Our Squad, Our Village

Just like our ancestors moved North for better economic opportunities and to leave the hardships of the South, we too are moving up in the world by seeking better treatment and leaving high infection rates behind.

Up to this point, RoyalTea has hydrated us with tools for self-care and finding the right accountability partner to keep our care in check. The next person to recruit into your tea time crew is a medical professional.

And no sis, this isn’t just us Googling the closest doctor to us; we wouldn’t do that for a restaurant to get food or a salon to get our hair styled. In fact, many of us don’t make any vendor decisions without testimonies from friends (and maybe an assist from Yelp).

So, don’t make a decision about a medical provider without the same investigation. Ask your friends and family, meet with medical professionals, and procure as many opinions as possible to determine who is the right fit for you. The questions you ask about your doctor today may be the answer to saving your life down the line.

Not sure where to start your investigation?

EXERCISE:

Ask women in your circle for referrals, and if you want a place to start, here are 3 questions to ask:

1. Do you feel safe and comfortable having honest conversations with your doctor?
2. Would you recommend your doctor/nurse/clinic to a friend?
3. When was the last time you saw your doctor/nurse or went to your clinic?

So, you’ve found the doctor, now it’s time to prepare for your appointment.

Prepare For Your Appointment

This means more than wearing clean underwear and socks because studies have shown that Black women are less likely to be trusted by doctors.

Don’t believe us? Just ask Serena Williams.

Serena brought her tenacity from the tennis court, to the delivery room, to ensure her safety during childbirth. No doctor or nurse could convince her she was alright when her body told her something was wrong.

Black women, we have to be the champions of our well-being. We have to march into our doctor’s office like we’re the drum major for an HBCU band and our appointment is the half-time show. Blow the whistle to raise attention, questions, and awareness if you feel something isn’t right.

How many of us have felt something wrong but been scared to say it? (Raise of digital hands)

How many of us have expressed that something is wrong only to be told not to worry as it wasn’t a big deal? (Raise of even more digital hands)

Sis with the twists, you aren’t alone.

Sis with the press, you aren’t alone.

We aren’t alone.

Doctor’s appointments can intimidate and/or frustrate the best of us. It’s not that we are weak. It’s because really, who wants to admit or find out if anything is wrong?

Black women are often characterized as being outspoken, but we can afford to be more “Upspoken” when it comes to conversations with our doctor. None of us can afford to keep quiet in this scene.

Need a script? THIS cheat sheet will have you feeling like you’re Viola Davis interrogating a witness on “How To Get Away With Murder.”

1. Practice setting boundaries; remember, our bodies are gardens and it’s up to us to provide proper fencing. Let’s learn the sexual history and testing status of the people we’re intimate with to reduce the risk of infection.
2. Know the truth about how STIs are transmitted. We already know about sexual transmission from Sip 2, but we’re at risk of infection whether we are sexually active or not. For example…
   • HPV is not transmitted through bodily fluids, but rather through skin-to-skin contact (HPV Upspoken Article).
   • Many STIs are spread through contact with infected body fluids such as blood, vaginal fluids, or semen.
   • They can also be spread through contact with infected skin or mucous membranes, such as sores in the mouth.
   • STIs transmittance can also happen when sharing needles or syringes for drug use or beauty regimens such as ear piercing and tattooing, etc.
3. Know the available immunizations, vaccinations, and considerations for your care, just like you know the lyrics to your favorite Anita Baker or Cardi B songs.
   HPV
   • The good news about HPV is that there’s a vaccine, a vibranium , that we can use (Source). There are more tips and sips in this Upspoken Article too.
   • Just like Michael B. Jordan was trying to get the vibranium in Black Panther, we can seek out this vaccine as it can protect us from some HPV types that lead to cancer and genital warts. In fact, 80% of cervical cancer cases and 90% of genital warts cases are caused by specific strains of HPV (Source), making this STI a bigger villain to combat than most of us realize.
   • So now that we know to consider the vibranium that is the HPV vaccine, let’s discuss its use. The vaccine is a series of 3 separate shots received over a span of 6 months. Everyone from 9 to 45 can get the HPV vaccine, so mothers take your daughters and sisters take your sisters. Shoot, take everybody. While it is recommended that we get the vaccine before becoming sexually active, anyone 45 and under can consider it. If we haven’t heard this mantra enough while sipping this tea, let us pour this thought one more time; it’s never too late to utilize all the available tools to promote our sexual health.
   • It should also be noted that while HPV vaccines protect against cancer-causing strains of the virus found in the overall population, these are not necessarily the strains most likely to be found in Black women. Because of this, the HPV vaccine may not work as well to protect Black women against the virus and cervical cancer (Source). This being said, condoms plus vaccine are a great way to armor us from this STI.

