Sexual Health Is Health: Living Fully, Without Shame or Stigma

Sexual health is about so much more than avoiding disease. It’s about knowing our bodies, understanding our options, feeling free to ask questions, experiencing intimacy and pleasure, and having care that lets us live our healthiest, fullest lives. That’s exactly why sexual health belongs at the center of public health, not the margins.

This week, Black Women’s Health Imperative President & CEO Joy D. Calloway, M.B.A., M.H.S.A. joined a panel on sexual health as a public health priority, and she got right to one of healthcare’s most stubborn truths: having prevention tools and treatment on the shelf means very little if the people who need them can’t actually get to them.

“When healthcare systems fail to reach people where they are, under-resourced communities pay the highest price. Cost, inadequate coverage, geography, transportation, provider shortages, and the complexity of navigating our healthcare system can all put needed care out of reach.”

That reality carries extra weight as we mark Southern HIV/AIDS Awareness Day on August 20, a day created by the Southern AIDS Coalition to confront HIV-related stigma and push for the resources Southern communities need.

But access is only part of the story. There’s also what happens once a Black woman is actually in the exam room. There’s the stigma that can keep someone from asking about HIV testing or prevention, and the quiet assumptions about who is and isn’t “at risk.” And there’s something that has been missing from conversations about HIV for far too long: our right to experience love, intimacy, pleasure and joy.

Two recent BWHI conversations, with OB-GYN Dr. Tamika Cross and HIV advocate LáDeia McNeal, show why the provider’s view and the lived experience both matter.

The Provider Perspective: Prevention Starts With Conversation

For Dr. Tamika Cross, a BWHI provider ambassador and board-certified OB-GYN, sexual health isn’t a separate category. It’s part of our whole health.

“Part of loving ourselves is really being able to embrace all aspects of us and being the healthiest version of ourselves,” she shared during a recent conversation at Essence Festival. And yes, that includes the topics we were raised to treat as off-limits.

When asked what she wishes Black women talked about more when it comes to sexual health, Dr. Cross didn’t hesitate:

“Prevention, we don’t talk about it enough.”

She added a reminder worth holding onto:

“Talking about these things and educating ourselves on these things is what protects us.”

One of those conversations is about PrEP, or pre-exposure prophylaxis, a medication people who don’t have HIV can take to lower their chances of acquiring it. PrEP is one of several options recommended as part of comprehensive HIV prevention. Yet Dr. Cross says too many women still run into providers who brush off their questions or decide for them that prevention isn’t relevant to their lives.

Her message to providers is simple: listen first. “A lot of times how we respond to patients, that initial response is what can either reel them in or push them away,” she said. That first moment matters, because no woman asking about PrEP, HIV testing or any part of her sexual health owes anyone proof that she’s the “right kind” of patient before she gets information.

Dr. Cross also names the bigger equity problem. HIV prevention messaging wasn’t always designed with Black women in mind, and the result is a gap in awareness about our options, reinforced by stigma that keeps whispering HIV belongs to somebody else. Her response cuts through all of it:

“Everybody needs to have the same access and opportunity.”

And when a provider simply won’t listen?

“Find another doctor. You can fire your doctor.”

It gets a laugh, but she means it. Black women are entitled to healthcare relationships where our questions are heard and we’re full participants in decisions about our own bodies.