DC Ends HIV podcast hosts

Episode #3: MENTAL HEALTH AND HIV

Positive Voices

#3

Mental Health and HIV

January 16th, 2023. 41:10

In this episode, Leah and Malachi discuss all things mental health with Dr. Shanéa Thomas. Mental health and HIV are closely intertwined, but the ways they interact are unique to each person. Join our discussion on therapy, the importance of hopeful stories, trauma, and the need for a sense of power over your health and wellbeing.

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Transcript

Speaker 1: Anytime somebody asks me to like, do a workshop or, or training around HIV, they always want me to talk about the bad things. Like, tell me about the medication and tell me about how people are gonna get sick when we're literally, I say, I can talk about how people are living and thriving with HIV. Like I can do that.
Speaker 2: Hello and welcome to another episode of Positive Voices. I'm your host Leah Henry.
Speaker 3: And I'm Malachi Stewart. My pronoun purposes are he, him, his, and we are here with Dr. Shanea Thomas. Dr. [00:00:30] Schmid, introduce yourself. Tell us your pronoun preferences.
Speaker 1: Sure. My pronouns are he and she. I don't use they and if all else fails, Dr. Thomas is perfectly
Speaker 3: Fine. Awesome, awesome.
Speaker 2: Perfect. I'm really excited to have this conversation today because I think, you know, we're in this kind of resurgence of mental health, right? When we're discussing, you know, in communities of color, mental health, it's, the conversation is expanding and I think it's super important for this podcast when we're talking about positive voices and we're talking about the things that the, the community needs in [00:01:00] a positive space, mental health and HIV I think go hand in hand. So, thank you for joining us today. We're really excited to have you here.
Speaker 1: Yeah, thanks for having me. I'm really excited about conversation today,
Speaker 3: <laugh>. So, with that said, Dr. Thomas, tell us a little bit about what you do. Tell us a little bit about your background.
Speaker 1: Sure. I do a little bit of everything. So, I'm originally from Hampton, Virginia. I came here around 2002, do some work. I wanted to be a social worker, so I went to Howard University. Hey,
Speaker 2: You come on
Speaker 1: School of Social work. And [00:01:30] from there that kind of like catapulted my ability to be able to work in different spaces. Schools were really important, particularly in the work that I do, working in special ed or accessibility services. And then once I was kind of doing this work in schools for a while, I really wanted to move into sexual health, working around educating around human sexuality more. So that came from working with teachers and teacher assistants and administrators. Mm-hmm. <affirmative>. Yeah. Who we were having this in my day, this resurgence of like queer kids coming out [00:02:00] and being out. Yeah. Yeah. And nobody knew what to do to do. Yeah. And I think honestly, in the intersection of that, I was also coming out too. So, I was just like, well, how do I also learn to give a proper service and get proper service? How can I do those things at once?
Speaker 1: Which I went back to school, went to wider university for my degree in human sexuality studies and education, and now I have a doctorate degree in organizational change in leadership. I've been here in the DC area since 2006. So, it's nice to be able to have a home to [00:02:30] where this work can grow. I'm very proud to say that I'm, I'm at University of Maryland right now where I'm their L G B T Q training specialist and assistant clinical professor. And really my job is to take these wonderful products that University of Maryland Prevention Research Center created and really instill it into the community for mental health professionals. Mm-hmm. <affirmative> to be a little bit more competent around L G B T Q work. So that's been great. I have a private practice. I'm also a licensed clinical social worker, so I do the actual work.
Speaker 1: Yes. On top of, I work with organizations, [00:03:00] institutions, different schools and universities around helping them build particularly d e I initiatives. So, a lot of times when we think about d e I, we think about like race and we kind of stop there. Yeah. Um, but nobody necessarily thinks about how gender plays a part in the way that we treat people. How sex plays a part in the way that we treat people, especially when we're talking about social workers, human service providers. So, my goal is just to be a social worker among social workers and to kind of help people be a little bit more competent so we can all give really good care.
Speaker 3: Absolutely. [00:03:30] Yeah. And it, it sounds like a lot of the work or a lot of what fueled your work was sort of providing or being in spaces which you would've needed in that moment. Mm-hmm. <affirmative>, and as Leah said, we're right. We're in a time where like it has never been more acceptable, particularly as black people Yeah. To go to engage in therapy services. For somebody who's watching, who's still on the fence, who's still like, is therapy for me is, is mental health services for me? How do I engage that? What would your professional response be for that?
Speaker 1: Ooh. See, professional [00:04:00] and personal would be different. So, for ok. Wait, wait, wait, wait. I'm here for the, I'm here for the personal too. <laugh>. So, first of all, I would say professional. Yes. Right? Mm-hmm. There is mental health services that are for everybody. You may like C B T or cognitive behavioral therapy. You may like D B T, you may like EMDR, right? Mm-hmm. <affirmative>, there's all these different types of therapy that people can engage in. Yeah. Yes. I think there's all types of ways that people can have access to those services. You know, we are growing now to where we're moving to telehealth. So [00:04:30] there are plenty of telehealth services. Yeah. You also have like particular organizations that also specialize in certain populations. So, you have therapy for black girls. Yes. Therapy for black men. Yes. My friend Erica Woodland created the National Queer and Trans Therapist of Color Network.
