What do you love most about working in STD prevention?

It’s about the people – talking about and destigmatizing sexual health and the health of people who use drugs opens up ways of seeing and learning from both my colleagues and members of our communities in ways that I’m not sure any other field could. I can nerd out about the conditions we follow (I came for the HIV, but I stayed for the syphilis), about epidemiology and demographics, and about structural factors, but what I end up happiest about is the community of workers and the members of our communities with whom I get the privilege to connect and from whom I get to learn and to whom I get to provide support.

What do you think are the biggest challenges facing our field?

One of them is resource constraints. We have been so underfunded and understaffed for so long that we’re painted into a corner in terms of how effective we can be. It makes us rob Peter to pay Paul and causes us to have competing priorities, rather than being able to help everyone in the way that best meets their needs and is congruent with the cultural and linguistic features of their communities that affect sexual and overall health. In some cases, this can lead to management of programs in ways that lead to clear demonstrations of inefficacy, and then resources are further reduced. In order for us and our communities to succeed, we must fully resource our core activities.

Another is stigma – STIs, HIV, and hepatitis are all very stigmatized conditions in our culture because their modes of transmission are stigmatized. Sexuality is a part of whole person health, for example, but is often treated as this alternate box of misfit toys many service providers don’t want to touch. People across all kinds of walks of life use drugs, legal or otherwise, for example, but we as a society stigmatize substance use rather than see it as just part of what members of our communities do and see addiction as a health matter.

A third is societal inequity and discrimination. Show me a community of people who have been discriminated against in our society, and in most cases, because of how that affects access to resources that affect social determinants of health, I can show you a community of people who suffer from disparity in reported cases of STIs, HIV, hepatitis, or more than one of them.

These three challenges are intersectional and work together to make the lives of the people we seek to serve hard, and to make the work we do to serve folks harder than it should be. In an overly simplified example, institutionally, stigmatization of this work causes some not to appropriately resource our work, and unconscious or conscious bias leads us to not dedicate resources to those who most need support when we are faced with competing priorities, which perpetuates inequities that flow from historic and current discrimination. Thus, these three things perpetuate ongoing white supremacy and sexism in the structure of our work, and also perpetuate understandable distrust in communities we seek to support. Many of our systems were designed to produce the disparate outcomes we see. We must accept that this is the case, but not accept that it must stay this way, and struggle in concert with our communities against the boxes we were given to restructure our work to do better.

When you’re not working, what’s your favorite thing to do with your free time?

My favorite things to do with free time include spending time with my husband, our kids and grandkids, snuggling with animals, wandering around in nature (especially high altitudes), reading, and growing plants (particularly edible things, orchids, carnivorous plants, and African violet relatives).