Breaking Disparities

■ COLEMAN GOODE AIDS FOUNDATION OF CHICAGO Kink Issue 2018

Why POCs are Not PrEP’d

Pre-exposure prophylaxis (PrEP) has been transformative in the crucial fight to bring an end to the HIV/AIDS epidemic.  When taken as prescribed, this anti-HIV medication has been proven to reduce the risk of an HIV negative individual of becoming infected with the virus by over 90%.  During the period of 2012–2016, according to an analysis done by AIDSVu, the number of PrEP users in the United States increased by 880%.

Reports have shown that 73% of those who used PrEp where White, while African Americans made up only 10%, 13% Latinos, and 4% Asians. In the LGBTQ community, the biggest demographic utilizing PrEP are White males ages 25 and up.  Now let’s be clear this is a demographic that has seen dramatic drops in HIV infections. Black Men who have Sex with Men (MSM) in the US make up two thirds of new diagnoses, and the Centers for Disease Control and Prevention reported that if the current trend holds half of all Black MSM will contract HIV in their lifetime, compared with 1 in 11 of their white counterparts.

Then why is PrEP so under-prescribed in Communities of Color? Is it Homophobia? Stigma? Racism? Access to health care?  It would be easy to lay all the blame on systematic racism which definitely is a huge contributor. The problem isn’t really about White people and the racial barriers to care are just a part of the problem when it comes to the lack of PrEP utilization in Communities of Color.  The social determinants to health have been baked into these communities.   Black and Latino MSM have issues that range from access to and maintaining linkage to care, stable housing, community perceptions on lacking insurance and the idea of taking advantage of preventative care.

Thanks to the Affordable Care Act (ACA) states which have the resources available to offer free access to PrEP, access to supportive services such as regular HIV testing, sexual health care, monitoring, and access to one-on-one counseling in their communities. This is imperative in keeping POCs engaged. There are many organizations such as Black Aids Institute, AIDS Foundation of Chicago and the Positive Women’s Network which are working hard in their communities to make sure that PrEP is getting in the hands of those who could benefit from it the most. Silence, stigma and ignorance has kept us in bondage for too long. It’s time to educate, advocate and liberate our communities.