At the launch of Dialogues: Education and Treatment for a Well Planned Future?a national, non-branded education initiative for people living with HIV/AIDS?an audience member spoke up from the back of the room, concerned about images of irresponsible sex in hip-hop and other music videos. The topic came up because Tionne ?T-Boz? Watkins and Rozonda ?Chilli? Thomas of the group TLC were on-hand to promote the initiative, which encourages people living with HIV/AIDS to become involved in their own care by learning about the disease and treatment options, and by developing strong communicative relationships with their healthcare providers. They listened to the audience member and agreed about the rampant machismo in hip-hop, but then gently begged to differ?at least where TLC is concerned. They pointed out that they were wearing condoms as a fashion accessory back in the early nineties. The video for their number-one hit ?Waterfalls? represented sex in the age of AIDS. (Who can forget that haunting image of a buffed, young man checking the mirror only to find a KS lesion?) And last year, after the untimely death of bandmate Lisa ?Left Eye? Lopes, T-Boz and Chilli set up a one-time $25,000 Lisa Lopes AIDS Scholarship through MTV?s Fight For Your Rights: Protect Yourself campaign as a way to continue the work that Left Eye believed in. T-Boz and Chilli?s point is well-taken?when was the last time you heard the mainstream media tout the positive actions the hip-hop community has taken over the years?

The death of Eazy-E from AIDS back in the mid-nineties perhaps first galvanized an AIDS-aware hip-hop consciousness. But the groundswell had already started, thanks in part to TLC. The hip-hop community?s response to fighting AIDS now includes among its ranks Missy Elliott, Sean ?P. Diddy? Combs, Jay-Z, Ashanti, Eve [A&U, May 2002], Mary J. Blige, and L?il Kim, to name a few. BET?s live countdown show, 106 & Park, has kept HIV in steady rotation and that network?s Rap-It-Up campaign has sent hip-hop ambassadors around the country to promote AIDS awareness. TLC was able to establish its place in this firmament early on because of their uncanny ability to craft tunes about the pleasures, responsibilities, and politics of sex in a way that resonated with everyone, but especially women. The Grammy-winning group didn?t become the best-selling female group of all time by playing it safe, though. Graphic lyrics abound, sure, but their music does not deliver market-savvy fantasies about how women should relate to their sexual desires: It delivers the realities that many women face in life and love. Listen to the words from ?Unpretty,? off the FanMail CD: ?You can buy your hair if it won?t grow/You can fix your nose if he says so/You can buy all the make-up that MAC can make/But if you can?t look inside you/Find out who am I to/Be in the position to make me feel so damn unpretty.?

Now T-Boz and Chilli are lending the power of their celebrity to Dialogues, but they aren?t simply in it for the photo-op. (They are quick to point this out, knowing that their latest album, 3D, is still on the charts but adamant that their involvement not be brushed off as some sort of PR stunt.) The initiative is simply the latest?and certainly not their last?effort in their longstanding commitment to self-empowerment and sexual health. They said (T-Boz and Chilli often talk as a team, completing or adding to each other?s thoughts seamlessly) that their involvement is ?from the heart,? borne from knowing people close to them who are struggling with or have died from HIV/AIDS as well as from a concern about the wider community, specifically African-American women.

Dialogues is?well, it?s all in the title. As Dr. Douglas Dietrich, professor of medicine at Mt. Sinai Medical Center, pointed out at the launch, one of the obstacles standing in the way of quality care is good communication between patient and doctor. Another speaker at the launch, Dr. Luther Virgil, a physician at Providence Hospital in Washington, D.C., added that trust and support in this relationship are also necessary. Bridging this communication gap is important for adherence to meds, says Dr. Virgil. Empowerment is also important?becoming informed about and active in one?s own health goes a long way in meeting the challenges of living with HIV or AIDS.

When I talked to T-Boz and Chilli by phone from a studio in Atlanta, they agreed. Says Chilli: ?Often, people with HIV don?t know enough [about HIV] to talk to their doctors or nurses. They feel overwhelmed. But if they don?t ask questions, they leave the doctor?s office and are confused as to what they should be doing and why. They need to get the facts from Dialogues and get involved in their own care so they have the best chance of living a long time with HIV.? Chilli, who joked that she thinks she was a doctor in a previous life, mentioned that she had an experience with a doctor whose ?bedside manner wasn?t so cool,? and that having a strong relationship with one?s healthcare provider was important ?especially if people can?t talk to anyone else [about their status].? T-Boz feels that ?if you show you?re educated and interested in your own health, [then] you get more respect [from your physician].? She added: ?It?s important because they need to have an open line of communication to understand how to fight HIV now and in the future. This communication?and knowledge?will give them the empowerment to take an active role in their own care.?