   Hepatitis

   • We can call this section the good news channel as both Hepatitis A and Hepatitis B have vibranium-like vaccines too.
     • Hepatitis A
       • The Hepatitis A vaccine is brewed with killed Hepatitis A viruses that stimulates our body’s immune system to produce antibodies against the virus. And sis, it works fast! For most vaccine recipients, the antibodies start to develop immediately after the first dose. But that doesn’t mean you can put your guard down yet. The vaccine does not reach protective levels for 2 to 4 weeks. For maximum security, a second dose of the vaccine is recommended at least six months after the first, to provide prolonged protection (Source).
     • Hepatitis B
       • Think of the Hepatitis B vaccine as “vibranium plus” as it has reduced the number of new cases of Hepatitis B by more than 75% in the United States. How does it do this? The Hepatitis B vaccine brew contains a protein (antigen) that stimulates the body to make protective antibodies. What’s the tea on process? Examples of Hepatitis B vaccines available in the United States include Hepatitis B vaccine-injection (Engerix-B and Recombivax-HB). Three doses, taken at 0, 1, and 6 months, are necessary to assure full protection (Source).
     • Vaccinations for HIV and Herpes (HSV)…Yes, girl yes, they are in development.
4. Review which tests screen for which STIs and the CDC recommendations about testing frequency
   • Each STI has its own test. STI testing may include (Source):
     • HIV – A cheek swab where you rub the inside of your cheek with a soft swab.
     • Herpes – A physical exam where your nurse or doctor looks at your genital area to check for warts, sores, rashes, irritation, or discharge. Any sores are tested by taking a sample of fluid with a swab.
     • HPV – A swab of discharge or cell samples from your penis, vagina, urethra, cervix, anus, or throat.

Our RoyalTea power has encouraged us to have difficult discussions with friends, family, ourselves, and our accountability partners.

There are two more people to add to this discussion, and no, we’re not adding them because we want to have our business on the street.

Our medical provider and sexual partner(s) are not exempt from the tough conversations we should have about our health to strengthen our care.

Let’s put our Annalise Keating persona back on, see below to view scripts for tough talks we need to have with your doctor and partner.

Other “sips” that can be taken into the dialogue with our doctors are below:

1. In most cases, STI screening is NOT part of your normal health care, so be proactive and ask your doctor to be tested.
2. Do not assume that an STI panel will include all the tests you would like (be specific in asking your medical provider for exactly what you want).
3. For comprehensive STI testing, you may request the following tests:
   • Chlamydia
   • Gonorrhea
   • Syphilis
   • Herpes
   • HIV
4. Do not assume that your doctor is taking an HIV test because your blood has been drawn.
5. Ask your doctor to test you for HIV annually (even if you feel you are not at risk).

Now that we’ve nailed the questioning with our medical provider, let’s bring our next witness to the stand, your sexual partner.

In addition to asking our partners about the tough questions about getting tested, below are more Qs to ask our mates to maintain our sexual health:

• How do you feel about abstinence?
  • Abstinence is the temporary or strict avoidance of all forms of sexual activity.
  • To those of us interested in making this choice, we need to have this conversation with our partner.
• Are you down for monogamy?
  • A mutually monogamous relationship where both people have been tested for STIs is generally considered to be one of low STI risk (Source).
  • Trust is one of the most important things in a relationship—do you trust your partner?
  • In a monogamous relationship, it’s more comfortable to get tested for STIs together.
• What are your preferred sexual practices and boundaries?
  • Anal?
  • Are you a pain is pleasure type?
  • Dominatrix?
  • What type of lube do you prefer?
  • To have sex when on my period or abstain?
    • To those who think bloody sex is safer, you can actually still get pregnant when you’re on your menstrual cycle. However, there are benefits such as:
      • Shorter, lighter and less painful periods
      • Reduced stress
      • Improved sleep
      • Improved immune system
  • What drugs, if any, do you use or experiment with?
    • To those of us who are dating someone who is using drugs, evaluate the risk of infection, especially if they use needles.
  • What’s your STI history and current status?
    • If they don’t know, or haven’t been tested in the last 6-12 months, they should join you at your doctor’s appointment.
    • On the other hand, if our partner shares that they have been tested recently, then we should ask to see their results.
    • We covered this in Chapter 2, but thought it was worth the stutter; knowing the HIV status of your sexual partner is well within your rights. To protect yourself, you can ask your sexual partner to get tested before becoming sexually intimate. To protect each other, make sure this dialogue is a two-way street.

EXERCISE:

Ask these tough questions to your medical provider during your next appointment and with your partner, tonight.

Check out the resources section to go deeper on this topic.

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