Uncovering the truth about HIV.
The African-American woman in the photo looks about 60, maybe 65. Her graying hair in a tidy bun, she wears a neat blue and white silk dress with a bow at the neckline. She tilts her head and gives a melancholy half-smile for the camera. Above her head are the words "I Never Asked. I Wish I Did."
Inside the brochure this sweet-looking lady tells her story. She'd been widowed. She began dating a longtime friend. They never discussed sexual history, and because of her age, birth control wasn't an issue.
Now she has HIV.
It seems strange, even freakish, but it's all too common.
HIV/AIDS is the No. 1 killer of black American women between 25 and 34. But the fastest growing segment of HIV incidence is among black women in their 50s and 60s.
Grandma has AIDS.
Women get together to discuss many different things. We talk about family, we talk about politics, we gossip endlessly. But when it comes to talking about HIV/AIDS and the simple things we can do to prevent it, our mouths are shut.
Philadelphia-specific HIV statistics are grave. Averages here are higher than the rest of the nation, especially among women. Philadelphia's response is appropriately targeted, with some of the best resources that a handful of clinicians, dedicated community outreach staff and concerned politicians have to offer.
But the issue remains unresolved because, despite all the effective treatment options, modern education models and testing programs, those at the highest risk of infection and transmission are still not talking to each other about their lifestyles and will not discuss HIV.
Rashidah Abdul-Khabeer refuses to get lost in a statistical forest. As the deputy director of the Circle of Care, part of the Family Planning Council and one of Philadelphia's major HIV/AIDS care facilities, she's been preaching about the importance of getting together to talk--simply and frankly--for years.
"I've given up on all the statistics," Abdul-Khabeer says. "If you want statistics, look in the paper. For me, its all about dialogue. The question is whether you have enough information to protect yourself and enough courage to implement what you know. And the answer is no, there's not enough information and there's not enough courage."
It's hard to believe there isn't enough information. Who doesn't know after all this time how HIV is spread? But there are women who still perceive HIV/AIDS as a gay male disease, or who are in denial about their boyfriend or husband cheating on them.
A Philadelphia woman, let's call her Emma, has one such story.
Emma had been married for four years. Her husband got sick with what turned out to be pneumonia during the winter months of 1999. One night, barely breathing, he was rushed to the emergency room and quarantined.
Hospital staff asked for a consultation with Emma. They told her that her husband had full-blown AIDS and that she and her three children needed to be tested.
More than a few voices caution that in the decade-plus since effective antiretroviral meds have transformed HIV infection from a death sentence into a chronic but manageable infection, too many people have lost their fear of the virus.