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HIV & DV INTEGRATED APPROACHES: FRAMING * IMPLEMENTING * SCREENING * ENGAGING * SUSTAINING Amelia Cobb The Wright Group PROGRAM SUSTAINABILITY CAPACITY BUILDING CLIENT ENGAGEMENT Susan Spencer SEXUAL SAFETY PLANNING Susan B. Spencer, Inc. SCREENING AND ASSESSMENT Jenny N. Karp HIV SCREENING IN DV SETTINGS Social Solutions International, Inc. FROM THEORY TO PRACTICE Christine McMillon PROGRAM IMPLEMENTATION ENSYNC DMS, Inc THEORETICAL FRAMEWORK Quinn Gentry Messages of Empowerment Productions, LLC GENDER-SPECIFIC Quinn Gentry, Messages of Empowerment, LLC Tiffany Pennick, Messages of Empowerment, LLC The RISE Coalition was developed by Messages of Empowerment Productions, LLC and funded by the DHHS Office on Women’s Health Black feminist theory provides an interpretive framework for examining how social, political, and economic issues that impact black women in particular. (Hill Collins, 2000). Black feminism is generally defined as a pattern of thought that recognizes how systems of power are configured around and maintain socially constructed categories of race, class, and gender (Taylor, 1998). THEMATIC DISCUSSIONS CORE THEME DEFINITION Self –definition and Self-valuation The process of rebuilding ones self worth after experiencing oppression or trauma Controlling Images Images constructed for certain groups designed to objectify them Unique Experiences Refers to a safe space to address unique issues often associated with sexual, physical, and emotional abuse Race, Class, and Gender Views race, class, and gender as “equally oppressive Structure and Agency Systems and individuals must change R REACHING I INTERVENING S SURVIVORS E EFFECTIVELY and with CORE THEME HOW APPLIED IN THE RISE INTERVENTION SELF –DEFINITION AND SELF-VALUATION Survivors participate in a process to help them redefine themselves and place a value on their lives as a precursor to thinking about preserving and protecting self through a sexual safety plan. RACE, CLASS, AND GENDER We see race, class, and gender inequality as “equally oppressive” and do not privilege gender over other oppressive structures. The RISE Intervention helps women who have internalized the names they are CONTROLLING IMAGES called (slut, whore, etc.) and other controlling actions find a voice to challenge externally defined images. UNIQUE EXPERIENCES Women may not be open to discuss certain high risk behaviors in group settings. This is primarily due to the fact that some have been degraded to a point where they feel a loss of sexual power. The RISE Intervention helps women address “embarrassing encounters” that place them at risk. STRUCTURE AND AGENCY The RISE Intervention challenges organizations to rethink their approaches to structural and individual approaches to service planning. Structure & Agency COMMUNITY-LEVEL COMPONENT Conferences, social marketing, and coalition-building to raise awareness about the relationship between IPV, HIV, SA, and related social problems. Self definition valuation & self SMALL GROUP-LEVEL COMPONENT “Discussions” and “Discoveries in smaller groups of 8-10 about shared experiences and solutions to similar social and health problems. Unique Experiences INDIVIDUAL-LEVEL COMPONENT One-on-One sessions with women to discuss unique issues and risk factors that require confidentiality and privacy aimed at developing a sexual safety action plan. Black feminist theory enhances behavior change theory (trans-theoretical theory) by making the latter more relevant to women who survive domestic violence and are at risk for HIV. When women have no intention to adopt (and may not even be thinking about adopting) the recommended protective behavior. PRECONTEMPLATION (Unique Experiences) When there is a firm intention to change in the immediate future, accompanied by some attempt to change the behavior. CONTEMPLATION (Self-definition and valuation) When women have formed either an immediate or long-term intention to adopt the behavior but have not begun to practice that behavior. ACTION PLANNING (Addressing Controlling Images) The period beginning 6 months after behavior change has occurred and during which the person continues to work to prevent relapse. Take Action Maintenance (Structure and Agency) (Race, class, and gender perspectives) When the sexual safety plan is being consistently performed but for less than 6 months. SELF ACTUALIZATION Personal growth and fulfillment SELF ESTEEM NEEDS Achievement, status, responsibility, reputation, character, respect Physical Safety Socioeconomic Stability Sexual Safety BELONGINGNESS AND LOVE Family, affection, relationships, teams solidarity SAFETY NEEDS Protection, security, order, law, limits, stability BASIC NEEDS Basic life needs—air, food, drink, shelter, warmth, sleep Self-definition and Valuation Race, Class, and Gender Stage 1: Courtship Stage 2: Commitment Low/No Condom Use Low/No Condom Use Limited/No Sex Building Trust High levels of Trust Betrayed Trust Stage 3: Conflict Unique Experiences Stage 4: Compromise Make-up Sex Renegotiate Condom Use Stage 5: Conclusion Ending Old Relationship Beginning New Relationship Rebuild Trust Source: Gentry, Q. 2007. BlackWomen’s Risk for HIV: Rough living. New York: Haworth Press, Inc. The RISE COALITION incorporates 6 core elements into the implementation process using the five themes of black feminist theory. 1 • INTIMATE PARTNER VIOLENCE SURVIVORS AT GREATER RISK FOR HIV Information sharing using self-definition and self valuation 2 • HIV PREVENTION RISKS AND PROTECTIVE FACTORS FOR WOMEN 3 • PERSONAL GOAL SETTING Client action planning to incorporate women’s unique experiences 4 • ASSERTIVE COMMUNICATIONS SKILLS TRAINING 5 • SEXUAL SAFETY PLANNING 6 • HIV TESTING AND COUNSELING Information sharing about controlling images that place women at higher risk Client skill-building within the context of structure and agency Client action planning within the context of structure and agency Client action taking and uses all five aspects of black feminism