Speaker 1: So, there's literally a directory of trans and queer therapists of color. I love that. Who are actually giving services, right? Mm. So, yes, I think all of that is really accessible to people in some ways, right? Mm-hmm. <affirmative>. And then I think my professional opinion is [00:05:00] not for everybody, right? Hmm. Sitting down and actually talking to somebody is not always a proper way to be able to give mental health services. Hmm. You know, even thinking if we're gonna move and talk about accessibility services and talk about neurodivergent people mm-hmm. <affirmative>, when we are talking to certain folks, like talking doesn't get it, but thinking about art, art therapy, thinking
about community groups, thinking about, you know, how can we get you connected school community that like has parties or has like, you know, SIP and paints, or how do we, how [00:05:30] do we get you instilled in a community to be able to support you?
Speaker 1: And that's the type when I'm in therapy, you know, even, even when I'm working with my clients, my skill is always let's talk about who we can connect you to. Right. Because I'm not always gonna be there forever. Right, right. You know, the pro, you know, in therapy, I want to be able to help you instill yourself to be able to take care of yourself in some way, shape, or form. And a part of doing that is community healing. So twofold, right? Yeah. So like, yes. And I think there are other ways outside of sitting [00:06:00] on a couch and talking to somebody that actually provides a certain level of healing for folks.
Speaker 2: Well, and I think that's like an important part. You talked about community and when we're talking about H I V and diagnosis, we know that there's a stigma attached. We know that honestly, a lot of people who are diagnosed with H I V don't want to share with their community due to Absolutely. You know, a plethora of reasons. So talk about, you know, in some of the work that you've done, you know, in your space with HIV, how that stigma can affect people not wanting to be a part of community during that time.
Speaker 1: Absolutely. [00:06:30] I will say that I didn't come into, I didn't come into LGBTQ Q work doing HIV work. Mm. That actually work came before <laugh> getting into doing like LGBTQ training when I worked at schools, particularly when I worked at a high school. I think that was my first like, interaction with kids who were living with HIV. And I was just like, okay. Don't know a lot. Right? Yeah. I come from the generation of like, I learned about HIV from Magic Johnson when I remember right. Back in the day [00:07:00] on BET I'm watching videos and then there's like a break in news and it's like, Magic Johnson has HIV and I don't know what that means. Right, right. I'm a young kid, I'm like 10, 12 at the, at the time and living in the south, you know, particularly having parents from the deep south, they're also stigmas that I was, that I just was taught back in the day.
Speaker 1: Yeah. So now that I'm an adult mm-hmm. I'm in a position of power when I'm teaching and educating and doing social work. And I have a kid that comes to me and it's just like, you know, I just found out that I'm HIV V positive, what [00:07:30] do I do? Yeah. I have to check a lot of my own stuff. Come on. Right. There was stuff that I was coming in with that I really had to think about and work through myself. Yeah. And so I think that, you know, one thing that I have seen, especially in working with other clients is that yes, as much as I connect people to community, that's the important thing, right? Yeah. Finding other people who are like you, finding other people doing, you know, working through the same issues. The struggle is what happens when you leave that community.
Speaker 1: Yeah. That's where the work gets hard, because they don't wanna tell their friends, they [00:08:00] don't wanna tell their partners, they don't wanna talk to their kids about it. You know, even now, you know, when I'm hearing people who are just, you know, we have wonderful things such just pep and prep and I'm having conversations with them even when I'm sitting in a classroom realizing that for me, I'm a professional gay. Right. So it's just like, nah, I'm gay, literally for like, I just, that's part of my job. Right. But when I get into a classroom and talk about PEP and prep, a lot of my heterosexual students have no idea what that is, right? No. And these are the next level of social workers and human service providers. [00:08:30] So I think for one, in, in order to help combat some of the stigma is just really kind of educating our ourselves very early, no matter what profession we are in. Yeah. We're always going to interact with some, you just never know, right? Mm-hmm. <affirmative>, you just never know. And then for two, I think it's really kind of continuing to instill this really strong community within oneself, right? Being able to find places where you can go to get respected. Being able to, to find also positive images in the media. I feel like that's something that I also had to [00:09:00] battle up against. It doesn't matter how much I talk to a client. If you are watching a Tyler Perry film, sorry if y'all are filming, but
Speaker 3: If I, if you're watching
Speaker 1: And you see that, oh my gosh, once I get HIV v, like I'm gonna be decrepit and nobody's gonna want me. Like, yeah, you come to therapy, I can create a safe space for you. But once you leave here, like, what does that look like? Well, what kind, what do you consume that, what do you consume? Right? Like that affects your mental health. And I think that goes back to when we think about particularly science and research around minority stress theory. It's not only about what happens [00:09:30] when I leave a particular place, it's also what I'm internalizing. What am I watching on tv? How are my friends talking about me? I had one client who didn't even want to tell her family because she saw how another uncle was being treated and how he was given like paper plates and like paper napkins. Yes. And everybody else was given Yes. Like, you know, ceramic, you know, ceramic wearing glassware because they were fearful of just like having these old stigmas, like Yeah. Passing it on in certain ways that just don't exist. Right. Without some level of education. So I think it's [00:10:00] hard, like, I think it's hard to be able to maintain a safe space within yourself and community. Mm-hmm. <affirmative> and then the, the lack of safety of what happens when you leave that is really difficult for folks. Yeah.
Speaker 3: Absolutely. I have a question for both Shea and Dr. Thomas. I'm interested in
Speaker 4: <laugh>. Oh, right. Ok. We're interviewing two people. Ok. Right. Ok.
