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Office of Minority Health Resource Center PO Bo.v 37337 Washier!. DC 20013-7337 . A Woman's Guide To AIDS Published by the New YorkCityDepartmentofHealth WOMEN AND AIDS This booklet was writtenby women for women. BecauseAIDS is a part of all ofourlives, weall need to know how to stay healthy. While thereis no partofall ourlives, cure forAIDS, wecan learn how to protectourselves from getting it, and stayhealthy ifwe are infected. how to stay healthy. We've written this to help you decideifyou are doing anything thatputs you in dangerofgetting HIV—thevirus thatcauses AIDS. It will also help you find the services you need ifyou think thatyou orsomeone you love is infected, orifyou arealready taking careofsomeone with AIDS. Women's lives are changed by AIDS in three main ways: Wecan get HIV, thevirus thatcauses AIDS, and becomesick. We can pass the virus on to our sex partners, needle-sharing partners, ornewbornsduring pregnancy. In caring forothers, we may forget to takecareofourselves. Afterreading this booklet, you may have questions to askoryou may just want to talk with someone. The New York City Department ofHealth (NYCDOH) AIDS Hotline-212-447-8200~is open sevendaysa week from 9:00 in the morning until 9:00 atnight. The Hotlinecounselorsare trained and caring professionals who haveinformation aboutmedicalcare, coun- seling, testingand support. They will answeryourquestionsand listen to yourconcerns. You do nothave to give your name. Wecan help peoplewho have HIV or who aresick with AIDS. We have the power tokeepourselves and others from getting AIDS. Consider the safety guidelines presented hereand startpracticing them in yourlife. Let's do itforthe love ofourlives. OVERVIEW 1 What Are AIDS And HIV? This Booklet Is AboutAIDS And HIV. AIDS stands forAcquired Immune DeficiencySyndrome. AIDSis the name for a disease that weakens thebody's ability to protectitselffrom getting sick. Having AIDS may mean gettingvery sick oreven dying. HIV stands for Human Immunodeficiency Virus. HIV is the virus that causes AIDS. IfHIV gets in yourbody,you may stay healthy oryou could getsickand develop AIDS. HIV is also called the 'AIDSvirus." How Does AIDS AffectWomen? In NewYorkCity,AIDSistheleadingkillerofwomenbetweentheages of25 and 34. Women who are infected with HIV (the AIDS virus) can pass the virus on to theirsex partners, needle-sharing partners, ornewborns during pregnancy. Women are taking care of husbands, lovers, children and friends with AIDS. Women can help each other. We can teach other people to help themselves. AIDS ispreventable. How Do We Become Infected? Most women become infected with HIV through sharing needles, cookers, orcottons ("works") with someone who is infected. Womenalsobecomeinfectedifthepersontheyhavesexwithisinfected. Rememberyou can't tell ifsomeone is infected by thewayheorshelooks! Some women who had a blood transfusion or received blood products before March 1985 becameinfected. Alldonated blood is nowcheckedforHIV. Asmall numberofwomenbecameinfected through artificial insemination because the man donating sperm was notchecked for HIV. Somebabiesbecomeinfected during pregnancy, birth, andasa resultof breastfeeding when theirmothersare infected. AIDS Is Not Spread By: Donating Coughing Sharing: Touching: Bug Bites: Blood Sneezing Glasses Toilets Mosquitoes Kissing Dishes Doorknobs Ticks This diseasecanbe frightening. Butyou canprotectyourselfand the peopleyou love bygetting information, medicalcare andsupport. (See"Resources") 2 WHATAREAIDSANDHIV? Sex AndAIDS: JustThe Facts HavingOnly One Sex PartnerDoes Not Protect You From AIDS. You canprotectyour- Many ofus thinkwe are notatriskforgetting HIV, theAIDS virus, ifwe selfand thepeople only haveonesex partnerand ourpartner is faithful to us. This is not you love bygettingin- necessarily true. HIV can live in a person'sbody forten yearsor more formation, medical without him orherknowing it. During theseyears, thevirus canbe passed on toother people—i/o»~through unprotected sex or sharingneedles. Ifyourpartner is infected with HIV, heorshecan pass the virus on to you. Thiscan happeneven ifyourpartner is no longerusing drugs or having sex with anyoneelse, and looks clean and healthy. Thiscan happeneven ifyour partnerdoesn'tknow heorshe is infected with