Why are women of color not on PrEP?

Why are women of color not on PrEP?

    On this National Women and Girls HIV/AIDS Awareness Day, NMAC wants to know why women of color not on PrEP, tell us why???

   This year marks the 12th year of this awareness day. The most current data from the CDC reveals that from 2005-2014, the number of women diagnosed with HIV has decreased by 40%.  Importantly, they found that there was a 42% reduction among African American women, a 35% reduction among Latina/Hispanic women, and a 30% reduction in rates among White women. However, as promising as this sound, the United States still faces massive obstacles to ending the HIV epidemic. There is a racial divide that asks the question: why are African American women (61%) and Latinas (17%) most of the women living with HIV in America?

   According to an article in aidsmap, 74% of Americans are PrEP are White.  Latino (12%), African Americans (10%) and Asians (4%) account for much smaller percentages of Americans on PrEP.  There were no numbers given for Native Americans.  21% of the people who start PrEP are women. However, the rate of usage for women continues to decline, from 49% in 2012 to just 11% in Q3 2015.  Black women were more than four times less likely than white women to have started PrEP.

   Each time we read statements and figures that under-score the reality of disparities that exist for women of color who have HIV; we are confronted with the question of what should be done.  Where should people begin? What are you doing?  We all know some things to do such as:

• Hire staff at all levels of the organization that reflect the target population;
• Do strategic and focused outreach;
• Advertise services more aggressively toward the diversity of your client base;
• Encourage testing;
• Have peer support;
• Advocate for more resources.
• These are key things to do in normal circumstances, but these are not normal times. We must do more.  We must first acknowledge that woman needs to be heard. Are you listening to the voices of the women? Do you hear and understand that they as women, heterosexual, Trans, lesbian bring a lot to the table? Many are frustrated; many may live outside of the ma or cities where the services and information that they receive is insufficient to address their needs. PrEP must be incorporated in discussions with them. Everyone has a right to receive high quality in-formation on all resources that can assist those living with and at risk for HIV to thrive. Women are at the forefront of so much; they will be at the front to end of the epidemic, if given the chance. This may mean that things will change but that is life; things change.  Are you the change that you want to see? It starts with you. Do an inventory; a self-assessment of whom you are serving and with what and by whom?
• NMAC will be sending out a self-assessment tool over the next several weeks to ask you about your use of PrEP.  In the arsenal of HIV prevention tools, biomedical methods, such as PrEP can help HIV negative persons who are deemed eligible and adhere to it as prescribed to remain negative, even when inadvertently exposed to the HIV virus. There are also human navigators who can guide and direct others to resources and services to help overcome some of the disparities in their healthcare.
• We will be assessing your use of both, PrEP and Navigators. The goal will be to develop a comprehensive understanding of the use of HIV navigators, particularly PrEP navigators, by HIV/AIDS serving organizations: the proportion that use them, for what tasks, barriers to usage, awareness of their impact on clients’ lives/out-comes, and satisfaction with their usage (organization, client, and navigator).
• However, we are challenging you now to start your own assessment.

Evaluations, assessments, often mean a systematic review of a program, model or event by an objective person, usually someone external to the activity or event.  Self-reports require a more reflective view of one’s own actions.

What are you doing to help cis and Trans women and girls of color to navigate PrEP and other essential services, to remain negative? What are you doing to assist cis and Trans women and girls who are HIV positive to navigate their care and remain healthy?  Women and Girls HIV Awareness Day is only once a year; what are you doing the other days?

• Yours in the struggle,
• Robin Kelley & Navneet Sehdev