Speaker 1: Live
Speaker 3: For that. So as you know, you, you know, some of my story, I was diagnosed in 2008. It was not a time where mental health service were being heralded. It was a whole different time actually. And [00:10:30] we both worked in some clinical settings together so we know, you know, red carpet services, things like, you know, you test positive and we elevate you to the next level. None of that existed. I literally found that I was positive in the hallway. <laugh> rider saw me in the hallway, told me I was positive that was it. No one connected me to Ryan White Services. I didn't know that there was connection to pay for my medication. Like that. That was a different time. And because I was dealing with the stigma in my own internalized stigma I was dealing with, like, this was a traumatic [00:11:00] event to hear that. Yeah.
Speaker 3: And as black as black men who had sex with men as a queer black man, in some ways it's something that we always know is in a realm of possibility. There's a part of you that's always expecting it. But when it happened, it was so traumatic that I felt like I was stunned. And I remember taking, like the first at o child, at the, at the time, there was only one, one color day regimen. I'll just say that. And it did not work well for me. It's one of the medicines either work really good for you or doesn't. And it, it, my experience even [00:11:30] no one prepared me for it. And I'm saying all that to say that I was going through so much changes mentally, like my mind taking medication, feeling like I'm like sick on it. I'm like, I'm gonna die because I saw movies like Philadelphia.
Speaker 3: Yeah. I, you know, these are my references. And with no one to step in. I'm saying that in juxtaposition to having worked with you professionally, and I know how many clients I have been like, you know, I'm gonna go ahead and forward this encounter to, you know, to Dr. Thomas and let them follow up with you. And, and I've watched your support [00:12:00] change people's adherence to their medication. I've watched your support. There's so many people, so many patients that we've shared who have been diagnosed since the eighties, ci since black women, you know, queer black men, you know, trans women who had never experienced what it was to be undetectable. And now they had this experience. And I know so much of that was the mental health beast. It was finally somebody here to just talk about, to unpack the emotions when you talked about that paper play I have had since hetero women [00:12:30] tell me, like, I came to the cookout and I made the macaroni salad and nobody ate. Mm. Mm-hmm. And they wouldn't eat for my children. Mm. And now I don't go to events and now I don't go outside. Yeah. I've had patients, you know, just develop all types of phobias around going even out the house because of how important have you found in your work is providing these mental health services to HIV positive patients when it comes to their adherence, when it comes to like keeping them retained in care? Like what is, what is your experience been with that?
Speaker 1: Yeah. So important, right? Like having [00:13:00] the space. Like that's make me so happy that people are <laugh>, that people feel that way. I think it's, it's not only Dr. Thomas Shania, right? Yes. Mental health services are important in order for people to feel great. I think the type of mental health services is the difference, right? Mm-hmm. <affirmative>. Because when people come to me, I'm not saying like, oh, you got HIV,you gotta take a medicine. Like yeah, it's, let's talk about why you're not adhering, right? Mm-hmm. <affirmative>, let's talk about like, okay, we can't do all of the medication then let's talk about one pill. Right? Let's make a schedule for you. Yes. I [00:13:30] understand. It's hard. I know every time you take it, it you of this one night or this incident or this person, right? Mm-hmm. <affirmative>, I know these things, right. It's being able to sit literally where the client is, which I think makes the difference in being able to have some level of adherence.
Speaker 1: And as a person who is HIV v negative, I think I had to check myself around how, you know, in the clinical sense, yes, I wanted to make my, you know, make my patient take their medication and for them to be adherent. And once I say, you know, you know why you have to take it, right? Right, right. But it's just like, I have [00:14:00] to understand that if I'm a, if something I'm taking is literally reminding me of a not so great time or reminding me of just like a trick being told in a hallway. Right. If I, if I am able to sit with that person and say like, I understand why this is hard. Mm-hmm. <affirmative> Yeah, that sucks. Yeah. I'm really sorry that happened to you. How can we both empower ourselves in this moment in order to move forward, okay, we're not taking our medication today.
Speaker 1: Cool. We know we gotta take it. Right? So when are we gonna decide to take it? Right? Right. So I think yeah, [00:14:30] being able to put the power back into the person and to be able to have some level of just like, I want to take this back from the experience that I have and not to color that all experiences around being told or bad. Right. Like, I also don't wanna say that, but also it doesn't help when you have a community or you live in a society that is phobic <laugh>. Right. Like, doesn't help. So I think, yes, mental health services is very important. I think having providers that are particularly trained and competent and sensitive and compassionate, it makes the difference. Yeah. Because [00:15:00] you can have a mental health provider and they'd be, I'm crappy. Yeah. See, I corrected myself. See?
Speaker 2: There you go. <laugh>. Yeah. Yeah, yeah. You did well, <laugh>. No, but I wanna circle back cause I think there's, there's something <laugh> really important in what you said. Cuz I don't think I even thought about it like that. Of, of course I've never experienced that as a negative person, but the trauma within the diagnosis. Mm-hmm.
Speaker 1: <affirmative>,
Speaker 2: Can you talk a little bit more about that? And, and Malachi, you know, you as well because I, I think the moment you said taking a pill reminds you of a moment [00:15:30] and that's super deep. I don't like, I'm sitting on the couch kind of stunned at the idea of the trauma that you kind of relive in the sense of like, taking care of yourself. So talk to me about, you know, just your experience with having patients or having people that you treat where it is so much trauma attached to a diagnosis and how people are able to move forward. Cuz I know there's somebody's listening right now who can relate to taking a pill and remembering a night, right? Yeah. Remembering a day that changed their entire life and how they navigate their [00:16:00] lives. So talk to me more about that, cuz that's a really interesting thing.