HIV. Withdrawal Does Not ProtectYou From AIDS. Withdrawal (when the man takes his penis outbefore hecums) is not good protection from HIV or pregnancy. A clear liquid comes outofa man's penis beforehecums, which he doesn'teven feel. This clear liquid may have HIV in it, which can be passed on to you. Douching Does Not ProtectYou From AIDS. Douching after intercourse does notofferany protection from HIV or pregnancy. In fact, douching pushes thesemen (cum) and anyvirus far- ther into yourbody. Sodon'tdouche, unless yourdoctorrecommends it foranotherreason. Birth Control Pills And Diaphragms Do Not Protect You From AIDS. The pill and the diaphragm do not prevent HIV infection. They can be good birth control methods, but they will not protectyou oryourpartner frombecoming infected with HIV. Learn the factsaboutAIDS soyou can protectyourself, your partners, family and friends. Ifyou have questions orconcerns, talkwith your partner, a friend, a counselor, ortheAIDSHotline: 212-447-8200. Tlie more you know, the more choices you can make. WHATAREAIDSANDHIV? 3 Sex And AIDS: For Women Having Sex With Men Even with the dangerofAIDS, we don'thave to stop having sex or having babies. Butwe do have to protectourselvesand ourloved ones. Un- protected sex with an infected partnerputs us in dangerofgetting HIV (theAIDSvirus). This is also true ifwe trade sex fordrugsormoney. We canpreventinfection with HIVby practicing sexual behaviors thatdonot getsemen (cum), vaginal fluids, orblood into ourbody orourpartner's body. You Can'tTell If Someone Is Infected ByThe WayHe Or She Looks. You oryoursex partnermayhavebeen infected manyyearsbeforeyou got together. A lotofpeople who have thevirus stay healthy and haveno symptoms for a long time. Theymaynoteven know theyare infected. It's importantthatyou talkwith yourpartner aboutpastpartners and follow thesafety guidelines on the nextpage. Ifit is difficult for you to askyourpartner to use condoms and follow safersex practices—orifyou fearphysical violenceorotherresults from saying no to sex—get help to decide what to do. Call a hotline ortalkto a health provider, counselor, or friend. You are notalone. Remember: StartNow BePositive Reach OutFor Help TJie ChoiceIs Yours Call The NYCDOH AIDS Hotline: 212-447-8200. E SEX AND AIDSFORWOMENWITHMEN Guidelines For Women Having Sex With Men You areatrisk forHIV infection ifyou have unprotected vaginal, oral or The firststep toward anal sex with an infected man. Both men and women can pass HIV on to safersex is communica- theirpartners throughunprotected sex. tion .... Practice makes iteasier. The following guidelinesare designed to helpyou stay healthyby protect- ing yourselfand assessingyourrisks. Know HowTo ProtectYourself. Thesesexualactivities are safestbecause thereisnoexchangeofvaginal secretions,blood, orsemen: Hugging Massaging Masturbating Body-to-bodyRubbing Kissing Fantasizing Cuddling Using SexToys With Condoms Use Condoms DuringVaginal Sex And Anal Sex (sexual intercourse). The best protection against HIV is a latex condom (rubber) combined with a spermicide. Spermicides with Nonoxynol-9 kill HIV. Natural or lambskin condoms can let HIV pass through. You can use condoms and spermicides together by putting the sper- micidal foam or jelly into the tip of the condom, or you can use condoms lubricated withspermicides. Usewhat'sbest foryou. Condomsvary. Experimentuntilyou find a comfortableone—itmay in- creaseyourpartner'swillingnesstousethem. Nomanistoobigorsmallfor a condom. Snug fitcondoms areavailable forsmallermen. Ifyou need lubrication duringsex, usea water-based lubricantlike K-Y jelly or diaphragm jelly with Nonoxynol-9. Stay away from oil-based lubricants(likebutter,Crisco,orVaseline).Althoughthesearepopular,they maymake the condom break. Use Condoms OrDental Dams During Oral Sex ("going down" ). When you godownona man,useunlubricated condoms. Bywearinga condom, your partner is preventing his fluids (cum) from getting into your mouth. When a man goes down on you, usea dental dam (a thin layeroflatex) or plastic (like plastic wrap for food). By covering your vagina you are preventingyour fluids from getting into his mouth. Practice Makes ItEasier... Weall have to learn to have sex ina different way—a safer way. The first step toward safersex is communication. Sexcanbe funand erotic,even when using condoms, dental dams, and spermicides. Talk with yourpartner, experiment, enjoy, and stay healthy. SEXANDAIDS.FORWOMENWITHMEN 5 Sex And AIDS: For Women Having Sex With Women Being a lesbian does notexemptus fromAIDS. All women areatriskof becoming infected withHIV,thevirusthatcausesAIDS. Lesbiansdo get AIDS. The risk ofgetting AIDScomes from whatwedo, notwhatwecall ourselves. BehaviortransmitsHIV. So How Do We Protect Ourselves? Womenneed to talkabouttwo issuesbeforehaving sex: 1. Talkaboutwhetheryou oryour partnerareatrisk forHIV infection. 