Why Aren’t More Black Women Taking PrEP?
Those who can potentially benefit from HIV prevention pill PrEP may not have access to or even know that the drug exists.
Last Wednesday, Spelman College’s Dr. Alix Chapman moderated a round table discussion about the latest approach to HIV and AIDS prevention, PrEP. Chapman, along with five expert panelists, shared their insight, as PrEP users and healthcare professionals, thus confronting everything I thought I knew about PrEP and prompted me to do my own research.
What is PrEP?
Approved by the Food and Drug Administration (FDA) in 2012, PrEP (pre-exposure prophylaxis) is a daily pill regimen that drastically lowers the risk of contracting HIV, up to 99%, if used as prescribed. It’s a combination of two HIV medicines, tenofovir and emtricitabine, but it’s often used interchangeably with its trade name, “Truvada.”
Who’s eligible for PrEP?
The Centers for Disease Control (CDC), recommends this prevention option for HIV-negative men who have sex with men (MSM) and for heterosexual men and women who are at “substantial risk” if they:
- have an HIV-positive sex partner.
- have a high number of sex partners.
- inconsistently or never used condoms.
Blacks/African Americans account for a higher count of new HIV diagnoses compared to other ethnicities. In 2017, despite comprising only 13% of the population, black folk made up nearly 43% of new HIV diagnosis in the United States. Among blacks in America, about 73% were men and nearly 26% were women.
Black men and women are overrepresented among new HIV diagnoses making up nearly half of the carrying population. Combining both gender cohorts, only 1% of African Americans were prescribed PrEP in 2015. Healthcare experts are pointing fingers at factors that enable PrEP disparities like poor access to healthcare, deeply embedded shame and stigma, and lack of HIV awareness.
HIV has long been written off as a gay men’s disease but the statistics are staggering: Black women are 20 times more likely to contract HIV in the United States. Rarely are black women identified as substantially at risk. And for heterosexual black women who prefer partners of the same race/ethnicity? Options can be quite slim considering a disproportionate number of Black men are either dead or in jail.
While it’s important that experts point fingers at healthcare disparities that seem beyond their control, it’s also important to take note of the cultural competency required to further understand this issue. Medicine hasn’t been the kindest to Black people, let alone black women, and history has birthed a distrust in the institution. The birth of gynecology, non-consensual sterilization, and the Tuskegee Airmen who were infected with syphilis and went home to their wives with the infection are rarely mentioned when questioning why Black women aren’t taking PrEP.
What’s even more upsetting? Most black women won’t need history as a source of their distrust. Black women’s reservation stem from their own experiences.
Autumn Harris is a rising reporter from Queens, New York.
