This summer the Washington, D.C., Department of Health (DOH) rolled out its first pre-exposure prophylaxis (PrEP) campaign targeting Black women. The campaign #PrEPForHer—the first of its kind created by the D.C. DOH—invites Black women to take charge of their sex lives by taking the daily pill for protection against HIV, and explains that PrEP is safe and available for everyone.
The District’s HIV interim report for 2014 indicates that 92 percent of the women in D.C. living with HIV are Black, and 63 percent identified the mode of transmission as heterosexual contact. Nationally, HIV infection rates are down among Black women; however, Black women make up 64 percent of new infections and are twice as likely to contract HIV (pdf) during their lives as the average American.
“When we look at the number of new infections in the District, the second-highest group was African American heterosexual women. Effectively, 1 out of 5 new cases in D.C. are among African American heterosexual women,” said Michael Kharfen, senior deputy director of the HIV/AIDS, Hepatitis, STD, and TB Administration at the DOH. “That was the data-driven premise that determined the start of this campaign.”
Crafting culturally sensitive public health messages is paramount to the success of the campaign. When people see them-selves and their cultures represented in campaigns, they identify with the message more closely.
PrEP has been marketed to gay and bisexual males since its approval in 2012. Although it has always been effective among heterosexuals, that message was not always conveyed. So the D.C. DOH created a message designed to reach Black women.
“We started this by funding the Women’s Collective to do education and outreach,” said Kharfen. “Then we moved to getting the message District-wide. We did discussion groups and discovered that none of the women we spoke to were familiar with this. Their first reaction was somewhat angry because no one had been communicating to them about this option. Once they found out, they became much more interested.”
But actually getting PrEP into Black women’s hands will require them to demand the drug collectively, and the medical community to be more responsive. Other campaigns—such as the Centers for Disease Control and Prevention’s “Let’s Talk About PrEP,” rolled out in Atlanta, Baltimore and D.C.—educate Black women and encourage them to ask for PrEP prescriptions. The lack of awareness about PrEP can go both ways, though. Many doctors do not know what PrEP is or how it can help prevent new infections.
Myths make increasing PrEP uptake among Black women even more difficult. Many Black people mistrust members of the medical community, particularly with new medications, fearing harmful side effects.
“PrEP is safe. Very few people have side effects; those that do have very mild effects, like mild nausea. It’s not going to impact your health in a negative way,” says Kharfen. “If anything, it can make things better for women. Negotiating condom use can be challenging. Taking PrEP makes taking care of sexual health easier. This is a way that you can take charge and know for certain that you won’t be at risk for HIV.”
PrEP is for people, period. If you’re at risk of acquiring HIV, learn as much as you can about it.
Candace Y.A. Montague is an award-winning freelance journalist in Washington, D.C. Her work is featured in several online and print publications. You can follow her on Twitter.