?We decided to get involved with Dialogues because there are a lot of people with HIV who aren?t doing anything about it,? says T-Boz. Last year, the Centers for Disease Control and Prevention estimated that up to one-third of the 850,000?950,000 HIV-positive living in the U.S. do not appear to be receiving treatment. A survey of 1,259 HIV-positive people reported that more than sixty percent had not discussed long-term treatment planning with a healthcare provider in the previous six months. As a study of AIDS-related deaths at a Texas hospital showed, only forty-eight percent of patients who died between 1999 and 2000 were on a HAART regimen at the time. The study, published in Clinical Infectious Diseases, cited factors such as an inability to adhere to meds and an HIV diagnosis less than six months prior to death as the primary causes; also cited was an inability to tolerate meds due to liver disease. The study begs for future research, especially in light of the fact that a disproportionate number of those who died were minorities. Beyond medical issues and limited access to care, why aren?t people?especially in minority communities?taking charge of their health?

This question is far too complex to be answered here. Stigma and fear undoubtedly play a part, and the post-Tuskegee relationship between many African-Americans and the medical establishment has never been truly mended. And gone, it seems, are the days when a person living with AIDS was more likely to know more about the disease and its possible treatments than his or her physician. Dialogues takes the point of view that many living with HIV, and particularly African-Americans and Latinos, do not feel empowered to become involved in their own care. Finding out the reasons why is important, but Dialogues seems to think we can find out on the way?while we?re being treated.

T-Boz emphasizes this first step: ?Being African-American women and finding out HIV is growing so rapidly in our community made it important to speak out now?to tell people to find out about HIV, and, if they have it, to treat it.? Even if someone thinks they can?t afford treatment, she says, they should still seek it. T-Boz and Chilli have been educating themselves more and more about the specifics of HIV/AIDS and its treatment. Chilli admitted that she at first did not believe how quickly HIV was spreading in the African-American community. It?s understandable. Even as the HIV transmission rate has waned among whites, it has shot up in African-American and Hispanic communities. Currently, nearly seven out of ten HIV-positive people in the U.S. are either African-American or Hispanic. Among HIV-positive women, more than six out of every ten are African-American; nearly two out of ten are Hispanic. Alarming statistics, considering that African-Americans and Hispanics only make up about twenty-five percent of our nation?s population.

?As African-American women, we hope to reach our peers who are being hit hardest right now by HIV,? she says. ?We were surprised to see how much it is affecting this population and want to do everything possible to serve as role models to reach the African-American community with the education and tools necessary to fight this disease.? Indeed, Dialogues is targeted at underserved individuals: African-American but also Hispanic-American women, patients with co-morbidities (such as hepatitis C and substance abuse), women of childbearing age, and healthcare providers. Dialogues provides a handy guide for understanding and managing HIV, as well as tips on choosing your healthcare provider and developing a communicative relationship with him or her. It lets patients stay in control of their decisions by suggesting what might be considered when approaching treatment and managing HIV. The guide also provides other reference materials that cover everything from diarrhea to dry mouth, as well as personal planner tools such as a space to jot down questions for healthcare providers, a prescription tracker to record meds and the instructions for taking them, and a treatment planner. Developed by Agouron Pharmaceuticals, a Pfizer company, along with the expertise of the Association of Nurses in AIDS Care, the American Public Health Association, and the National Association of AIDS Education & Training Centers, Dialogues was smart enough to realize that T-Boz and Chilli were experts in perhaps the most important field: self-empowerment.

?We all?especially women?are vulnerable to entrusting our partners [with our health],? says Chilli, about the obstacles that prevent individuals from tapping into self-empowerment. ?We feel invincible, but should really take charge and protect ourselves. Dialogues, like our music, empowers people to get involved in their own care?to ask questions so they understand what their doctor is saying and let him know what they think and can do. Dialogues helps people learn enough about HIV so they feel like they can talk to their doctors and take a role in their own care.? Nurturing self-empowerment logically led to the setting-up of the Lisa Lopes AIDS Scholarship last year. Says Chilli: ?As a tribute to Lisa, we announced a $25,000 AIDS educational scholarship as part of MTV?s Fight For Your Rights: Protect Yourself campaign. The Lisa Lopes AIDS Scholarship was awarded to one young person showing dedication and leadership in the fight against HIV/AIDS and was coordinated by LIFEbeat: The Music Industry Fights AIDS, a national non-profit youth HIV prevention organization.? That individual was Ineudira Barbosa, who was awarded the scholarship based on her sexuality and sexual-health peer education work with Teens for Education, Advocacy and Leadership in Cambridge, Massachusetts. ?As you know,? Chilli continues, ?Lisa is one of the reasons we?re getting the word out about this new HIV program. It was Lisa?s idea to wear condoms on our outfits to promote safe sex. Now we?re taking the next step by encouraging people to get the facts about HIV and, if they are positive, to work with their doctor so they don?t run out of treatment options.?

TLC?s latest single, ?Turntable,? is a life-affirming song dedicated to Lisa Lopes. It talks about believing in yourself and overcoming struggle and captures exactly why they believe in Dialogues so much: ?Whatever your dilemma may be/You?ll learn/Life is worth it/Watch the tables turn?.?

For more information, log on to the Dialogues Web site: www. HIV-Dialogues.com, or contact the initiative by phone at (800) 576-6600.

Chael Needle interviewed Mara Brock Akil, creator, writer, and producer of UPN?s Girlfriends, for the April issue.