Speaker 1: Sure. Yeah. It just, it just really changes the trajectory of how you think about yourself and your health, right? Mm-hmm. Again, apart from what we are being told in society, what's being taught in schools, what's being taught in your health classroom. Like, there's no space that I know of in a random classroom where people are just like, it's great. Right? Yeah. You li like, anytime somebody asks me to like do a workshop or, or training around HIV, they always want me to talk about the bad things. Like, tell me about the medication [00:16:30] and tell me about how people are gonna get sick when we're literally, I say, I can talk about how people are living and thriving with HIV. Like I can do that. And I think my lessons around trauma, especially around like medication management and adherence came from kids shout out to kids.
Speaker 1: Like, shout out kids really shout out to kids. Like kids taught me about like, no, I actually don't wanna do this cause I didn't do this to myself. They're very honest, they're honest. I'm not taking, I'm not taking this <laugh>. I didn't do this right. I got it. I was born this way. Yes. Or somebody said something else happened, [00:17:00] I didn't do this. Yeah. So I'm not doing, I'm not doing that. You can't make me. So that was really my push of being able to figure out how do I help you regain a sense of power around your medication. Right? How do I, it's, maybe it's not about the pill, maybe it's about your health, right? Mm-hmm. <affirmative>, how do we wanna be healthy? How do we wanna think, you know? And, and, and a lot of these kids that I have, like they're in relationships. Like they're out here and they're having sex. Right? Right.
Speaker 1: As people who are educated around their bodies and have body autonomy. Absolutely. Should, right? I'm [00:17:30] gonna have the same conversation with you that I have with any other 16, 17, 18, 19 year old, right? Yeah. No matter what your status is, I'm gonna talk about taking care of yourself, I'm gonna talk about barriers, I'm gonna talk about the health of other person. We're gonna have healthy conversations. Like, that part does not change for me. Yeah. But I think the thing that I had to again, realize is that I had to meet people where they're at. It's hard, it's hard to even take a birth control pill every day. <laugh>. Right? It's like talk to talk to the girls out here now. Like first of all, it's even hard to do that, but to take something [00:18:00] that literally sometimes makes you sick, right? Mm-hmm. <affirmative> sometimes doesn't feel well that, that you have to literally stop in your day for 2.5 seconds to think about this one moment. Like I, I had to realize for me as a person who doesn't have to do that Yeah. How hard and difficult that is and sit, sit in them with it. So Yeah. Yeah.
Speaker 3: Yeah. And, and I, and I of course don't represent a collective, right? Yeah. But I do represent a lot of people and I saw it in, in a lot of clients, stigma says it's your fault. And so [00:18:30] if I am taught that I got this because of something I did mm-hmm. <affirmative> and I'm wrong, am I even forgiving myself enough to deserve what undetectable means? Mm-hmm. <affirmative>. That's what people don't realize. We're not even there. It's going through and when you don't have a outlet for the conversation mm-hmm. <affirmative>, you know, when I, when I, when I became positive, we were calling it the monster that was the nickname for it in the community. And I remember telling a friend and he was like, and Memphis, this like with full empathy, <laugh>, like, you got the monster. Mm. But you gotta think about the words, the monster, like [00:19:00] the fact that it's being connotated, like that's the connotations around it.
Speaker 3: Yeah. Right? Like what did that make you feel about this thing? Mm-hmm. <affirmative> that really, you just had sex honey, you didn't do nothing that like I had sex. Yeah. Unprotected the same way all of our parents did. Cause that's why we sitting here. Yeah. Like, you know that, but you're taught that your sex means something different. So what does it mean for not only like my deserving of this medication and this treatment and what it provides for, but what does it mean for my community deserving that? Because I didn't know ci, he people who [00:19:30] had it until I started working in the field. And I would say how I know that carried into my work, and I remember this kind of being a funny thing at first because I was calling patients sometimes just to say, you know, remind 'em of an appointment. But I would always, because I'm positive, I would always just say like, how, you know, how are you doing?
Speaker 3: How's your day? How's your And I patients would have go into full crisis. They would go into full crisis. Like, and I'm like, I just said good morning. How you doing? Because people are so used to treating people in a sterile way. Mm. And [00:20:00] when you know that you might be the only person that's calling this person and ever saying like, how are you? Right. How's, how's the last two weeks been? Yeah. How, and like people are really able to, to share with you in a way, cuz nobody's asked that before because No, and that's, I'm saying that to stamp the work. I'm saying that to stamp that mental health on whatever level that you engage it is so important because people would expect you toce convert to, to become positive mm-hmm. <affirmative> and to just snap into this regime of like, I'm a machine that's gonna take this medication. No, I need like emotional support. Yeah. I need [00:20:30] like an outlet. My spirit needs to be made. Right. I need to be affirmed. I need to, to know that my worthiness has not changed. And if you're not speaking to that, yeah. A person is sort of left in a space of like, you know, what do I do? So I think that's definitely important to, to really stamp the word.
Speaker 1: Yeah. And I will say also to that like, you know, a part of being able to do that level of check-in is, is having a sense of empathy. Right? Like I know where you are. I know, I understand. Absolutely. I think for me, something that I had to check due to all of my places [00:21:00] where I've got my in information, right? HIV like I had to check simple things like body language. I had to think of how I talk to people when my kids would come into my room. Like I had to, like I remember doing this like at first and I had to check myself. Yeah. Again, when you don't have the education, when you are not knowledgeable, ignorance, like subconsciously you, you can really like spread English and because of the level of heightened stigma, you know when that happens, right?