2. Talkabout safer sex techniques and the ones you wanttouse. BehaviorsThatPutUsAtRisk OfHIV Infection: Using IV drugs and sharing needles and/or works with someone who is infected Sharing sex toys with an infected partner without washing and covering them witha condombeforeeachuse Having unprotected oral sex ("going down" on each other) with an infected partner, especiallyduringyourperiod Havingunprotectedsex—especially formoneyorfordrugs-with women ormen who are infected How Does HIV GetInto YourBody? m HIV is transmitted by vaginal secretions, blood, and semen entering yourbody through yourmouth, vagina, oranus. For lesbians considering pregnancy through artificial insemination, if youdonotgothroughaspermbank,youandthemandonatingspermmay wanttobe tested for HIV. The choice is ours. We need to learn to talk aboutoursex lives, pastandpresent, and to negotiate safersex. 6 SEXANDAIDSFORWOMENWITHWOMEN Guidelines For Women Having Sex With Women Theseguidelines are forlesbiansatriskforHIV infectionbecause ofun- Beinga lesbian does protected oral, vaginaloranalsex withan infected woman orman. They notexemptusfrom areintended to helpyou makeeducated decisions aboutsex. AIDS ... Behavior transmitsHIV. AssessYourOwn Risk. Thefollowing sexualactivitiesaresafestbecause thereisno exchangeof vaginalsecretions,blood (especiallyduringyourperiod), orsemen: Hugging Using sextoyswithcondoms (rubbers) Masturbating Body-to-bodyrubbing Fantasizing Massaging Kissing IfYou ThinkYou OrYourPartnerAreAt Risk, You Can ProtectYour- selves IfYou: Use a dental dam or plastic wrap for oral sex ("going down" on each other), especiallyduringyourperiod. Washand coversex toys. Use latex coverings—finger cots—or latex gloves for hand/vaginal or hand/anal sex (fingering orfisting) ifyou havecuts on yourhands. Usecondoms withNonoxynol-9 ifyou havesexwith men. Usewater-based lubricants likeK-Yjellyordiaphragmjelly withNon- oxynol-9 to preventcondombreakages and skin irritations. Communication is thefirststep towardssafersex. Practice makes iteasier. Talkabout theseguidelines withyourpartner, a friend, ora counselor. Also, there arehotlines and otherservices that you cancontactthatare knowledgeableand sensitive tolesbian issuesand concerns. (See"Resources") SEXANDAIDSFORWOMENWITHWOMEN Drugs, Alcohol And AIDS All drugs including heroin, crack, cocaine, alcohol, marijuana, and prescription drugs can putyou atrisk forAIDS. Whenyou use drugs and alcohol, you may takechances—like having unprotected sex. Also, drugs and alcohol make yourbody's defenses weak and you mayget sick more often. Ifyou are already infected with HIV (the AIDSvirus), it's evenmore important to takecare ofyourself. The Danger Of IV Drugs (mainlining or skin-popping heroin, cocaine, speed, morphine, etc.): MorethanhalftheIVdrugusersinNewYorkCityareinfectedwithHIV and can pass it on to you. You can't tell ifsomeone is infected with HIV by the wayheorshe looks. HIVlivesinneedles, "works," cottons,andcookers. Sodon'tshare. Any- one—yourbrother, a friend, or "runningbuddy"—couldbe infected. Using IV drugs puts you at risk for getting infected with HIV, the AIDS virus. Youcan save yourlifeby getting offdrugs. You don'thave todo italone. Youcancall: Alcoholics Anonymous (AA) Cocaine Anonymous (CA) Narcotics Anonymous (NA) Association for Drug Abuse Prevention and Treatment (ADAPT) Ifyouaren't ready to stop using drugs, don't share needles and works. Ifyou have to shareworks, youmust clean them first. It's easy to do. Just follow the steps on the facingpage. The Danger OfTaking Chances: Even if you don't shoot drugs, you are still at risk for AIDS, because drugscanmakeyoutakechances. Ifyoutakeachanceandhaveunprotected sex, especially inexchange for drugs ormoney, you can get HIV. 8 DRUGS,ALCHOHOLANDAIDS