"Allow Me to Re-introduce Myself" -Jay Z

Why I decided to take a hiatus from full time clinical practice, as a sole provider at a Ryan White Clinic, to pursue a PhD at Johns Hopkins University?

"Girl you're going back to school again?!"

The above quote is pretty much the initial reaction I received from most of my friends when I announced that I would be relocating to Baltimore, MD to pursue a fully funded PhD at Johns Hopkins University (JHU). After that initial reaction I would get a ton of questions such as "Wow! How did you get into JHU?", "Will you make more money?", "How long will it take?", "What about babies and a husband?", and more.

I was not at all defensive when answering many of these questions, because throughout the process these are some questions I had asked myself...and some days I still ask myself. As some of my readers may know I have been a Nurse Practitioner in Stamford, CT at a Ryan White Clinic for going on a year and half. The transition from being a bedside labor and delivery nurse and APRN student to a full time sole provider was not easy to say the least. However I took on the challenge and fully embraced my new role. I set out to learn as much as I could and to make a measurable difference in the lives of those who trusted me with their care.

When I first interviewed for the position we were operating in collaboration with a local FQHC, however that was no longer the case when it was time for me to be on-boarded and credentialed. That major changed allowed me to have the unique opportunity to get involved in finding a new clinical space, naming the clinic using non-stigmatizing language, marketing, reengaging patients, recruitment, etc. Finally after 3 months we were back up and running and I was seeing my panel of patients living with HIV/AIDS in addition to PrEP patients, who I had advocated to implement since treatment=prevention. I'll probably write a future post about my time as a NP and the different positions I maintained, like a true Caribbean hardworking woman.

Long story short when engaging with many of the women on my panel who were already living with HIV and while trying to recruit women who may need PrEP I recognized a reoccurring theme...many of the black women did not perceive themselves to be at risk for HIV acquisition and even those living with HIV did not fully understand how they may have acquired HIV. For potential PrEP patients I would often reference the Gilead commercial and it was shocking to me the amount of women who assumed the black woman featured in that commercial was a transgender female. I tried to engage some churches and local associations and many times would hear "we (in reference to the black women in those communities) do not need this" when presented with HIV testing and/or PrEP information. I've even encountered some providers with similar biases when it came to women and the need for PrEP. My arguments would be quickly dismissed because stating "black women are #4 when it comes to new HIV infections" was simply not enough data.

I also realized using data about black sexual minority men ("MSMs") to target/reach black women pushed women further away and excluded them from very IMPORTANT conversations when PrEP services were being offered and implemented, which is a major disservice to my sisters. These two discoveries, in combination with a lot of other factors, gave me the motivation to pursue a PhD, in order to produce the research needed to implement change in the lives of my sisters all over the world. For too long we have been left out of the conversation and the data, which is costing us our lives without us even realizing.

At Johns Hopkins University I want to conduct a mixed methods study exploring HIV risk perception among black women and investigate how that influences their sexual decisions and behaviors. In addition, I want to use my findings to drive practice and policy changes globally. A major form of oppression is done by silencing an individual; through research I want to magnify and elevate the suppressed stories of so many black women, in hopes that we will no longer be left out of life changing conversations.

So to answer the original question: why I decided to take a hiatus from full time clinical practice, as a sole provider at a Ryan White Clinic, to pursue a PhD at Johns Hopkins University? Answer: Remaining silent and continuing to do nothing was no longer an option when the true cost, which is the lives and futures of black women...my sisters, became painfully clear.