Speaker 1: Mm-hmm. You see those things happen to other people. Yeah. So just like I would start [00:21:30] having lunches with them right? When they would come in the hallway and they'd be like, Hey Ms. Thomas, like, you know, I'm gonna shake your hand, I'm gonna touch you. Like we're gonna, we're gonna actually be close to each other. Mm-hmm. And when I have my client, you know, when I have my adult clients, like, we're gonna talk about intimacy. We're not gonna move away from any of these subjects. Yeah. Cause you're positive. Like you still need to be touched and loved and have compassion just like everybody else. So I, you know, again, it goes back to the to mental health piece where it's just like, it's not just how much you know. And if you have a degree in this and if you went to a training or two Yeah. It's literally doing the internal work of [00:22:00] undoing all of that stuff that you have learned from your parents, from your parents parents, from what you saw on tv Yeah. From the movies that you watch. Like, it's really important to do some of that
Speaker 2: Work too. And I think one of the things that is important that you said is about kind of what you consume. Cuz we we're talking about the media, right? As somebody who's a media personality, when people talk about the big bad media, right? Like, I think that everyone kind of assumes that there's this like agenda. But the reality is, is I think it's also a part of the consumption, right? Mm-hmm. <affirmative>, because you know, like you said, 20 years [00:22:30] ago, HIV was the monster, right? Even, even shortly as 10 years ago, right? But as we're moving now, I don't think there's necessarily a negative connotation, but I don't think there's a positive one either, right? So now it's like, okay, we won't make it so negative. Right? But we, we aren't making it positive, right? We don't see people living with HIV thriving, we don't hear the success stories.
Speaker 2: We don't have these type of conversations. And I think that that's so important too about what you're consuming because you talked about, you know, people pouring into you or the community. [00:23:00] But I think it's so important that you find someone in resources that are going to pour into you in those moments. Because again, like you said, even when you first started working with children with HIV, even body language said something mm-hmm. <affirmative>. So again, when people who are listening are trying to find healthcare providers or are trying to find outlets, it's so important for, you know, like, I'd like to say like who's pouring into you the glass that you're receiving that, that message from? Because again, some people might not know how to [00:23:30] handle, you know, people with H HIV V and like handle people who are living with HIV. And I think it's so important that you find providers and you find healthcare, like you said, there's therapy for black girls.
Speaker 2: There's therapy. But find someone who truly understands your plight, where you're at in your life. And that's, that's at, at all capacities. Not even just your status, but more so like who you are as a person. Like for me, when I went to therapy, I wanted my therapist to be a black woman and she had to be fat. Mm-hmm. <affirmative>. Mm-hmm <affirmative>. Listen, if you can't connect with me, cuz you're not gonna understand. If you've been skinny your whole life and you go to Orange [00:24:00] Theory every day, you're not going to be able to understand my play as a fat woman. Right? So, you know, it was important for me to find someone, you know, who's taking care of my wellbeing and my mental health to identify in the same way that I have that I do. So minimally, if you're listening to this podcast and you, you want help and you're looking for someone who's going to facilitate your care and your status, make sure you know that the person is not ignorant. Cuz let's be real, there's a lot more ignorant people than there are educated people. Yeah.
Speaker 1: So, and ask questions. Yeah. Like, I [00:24:30] also have to tell like my clients or people who are looking for like therapists, like ask questions. Mm-hmm. <affirmative> like, Hey, what is your experience around working with? Interview them. Interview them.
Speaker 2: I tell people that
Speaker 1: All the time. It's almost like dating. It's just like, hey, literally we got it because I'm about to tell you all of my businesses my
Speaker 2: Life, <laugh>.
Speaker 1: Ok. So in order for you to know my or have access, right? Mm-hmm. <affirmative>, because for me, I treat doing therapy with folks as a privilege, right? Mm-hmm. <affirmative>, you are coming to me for 50 minutes and we are talking about some of the things you are probably never talking about with anybody, anybody else. And so in [00:25:00] order for me to have access or to have that level of privilege and honor to be able to work with you, please interview these folks who you're working with. Like please ask very thorough questions. Mm-hmm. <affirmative>, because you're right. Like you can go to a perfect person and they might be black and a woman and fat. Mm-hmm. <affirmative>. And then you get there and then they start pushing diet culture. Right. <laugh> like, and that's not what you're looking for, right? So, right.
Speaker 2: Yeah. Well no, and that's what I tell people all the time because a lot of times, like we said with this, you know, resurgence and everybody starting to look for therapists, you know, a lot of my friends are like, Hmm, I went to this lady and you know, I didn't really like her. And I'm [00:25:30] like, it's literally like a first date every time. And it's unfortunate because you get there, they ask you all these questions about your past and it's like, you know, emotional off-putting, right? But it's like a date to me. Like you go on a date, you invest that time, you sit there at the table, the person could be a complete ass, but at the end of the day, you went on the day to figure out if that's your soulmate, right? Yeah. So the same way with therapy, I kind of look at it like, yeah, you do for that whole hour. Kind of sit there and, but it's important because if you do find your match, it's gonna change the trajectory of everything you do moving forward. Yeah.
