage in intercourse without condoms or other types of risky or unsafe sex were influenced by their inability to defend themselves as women and as FSWs, a social group of women isolated on the bottom rung of Brazil’s social and economic ladder. The respondents were clear that their gender was a definite factor in the many difficulties they faced.

DISCUSSION: Increased emphasis should be placed upon female-specific forms of protection, e.g. female condoms, microbicides. Unionization among sex workers is necessary to gain political acknowledgement of sex worker rights through legalization of the profession.

KEY TERMS: HIV/AIDS, Female Sex Workers (Profissionais Do Sexo), Race, Economic Vulnerability, Disempowerment, Gender-Based Violence, Structural Violence, Health Disparities, Human Rights, Salvador, Brazil

–Rachel Safeek

"Empower women in the situation of prostition"

“Work in solidarity with women in the situation of prostition”

Colorful sitting room

Working on art projects

Working on art projects

Mission Statment

Mission Statment

In focus group discussion

In focus group discussion

 

 

 

 

 

 

2013 International AIDS Society Conference in Kuala Lumpur, Malaysia & Journal Publication

7 Sep


This summer, I had the wonderful opportunity to travel to South East Asia to publish an article I wrote in the Philippine Journal of Nursing (photo below) and present findings from my undergraduate research at the 7th annual International AIDS Society (IAS) Conference on HIV Pathogenesis, Prevention, and Diagnosis Treatment in Kuala Lumpur, Malaysia. IAS 2013 is the largest HIV-themed conference in the world, bringing together researchers, HIV-related organizations and NGOs, and activists from all over the world.  Most notably this year at the conference, the World Health Organization launched its new Guidelines for HIV treatment , which called for earlier HIV treatment based on high viral load, regardless of CD4 count.

Publication in Philippine Journal of Nursing

Publication in Philippine Journal of Nursing, Rachel Safeek

As an HIV activist who has worked with HIV prevention and human rights advocacy among female sex workers in the past, I wanted to comment specifically on the topic of HIV transmission and sex work at the conference before delving into my own research. The topic is one of paramount concern, especially given that  HIV among commercial sex workers  is a topic currently being investigated in the United States.

Earlier in the week of conference (late June/Early July) the US Supreme Court ruled against the anti-prostitution loyalty oath, reversing the decision to forbid the use of USAID funding for marginalized groups, including commercial sex workers. Given the importance of this decision, I expected more attention would be paid to the topic of sex work at the conference. I was, however, a bit disappointed with the lack of emphasis on the topic.

Although mostly overlooked, sex work was not entirely ignored. A full abstract discussion section was dedicated to the topic, albeit on the final day of the conference in the afternoon. Additionally, one of the key speakers, Aziza Ahmed, a Northeastern University Associate Professor of Law, also dedicated much of her talk, “HIV, Law, and Stigma”, to addressing HIV transmission among sex workers and other marginalized populations.

The IAS did acknowledge the importance of the topic at the close of the conference, reprimanding the decision of the Greek government to criminalize sex work and demand compulsory HIV testing for sex workers. I was very pleased to see that after the conference, the IAS had issued a formal statement condemning the Greek government’s decision:

@RachSafeek@iasociety statement on Greek gov decision to force #HIV tests for sex workers and criminalize #sexwork.#humanrights http://www.iasociety.org/Web/WebContent/File/IAS_Greece_MOH_Statement_5_July_2013.pdf …

For the upcoming AIDS 2015 conference in Melbourne, Australia, I look forward to hearing more about the efforts being undertaken to hinder the transmission of HIV among sex workers.

Description of my research:

My research investigates how risky sexual behavior patterns, including condom use, may differ by age of college students and also by gender, race, and sexual orientation. Using data collected from Duke University’s Know Your Status, an HIV prevention organization providing free, rapid HIV testing to college students in Durham, North Carolina, I compared demographic information of students to reported risky sexual behaviors. Specifically, I looked condom use, number of sexual partners in the past 12 months, and frequency of condom use, comparing these data across race, gender, sexual orientation, and type of college, Duke (private four-year university) and Durham Technical Community College (public two-year college), as these two college environments host different age and race demographics.

The data for this project was collected as part of research-based independent study in global health at Duke University and other testing sites in Durham County, NC, under the supervision of Duke faculty, Dr. Mehri McKellar.

Please see my abstract below or my poster presentation

“Sexual behaviors and condom use among younger versus older college students in North Carolina, U.S”
Authors: Rachel Safeek, Mehri McKellar, MD
Duke Univeristy
ABSTRACT
Background: Young adults have high rates of STD’s, including HIV. We evaluated sexual behaviors and condom use at a private university and a community college in Durham, NC, to see whether younger adults (ages 16-24) had riskier behaviors and lower rates of condom use than their older student peers (ages 25+).
Methods: Data was collected anonymously between 2006-12 from college students undergoing free rapid HIV testing at Duke University (DU) and Durham Technical Community College (DTCC). Students completed questionnaires regarding sexual behaviors, including type of sex, number of partners in the last year, and condom use, including use at last sexual encounter. Students rated frequency of condom use on a 5-point scale from never (0) to always (5).
Results: There were 2146 students overall (63% from DU) who participated, of which 56% were female; 25% black, 30% white, 9% Asian, 7% Hispanic, and 24% were other or did not report.  Students ranged from 16-54 years old with 69% age 16-24; the mean age was 21.0 at DU versus 26.0 at DTCC. The majority at both schools were female (706/1373 at DU; 509/810 at DTCC); 51% (588/1156) at DU were white, while 86% (494/575) at DTCC were black or black/Hispanic. Fifteen percent at each site identified as gay, bisexual, or other. The average number of sexual partners in the last year was 2.7 for younger students versus 2.5 for older students. Sixty-eight percent (1106/1631) of younger students reported being sexually active versus 79% (406/515) of older students. Of those sexually active, 52% (574/1106) of younger students used condoms at their last sexual encounter versus 39% (159/406) of older students.  Of those in engaging in vaginal intercourse 38.2% (360/968) of younger students versus 23.3% (80/344) of older students reported always using condoms. 40.2% (111/276) of younger students engaging in anal intercourse versus 31.9% (45/141) of older students reported always using condoms. The top reasons for not using condoms were: monogamous sexual relationships, use of alternative contraception, and lack of condom.
Conclusions: The data suggests that more prevention initiatives should be geared toward both younger and older college-students. There should be a greater effort made by universities to promote the distribution of condoms in areas which are accessible to all students.

Photos from my time in South East Asia

2013 IAS poster Presentation

2013 IAS poster Presentation Rachel Safeek

Beijing 2013--Great Wall Trip

Beijing 2013–Great Wall Trip

Petronas Towers Visit, Batu Caves trip, Chinatown, and Mederka Square

Petronas Towers Visit, Batu Caves trip, Chinatown, and Merdeka Square

International AIDS Society Conference nametag

International AIDS Society Conference nametag

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Perhaps the most notable tourist attraction in Kuala Lumpur. The Petronas Towers

-Rachel Safeek