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December 5, 2012

When revealing HIV status turns deadly

Cicely Bolden, 28, was a mother, a twin sister, a daughter and a friend to many in Dallas.

"She was born one minute after me, so I grew up protecting her. We had this bond. Her life was my life," her twin, Chelsea Bolden, told The Root. "My sister wasn't perfect -- she liked the drama -- but she was a good person and a really good mother."

Cicely Bolden also happened to be HIV-positive, diagnosed almost two years ago. But her life didn't end because of health issues related to AIDS. On Sept. 6, her married boyfriend, Larry Dunn Jr., stabbed her to death, claiming that she had sex with him and didn't disclose her HIV status until after they were finished. Her two children, ages 7 and 8, discovered her body lying on her bedroom floor.

In a recorded police interview, Dunn stated that her alleged deception made him so angry that he ran into the kitchen, grabbed a knife and stabbed her. Dunn, who is currently being held on $500,000 bond, told detectives, "She killed me, so I killed her."

Sadly, no doubt many of you are thinking -- thanks to some salacious headlines and the brutal debate being waged online -- either Bolden deserved it or, while you don't condone what Dunn did, you understand. But before we rush to judgment and blame the victim, let's fill in some gaps that haven't been addressed.

First, having sex with someone HIV-positive doesn't automatically mean that you will contract HIV or die, as Dunn suggested, especially if you use condoms and if the HIV-positive person's virus is suppressed by medication. Second, how do we really know that Bolden waited to disclose?

Bolden's sister told The Root that Bolden was up-front about her status and that she wasn't ashamed of it -- even her children knew. And while it may be hard for folks to wrap their heads around it, there are plenty of HIV-negative men who knowingly and willingly have sex with HIV-positive women.

But most important, instead of putting Bolden's HIV status on trial, let's recognize that for women like her, domestic violence is a serious and all-too-common issue. A recent report found that 55 percent of all women living with HIV/AIDS have experienced domestic violence, which is more than twice the rate of the general population. And violence isn't just a quick reaction to learning someone's status; it can be long term and calculating.

Recent results from the Women's Interagency HIV Study (WIHS), the largest ongoing study about women living with HIV/AIDS in the United States, found that between 24 and 78 percent of women living with HIV/AIDS -- as well as women with increased risk of HIV, such as those living in poverty or in an area with high HIV rates -- report a history of domestic violence. In addition, 78 percent of the women in the study reported a lifetime experience of abuse, and 36 percent experienced abuse that had occurred in the past three months.

Violence and trauma can kill HIV-positive women, and not for obvious reasons. That same WIHS report found that HIV-positive women experiencing recent trauma were 4.3 times more likely to have their AIDS medications fail and 50 percent more likely not to be in medical care. Researchers cited a range of reasons, including depression and post-traumatic stress syndrome, that became barriers to adhering to medications and seeking care, even if care was accessible and available.

Naina Khanna, policy director at the Oakland-based Positive Women's Network USA, emphasizes that domestic violence can also be in the form of emotional abuse specifically aimed at HIV-positive women, such as withholding their medication, not allowing them to attend doctor's appointments or support groups and even threatening to reveal their status to others who may not know.

"A woman's HIV status can easily be used as a tool for manipulation and coercion," Khanna said. "Maybe her parents, her baby daddy or her landlord [doesn't] know about her status, and so the partner holds that over her head -- threatening to get the courts to take her kids away or make her lose her housing. This creates abusive situations, which, sadly, all too often turn violent."

While the act of disclosure is extremely complicated, by no means is anyone suggesting that HIV-positive people should remain mum about their status.

But the key is for everyone, including HIV/AIDS advocates, to look at the big picture.

Many HIV/AIDS leaders boast that disclosing is empowering and can improve one's health, but Dazon Dixon Diallo, founder and president of SisterLove Inc. in Atlanta, said she believes that this communal message needs nuance.

"We have to encourage disclosure in a way where we say that it has to be careful [and] prudent, and have conversations about where to tell and why to tell," she said. "Because right now we have a serious dilemma. We are fighting against prejudicial and unfair HIV nondisclosure-criminalization laws [that jail people for not disclosing their HIV status to partners]. And yet the HIV-positive people we are trying to protect [would] rather go to jail and not disclose than be killed because they did."

In the end, Bolden's death is another tragic reminder of the constant fear and violence that so many people living with HIV/AIDS, especially black women, face on a daily basis in the United States -- violence that is a direct consequence of the stigma and ignorance that HIV-negative folks create and perpetuate, yet are unwilling to own up to and admit is a problem.

"Cicely Bolden's murder is, for women, what Trayvon Martin is for the black men," says Dixon Diallo. "Another man is going to get off lightly or completely for killing a woman for disclosing her status, and in no day or any country should that be acceptable."

Terrell, an award-winning Chicago-based freelance writer who covers race, gender, health and pop culture, blogs about health for BET.com.

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