Speaker 1: [00:26:00] And I, let me, this is a sh shena talking. Okay. So you also don't have to find always your perfect match, right? Mm-hmm. <affirmative> sometimes the date is sometimes like this is okay for this week <laugh>. Right? So I don't, so it might be casual. Like I might go in and I might not want to go in and talk about like my deep childhood trauma because maybe I did that work somewhere else. Absolutely. Or maybe I have a group of people who support me around that. Absolutely. But here I might wanna talk about being diagnosed. Mm-hmm. <affirmative> here. I might wanna talk about coping, coping skills here I might wanna talk about my anxiety here. [00:26:30] I might just need you so I can have access to my medication through a psychiatrist. Right? So, you know, <laugh>, we know everything doesn't have to be deep sometimes, you know, and this is also, you know, this is coming from a person who really also talks about like, like polyamory. Like not everybody can meet with
Speaker 5: Your hands, right?
Speaker 1: So sometimes you pick, you know, this is this session that I'm having with you or this relationship is really for this one thing. Mm-hmm. <affirmative>. So I also wanna encourage people like, yes, we want people to have deep relationships with their therapists. That's great and fantastic. Yeah. But not everybody [00:27:00] needs that. Hmm.
Speaker 3: I've not always had that. I've had really, I've had, okay, so for a while it was me. You needed to be a black woman so that you could get me. I needed to be safe <laugh>, I needed a safe space. Black women have historically been a safe space in our community for, for particularly, for particularly as a black queer fme. Like it's, it's the women who'd be like Lee baby alone, <laugh>. So, you know, you feel like, I feel like I need to be connected. That's good. And I, it halted me for a at a point cuz [00:27:30] I was like, I can't find no more black women. And I remember the first time I had this like white guy who was from like mm-hmm. <affirmative>, I wanna say like Lancaster B and he tried to connect like we were both from Philly. I was like, no cuz that's Lancaster.
Speaker 3: Mm-hmm <affirmative>, not to be confused, but was one of the most effective therapists I had because he served another purpose. And I immediately just saw it when we were talking. I was like, you serve another purpose. There is something that you have to give to me that they did not have. Absolutely. This will be no boo boo here. Absolutely. This is, this was like, so [00:28:00] why you keep doing it? So why you keep you gonna stop? Cause I know you know better, like oh, oh, oh, I do know better. So I definitely can, can appreciate that. Right. I definitely can appreciate. I have a question for you because we talked about, and you, when we talked about kind of like that having a person be empathetic, you hit on the like para verbals, watching your body language. Love that you said it cuz I watched that in providers.
Speaker 3: And it also teaches you it's more than what they're just saying. It's also teaching you what professionals think about you. Yes. If I trust you as a professional and your [00:28:30] para of verbals is like jumping back, then I believe I'm untouchable. Yeah. This, this goes into, this goes into the back of my mind, this goes into my subconscious, right? Mm-hmm. <affirmative>, how do you think that spills into disclosure? Because for me, admittedly, disclosure was a hard thing. It was a hard topic. I did not get this from the professionals. Mm-hmm. My community had to help me with that. How do you think that spills into, how do you think that affects disclosure? How we're handled or like how, how we message to, to patient.
Speaker 1: Sure. Chanel will talk cuz I, I think something, I think [00:29:00] I had an incident where I, I learned this where I was with somebody that I was dating that told, that told me that they were, that they were positive. Okay. Really kind of along the lines that we were, that we were dating. And I, I think at the time I was not as educated as I was now. And so listening to them tell me, I kind of like blacked out a little bit.
Speaker 5: Like I was just like, whoa, what's happening? I don't understand. Like my, my mind goes all the way back to North Carolina and right by and Magic Johnson. I was like, oh my guys like, what's happening? Right?
Speaker 1: And so then I had to like stop [00:29:30] myself and then bring myself to, and then I remember getting up and hugging them and I remember when I got up to hug him, he jumped and I was like, dang. I was just like, I was like, first of all, thank you for, for telling me like I really appreciate you telling me. And I was just like, and now I'm realizing that one reason why you sat so far apart from me to tell me is because you thought I was gonna get up and I was gonna hit you. Yeah. And that blew my mind because I was just like, oh shoot. Like [00:30:00] I'm, I'm sure it was hard for you to have this conversation with me and so you are already prepared to be met with violence. Mm-hmm. <affirmative>. And that's what I hear from my clients. Like they are always in some way, shape or form be prepared to be met with violence every time with, you know, with cursing, with calling them names, with people, telling them that they're dirty.
Speaker 1: Like that is what I hear. Mm-hmm. <affirmative>. And so when, the part that I feel like plays into disclosure is that people don't like, people don't, and they make a choice not to. I think as [00:30:30] a clinician, I am all about body autonomy. I'm all about you making choices for yourself. So some people who choose not to, especially if you are undetectable, if that is something that you choose to do, that's fine. And if you want to have those conversations, if you feel like you're having a conversation and you're not too sure how it goes, like make a safety plan <laugh>. Right? Like yeah. We just never know how people are going to react. Yeah. But also I hope that you get to a point in a relationship with a person and you're having a, and and you get to know them well enough [00:31:00] to where if I do tell you like, you're not gonna hurt me, right?
