Growing up in South Los Angeles, Precious Jackson said she was attracted to the bad boys. "My father was a bad boy," she said. He was a hustler, a pimp, a drug addict. But Jackson also saw him as a gentleman who provided for his family. "I chose guys that emulated my dad," she said.
The men she dated offered an escape from life with her overprotective grandmother, who raised her from the age of 5. "They had to be from the streets; they couldn't be a square," Jackson said. "I had to have some excitement."
The excitement ground to a halt in 1998 when she received a letter from her then-boyfriend, who was in prison for drug possession. He was HIV-positive, he wrote. Jackson had tested negative before the relationship began. Her next test came back positive.
Until that day, Jackson thought only three types of people contracted HIV: gay men, injection drug users and people who slept around. She wasn't any of those, so hadn't thought herself to be at serious risk. But suddenly she was HIV-positive at age 26, and the virus had come from someone she trusted.
Now 40, Jackson considers HIV education her calling. For the last five years, she has worked with the Los Angeles-based Center for Health Justice, where she directs Project HOME Los Angeles. The program, whose name stands for Healthy Options Means Empowerment, serves women whose male partners are behind bars or have a history of incarceration. It teaches them how to become peer educators for the other women in their lives.
Jackson trains women in strategies to protect their physical health from sexually transmitted infections and to manage their emotional health and build better relationships. Self-esteem is not just a feel-good buzzword, it's a key tool in HIV prevention, Jackson said. "If a woman is not emotionally balanced, then she would find herself making unhealthy choices which will increase her risk for acquiring HIV."
Over the last three years, Jackson has guided 307 women through the program. Like her, many are black, facing one of the highest risks for acquiring HIV. Black people make up 12% of the U.S. population but account for nearly half the nation's HIV cases and almost half of new infections. In 2009, black women accounted for 64% of new HIV diagnoses among women.
Prisons and jails are also an important front in the fight against HIV and AIDS. William Cunningham, a professor of medicine and public health at UCLA, described jails as a revolving door between the criminal justice system and the community. A small percentage of inmates may contract HIV in jail or prison, but most face a greater risk of acquiring the disease through their behavior on the outside, Cunningham said.
When inmates get released, "one of their highest priorities is to resume relationships," Cunningham said. "High-risk sexual activity along with substance use is a volatile combination that increases the risk of transmission to the community."
Women in relationships with inmates may face additional risk. If her partner in prison was the breadwinner, a woman may feel strapped trying to support herself and him, Jackson said. She might engage in sex for money or have relationships on the side.
A woman needs to know her partner's HIV status to understand her risk, Jackson said. She encourages women to ask their incarcerated partners to get tested and mail the results home or to get tested together once the men are released.
"It is your right to know what's going on with your man's health" — even if it means asking difficult questions, Jackson tells her peer educators. A woman should "feel disrespected" if a man doesn't want to use a condom, and she shouldn't back down on her request, Jackson said. "If he still doesn't want to use a condom, then he's not worthy of being in your space."
It's a message Jackson wishes she could tell her younger self. Jackson recently discovered that the man who infected her knew he was HIV-positive before they started dating. She thinks he may have tried to tell her but skirted around the issue. When she asked about his status, he told her he had taken two tests, one positive and the other negative. She also knew his blood had been rejected from a donation drive. But she didn't probe further. At the time, Jackson worried, "I think this man might be positive, but I'm too scared to know."
When Jackson talks about the importance of healthy, communicative relationships, she speaks from experience. Her ex-boyfriend took care of her and made her laugh, but he could also be verbally abusive and disrespectful, she said. When he said he didn't want to use condoms, Jackson didn't argue. "I didn't love myself enough to protect myself by enforcing that he use condoms," she said.
The women Jackson works with say her experiences come through in her teaching. They describe her as sweet and tender but also strong and stern. "She's just a powerful woman," said Patricia Walker, 54, of Inglewood, who went through the peer educator training in June. After taking Jackson's classes, Walker found the courage to leave a 10-year relationship with a man who has been in and out jail five times. "She give you hope," Walker said.
In the last few years, Jackson has embarked on a side project to speak about HIV at black churches. "I was pretty popular on the church circuit," she said. After sharing her HIV story at her own church, the Resurrection Church of Los Angeles, "you could hear a pin drop," she said. Women were in disbelief, not realizing they too could be at risk.
Jackson runs her church's annual health fair, which includes an HIV testing van. She hopes other black churches, which historically have condemned HIV or avoided any discussion of it, will follow suit. "The more we have people talking about HIV, whether it's in the church house or on the street, the better it will become normalized," she said.
Married and divorced twice since her diagnosis, Jackson is now in a relationship with a man who doesn't have HIV. And she doesn't go for the bad boys anymore.