By Olivia G. Ford
When The Well Project community advisory board member Masonia Traylor first got involved with the making of the short documentary, Unexpected, she had no idea she would be at its center. "I know you want to try to hone in on me, but that is not going to work," the founding director of Lady BurgAndy and mother of two remembered saying. "If you want to focus on the South, Atlanta is not it."
Luckily Traylor – along with Unexpected's other focal point, Ciarra "Ci Ci" Covin, program manager of The Well Project, doctoral student, and mom to two kids – had a hand in the direction of the film, which begins streaming on Hulu on December 1, World AIDS Day 2023. They made sure the focus shifted from Atlanta – where Traylor lives, and where HIV community services are relatively accessible – to rural Georgia, where Covin grew up and was diagnosed with HIV.
Due to generations of systemic racism, HIV, like many health conditions, affects Black women at alarming rates compared to their white counterparts – especially in the US South. But this fact is not widely known, including to Black women who are most vulnerable to acquiring HIV. Women often do not receive their HIV diagnosis until pregnancy, when HIV testing is routine.
As the film highlights, stigma around HIV and other forms of difference, medical mistrust, and sheer lack of privacy in places where a key pastime is knowing other people's business are a toxic blend for people living with HIV in rural areas in the South and elsewhere. A paucity of HIV care, services, and prevention information – including lack of awareness that women and others can thrive, give birth to HIV-negative children, and otherwise enjoy full lives with HIV – can lead Black women to feel they are all alone.
The film follows Covin and Traylor as they connect with pregnant women newly diagnosed with HIV in rural Georgia. They offer care packages, reassurance, and resources – including a sense of community. "I been there – both of my kids, been there," Covin shares with one of these women, of being pregnant while living with HIV, in one scene in the film. "If you ever need any support, or when you think nobody understands you, at least you've got us – and we are just standing here as representatives of so many other women."
"I would like public health professionals to watch the documentary, particularly persons working in maternal and child health." – Margaret Lampe RN, MPH, US Centers for Disease Control and Prevention
After viewing Unexpected, Margaret Lampe, RN, MPH, who leads perinatal, maternal, and infant activity in the HIV research branch at the US Centers for Disease Control and Prevention (CDC), appreciated that the film "highlights the stigma and isolation that pregnant women with HIV can experience, especially women living outside major metropolitan areas. We know that isolation and loneliness negatively impact mental and physical health."
This is the urgency of Traylor and Covin's work in the film and far beyond. "Isolation is the main thing that's killing women," Traylor said. "They don't know they have support." Beyond care packages, she and a small group of community members have helped women with rent, support while in the hospital, childcare, and more – but their reach is limited. "How do we get help with marketing and capacity around building out this community?" she mused. "We don't know what we're doing; we just show up doing it."
"Isolation is the main thing that's killing women. They don't know they have support." – Masonia TraylorUnexpected also illuminates the need to improve healthcare access in the US. "[Women's needs are] not one-size-fits-all, and our system requires that," said Linda Scruggs, longtime advocate, cofounder of the nonprofit organization Ribbon and chair of The Well Project's board of directors, in her commentary in the film. "Often if you show up 15 minutes late to the clinic, you can't take an appointment," Scruggs explained. "Well, the lady who was 75 miles out may be 15 minutes late. The woman who took four buses and the train and her two kids may be 15 minutes late."
Dazon Dixon Diallo, founder and president of Atlanta- and South Africa-based SisterLove, Inc., and The Well Project executive director Krista Martel join Scruggs in providing commentary on the multitude of intersectional issues that Black women in the US South face. "The darker your hue, the more disparate your experience is" – in the US and throughout the world, Dixon Diallo reminded.
Film and television producer and director Zeberiah Newman, who directed Unexpected, was no stranger to HIV-related content; he directed another short documentary about experimental research and the business of HIV. But the devastating impact of HIV stigma and bias on Black women in the South, which he learned about while making that first film, was news to him. "It was a story I couldn't get out of my mind," recalled Newman. "I had to know more; I had to talk to women on the ground and find out what was happening."
"I learned that highlighting a woman's courage and her strength is more important than highlighting her trauma." – Zeb Newman, director
Working with Covin, Traylor, and others provided a powerful learning experience. "At every point of this process, from filming to edit to promotion, these women have shared their truth; it has been an honor to witness and be a part of this journey with them," Newman said. "Specifically, I learned that highlighting a woman's courage and her strength is more important than highlighting her trauma."
Covin got involved "with the goal of wanting to help my next sister," she shared in a recent conversation. "When the opportunity presented itself for me to be able to speak and share experiences that have helped me and a stage be given to that so that other people know that resources like this are available, and what sisterhood and support look like, I was gonna be there."
"Working with people who don't necessarily work in our niche every day, which is women and HIV, there are often things that can be overlooked or not considered," she said. "Being able to lend my voice to contribute to what this film is today – I'm proud."
Sheryl Lee Ralph, Emmy-award winning actor of "Abbott Elementary" and "Dreamgirls" fame, was inspired to join the project as executive producer. "Working with the ladies and promoting HIV/AIDS awareness, especially as it pertains to Black women, is about damn time!" said Ralph via email recently. Ralph has been an HIV advocate since her work in theater connected her with people living with HIV more than three decades ago, in the HIV epidemic's darkest days.
"Being able to lend my voice to contribute to what this film is today – I'm proud." – Ciarra "Ci Ci" Covin While there is no shortage of work to be done by advocacy organizations like Ralph's DIVA Foundation, The Well Project, and many others, Ralph said what she sees these days offers hope: "[T]he overall trajectory indicates positive advancements in HIV awareness, prevention, and management, fostering a more inclusive and supportive environment for individuals, especially Black women, impacted by the virus."
Lampe, of CDC, has aspirations for the public-health impact of the film. "I would like public health professionals to watch the documentary, particularly persons working in maternal and child health," she said. "I would like to see support for peer-support programs for pregnant women with HIV."
Indeed, for Covin, Traylor, and others who spoke in the film, the common denominator for women, not just during pregnancy but in the crucial postpartum period and across the entire lifespan, is the overwhelming need for more support from providers and others in their communities – and more connection with other women living with HIV.
"Working with the ladies and promoting HIV/AIDS awareness, especially as it pertains to Black women, is about damn time!" – Sheryl Lee Ralph, producer, Emmy award-winning actor
"HIV isn't the thing I think about first each day; it's those other things like children and finances and relationships," said Covin in the film. "To be able to have friends that understand those struggles, as well as HIV being a part of that? I wouldn't trade that for anything."
They also hope viewers' passion to help women living with HIV find support does not end when the film credits roll. As Unexpected reaches an ever-wider audience through screenings and streaming watch parties, Traylor wants these events to be a vehicle to help Black women not just feel seen, but get involved. She suggested "having something they can do right then and there – maybe actually making care packages for a rural area in the state that they're in, that can go to a local agency so a case manager can see that it gets to a mom living with HIV."
"We understand that none of this is about us," Traylor concluded. "It's 'about' us, but it's got nothing to do with us – it's a bigger happening."
Funding from ViiV Healthcare's Positive Action Community Grants supported the final steps in completing this film and its dissemination to film festivals.