Speaker 1: Yeah. You're not gonna call me these names, you know, and understand why I didn't say anything or that I'm saying something now or that we're actually having this conversation with each other. Yeah. So yeah, I think that even as a, as a older adult and kind of going through the years and seeing people having to disclose not only in per in intimate relationships, but with their doctor, right. So going from, you know, going from being HIV v negative HIV v positive, like it changes the way that doctors see you. It changes the way [00:31:30] the treatment happens, it changes, you know, it affects all the rest of the things that are happening in your body. It does. Um, you know, so, so it's just like, it it, and now we have to get more care. We might need to take more medications. Like some people just don't wanna go through that. Yeah. And, and if you are a person who is ill or chronically ill, like I get that. Yeah, I get that. I understand that. So I, yeah, I think that disclosure really is affected by, again, this whole societal aspect of how we think about people with H I V. But I, I, I really wish that in communities we had more [00:32:00] sensitive, compassionate conversations about how to support people around disclosure when they want to. Like I think that's
Speaker 3: Something great. Yeah, I absolutely agree. I think admittedly I was horrible with disclosure at first. I was not telling you mm-hmm. <affirmative>. And so, so my first like plan was like, I'm going to be super upfront and I'm going to let them know. Cuz it was a time where it was a time and not even the segue, but when protection just meant condoms mm-hmm. <affirmative>. Mm-hmm. <affirmative>, you know, we live in a time now where protection can mean what does it mean to you, you know, protection, you know? Yeah. But [00:32:30] at that time we were just looking at condoms and so I was like, I'm gonna be ready upfront. And it didn't go well. Mm-hmm. <affirmative> a lot of the times. Mm-hmm. <affirmative>, I get why they were ready to you. You should have to be ready to knock if, if you buck, if you're gonna have that conversation because people Yeah. It sometimes will unlock their worst selves and that is usually not personal. That is usually like community thing. That's how what you learn.
Speaker 4: Yeah. The reaction,
Speaker 3: What we learn to feel about each other. Yeah. What we learn Now all of a sudden, it doesn't matter who you are, you are the worst of the worst. You're the worst of whatever they, whatever your community believes about the games and the queers. And [00:33:00] so I get that. And that was why I was really, really horrible. And it was, it was some eldership like I remember I had, I had messed up. Mm-hmm. And I didn't disclose in a situation and then the person came to me and disclosed and I was like, oh, me too. I'm about detectable. And they were like, excuse me,
Speaker 4: I know you didn't. And
Speaker 3: I mean, elder read me for Phil. Yeah
Speaker 4: We need 'em. But <laugh>,
Speaker 3: They picked me up. I mean I came, they were like, come over and I was like, is the hook [00:33:30] up again? No,
Speaker 4: Not the hook. <laugh>.
Speaker 3: And they had books ready for me. I mean really like so ahead of the time and was just like, listen, and, and said something to me that may not resonate with everyone but changed everything for me. They were like, if a person rejects you in this space, then they don't deserve you. Yeah. That was powerful for me. Only because it meant, you know, I shared with you all that like what that means to get the diagnosis and the whole monster and all of that. How that speaks to self-worth, [00:34:00] worth and worthiness and forgiveness. All those things. That was a reiteration of like, you rebuilt my self-esteem. That was a no, you are still worthy. Yeah. He didn't say all of that. That's what it was saying to me. And it was like, oh I am, and I remember the first time happy at his house cuz somebody was hitting me up on Grindr way before Grindr had the little options. You know, grinder
Speaker 4: Jay, now you put it in
Speaker 3: Back in the day, mind your business. Do not wear my how old I am
Speaker 4: You a OG grinder? No, OG OG. Grind grinder. OG grinder. Okay.
Speaker 3: OG hookup apps.
Speaker 4: <laugh>
Speaker 3: The [00:34:30] originals. And I remember like telling somebody ahead of time, Hey, you know, this was in Con County two child, so you know,
Speaker 4: <laugh> what like DC
Speaker 3: Because we talk about another episode, but where you are changes things.
Speaker 4: Absolutely.
Speaker 3: And, and I remember saying like, you know, just so you know, I'm undetectable positive, you know, take my medication, blah, blah blah. And the first time I was like, yeah, cool, that's fine. I was
Speaker 4: Like, oh my cheese back <laugh> husband back.
Speaker 3: It changed the disclosure, the [00:35:00] conversation for me and it changed my confidence with it. And I, I don't know, it hasn't always been positive and everybody has not like pulled out the roses, but I just didn't care after a while. Yeah. I was like, you know, I learned to actually, I was a, you know, working at health at low level, working at like a health worker and the HIV testing counselor. So I had a little, I used to keep in the notes in my phone a little like spiel that I had. A person was like, oh no, I'm okay. I was like, okay, cool, cool. But listen, if you need to get tested, this is a great place to
Speaker 4: Like go.
Speaker 3: You should know your status and people won't tell you about it. And here's the sensing about where we live, 50% of the [00:35:30] people here. Like, I wanted to have the conversation because if yous that scared know that I'm the one that told you, yeah. Most of these people are not gonna have, have that conversation with you. So I appreciate you sharing that about
Speaker 1: This. And, and, and maybe, maybe I have a question for you. So what I'm seeing is a shift in that mindset of being able to tell like, or being able, like for some people now, especially because now we have pep and prep mm-hmm. <affirmative> and people are undetectable. Like some people are, are, I'm now meeting people with the mindset of I am living with a chronic health condition. Correct. And so I [00:36:00] don't, and I'm taking medication, I'm managing it, you know, there's no way that I can pass it to another person. I don't feel like I need to tell. Like, is that the, is that something that you are seeing with people who you're
Speaker 3: Interact? I'm seeing it and I think it's valid. I would like to stand that. I think that's valid. If undetectable is not transmittable, then how was it your business? No. Gotcha. You know, like, I mean to the point y you know, I, I think that's fair. I enjoy disclosure. Mm-hmm. <affirmative>, I do, I enjoy disclosure because I need to see your response. Mm. So I can know if I want [00:36:30] to have you planned in my face or not. Because
Speaker 1: It means more. Right. I'm looking, it's not just the interaction, it's Right.
Speaker 3: I'm looking for the response. Get into this. Especially because with myself, I'm very openly positive. Mm-hmm. <affirmative>. So if this is uncomfortable for you, you gonna be uncomfortable. Yeah. I've had partners, a lot of my relationships have been with people who are negative, like, so discorded relationships. Mm-hmm. <affirmative>. But however I've had relationships with people who are positive, who are like, love it for you. Great. I'm not comfortable with how much you share. Mm-hmm. Because it may my friend ask me questions. Yeah. [00:37:00] You should be with somebody else. So for me, wow. Personally not, and that's why I wanna again make it, it is a personal thing. It's about, you know, just knowing who, who you are, knowing how you show up in the world mm-hmm. And making decisions according to that. I also support people making decisions in accordance with their safety. Cuz it is not the same everywhere. And, and that's even in the D M V. It depending upon when you are, it can change drastically how safe it is for you to disclose or, and, and we still live in a time where if you're in an area where people are not educated, people will spray you, people will see your news and [00:37:30] they will make you the newsfeed. Yeah. They will go on Facebook. So I would never, I would never tell anyone to, to disclose. Yeah. Necessarily.
Speaker 1: And I also wanna add in case people are listening and they're like, oh my goodness. Like, you know, I'm, I'm really concerned about like, you know, people not telling or x, y, and z. Like, but, but for me, and then, then the encouragement I have is then you can do something about that. Right. Right. Like that, you know, it, it's having a conversation with your healthcare provider, making sure that you're getting texted regularly. Making sure, you know, and I, you know, as a person who was assigned female birthing [00:38:00] also takes prep. Like I tell people, like I tell, tell them about my story around like, this is why I do it. This is why I protect myself. You know, so there are choices for everybody around Absolutely. How you want to exist. So I, I don't want this to be a conversation where it's just like, oh, people just out here running rampant and not telling nobody. Yeah. It's just like <laugh> maybe. But also there's things that everybody individually can do. Yes. In order to, in order to take care of yourself.
Speaker 3: Absolutely. Cuz that's, it's your responsibility also.
Speaker 1: It's your responsibility. Yep.
Speaker 3: Absolutely. Yeah. Well
Speaker 1: We wanna thank you [00:38:30] so much for coming on today. Oh, that was it. Yeah.
Speaker 2: The clock went by. But we do wanna ask, let everybody know where they can keep up with you. Follow, you get in touch or just, you know, have a confidant in you because you are giving, let's talk, let's chat sis. Okay. Yeah. So let everybody know where they can, uh, follow you. You do social media or your website?
Speaker 1: Sure. So you can find me on Twitter at doctor_ Shanea. I am at University of Maryland School of Public Health in the Prevention [00:39:00] Resource Center. So if you Google us I am there. I will pop up as their LGBTQ Q training specialist. I'm on Facebook, I'm on Instagram. Oh, I don't know what else. Christian Mingle. No, just shout TS Madison. But no, I don't, I don't have any, anything else. That's where you can Google me. I'm around. But this was great. I really appreciate having these like nuanced conversations, especially. Absolutely.
Speaker 2: Absolutely. You Thank,
Speaker 3: Thank you again for coming Shanea. I really, really appreciate you in the conversation. And for those that are listening at [00:39:30] home or watching this podcast, please log into dcendshiv.org/podcast. You can find that right here in front of me. For those who are listening, you can find us dcendshiv.org at your earliest convenience.
Speaker 2: Yeah, absolutely. And make sure you use the hashtag positive voices. We wanna hear from you. We wanna know what you want us to talk about next. If you have a guest or if you wanna share your story with us, we would love to, you know, have you join Positive Voices. So thank you so much for tuning in and we'll see you next time. Positive Voices is produced by Chris and Tiana. [00:40:00] Our production team is led by C3 Creative Agency.

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Dr. Shanéa Thomas
LICSW, LGBTQ+ Training Specialist and Assistant Clinical Professor

Dr. Shanéa Thomas, LICSW (He/She/Dr.) is a seasoned scholar-practitioner with more than 15 years of professional social work experience in the Washington D.C. metro area. His main commitment is training and strategizing with social workers, educators, and service providers around building safer therapeutic and educational spaces for all people. This is especially for those working in communities who are underserved and under resourced, and those identifying as Black, Indigenous, people of color, and LGBTQI+ folks. Dr. Thomas has facilitated over 60 workshops centering DEI needs, grief and loss, mental health, sex and gender, and LGBTQI+ populations.

When creating organizational change through strategic planning, Dr. Thomas' work unapologetically centers marginalized voices with community organizations and healthcare institutions to help shift power, privilege, and organizational accountability. Dr. Thomas has been a Senior Lecturer within the University of Southern California's Suzanne Dworak-Peck School of Social Work for the last 10 years, and has recently been appointed as the LGBTQ+ Training Specialist and Assistant Clinical Research Professor at the University of Maryland School of Public Health’s Prevention Research Center.

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