“Prevention is better than cure” is far more than a cliché—it’s a guiding truth for anyone committed to protecting their health. And for us in the Black community, prevention must be front and center, especially when it comes to HIV. The burden of this disease remains disproportionately high in our community. A 2024 publication from KFF revealed that 39% of new cases of HIV are from Black people, even though we make up only 12% of the US population. Even more painful is the reality that 43% of the annual HIV-related deaths are Black—the highest of any racial or ethnic group in the country.
During the 2024 National Black HIV/AIDS Awareness Day, Timothy Harrison, PhD, principal deputy director of the Office of Infectious Disease and HIV/AIDS at HHS, echoed the same truth: HIV continues to disproportionately impact the Black community.
Condoms have been our go-to protection, but aside from using condoms, what else can we do? The issue is that after using condoms, the frequent question of “AM I REALLY SAFE?” wears us down. The burden that follows is one no one wants to carry. When you look at a friend or family member living with HIV, you begin to ask, “Could this happen to me someday?” A condom guarantees HIV protection between 71% and 80%, according to the Cleveland Clinic; some researchers even put it below 70%. This 29% chance of HIV infection is a risk that gives much heartache.
What about those who shared a needle with a partner but weren’t sure of their status? A condom can’t protect them in this case. All these uncertainties breed worries that have become daily realities for many Black people.
However, Timothy Harrison provided the perfect way out of all these questions and uncertainties. In his own words, he said, “We must really double down on efforts around PrEP prevention tools so that we can avert new HIV infections.” PrEP lowers the risk of HIV infection by 99%, according to the American College of Obstetricians & Gynecologists (ACOG).
What Exactly Is PrEP?
Pre-exposure prophylaxis, better known as PrEP, is a medicine you take before any possible exposure to HIV, that is, before sex or injection drug use, to reduce the risk of infection.
According to the Centers for Disease Control and Prevention (CDC), PrEP is:
- Pills or shots that help reduce the chances of getting HIV
- For people without HIV who may be exposed to HIV through sex or the use of injection drugs
- For preventing mother-to-child HIV transmission when a woman is trying to get pregnant, during pregnancy, or while breastfeeding
PrEP can lower the risk of HIV from injected drugs by at least 74%, according to ACOG, and 99% for sex. However, it does not protect against other sexually transmitted infections or pregnancy; hence, it does not totally rule out the use of a condom.
Breaking Barriers: How Accessible Is PrEP in Our Communities?
Through several awareness campaigns, there has been a notable breakthrough in accessibility within the US general population.
According to the CDC, most insurance plans and state Medicaid programs now cover PrEP. We can walk into any licensed healthcare provider and obtain the prescription. There is good news even for those without health insurance. HIV.org listed patient assistance programs and co-payment assistance programs among the options available to people without insurance.
Despite the proven benefits of PrEP and the work of organizations and advocates promoting its use, uptake remains low. Grantmakers in Health reports that PrEP remains underutilized, with only 25% of people showing interest in it. CNN US this in a 2023 report showing that only 14% of Black people use PrEP—even though our community is affected at a disproportionately higher rate.
The report identified several key barriers contributing to low PrEP utilization among Black communities:
- Cultural insensitivity from providers
- Lack of education and awareness
- Stigma and shame
- Systemic and cultural barriers
- Insurance noncompliance
- Geographical barriers
- Cost of required lab work
- Limited provider support
These results indicate that, despite the significant gains, more efforts are needed to address the needs of the Black population.
Let’s Talk Cost: Can You Really Afford PrEP?
According to the CDC, PrEP may be covered at no cost under the Affordable Care Act for Black individuals with health insurance. In most cases, your insurance will cover the medication, clinic visit, and laboratory tests.
For those without insurance, programs like co-pay assistance programs lower the cost of PrEP medicine, and ViiConnect helps cover the cost of PrEP shots. Some state governments have also taken the initiative with PrEP assistance programs, which include medication, a clinic visit, and a test. Check your state to know what is available.
Why This Matters in the Black Community
Blacks carry the lion’s share of the burden of HIV in the US. PrEP is an additional protection and an answered prayer. While prevention conversations can be a one-size-fits-all approach, risk, access, and truth vary. However, PrEP stands out because it’s a prevention method we can control.
What can you do?
- Ask your doctor, “Is PrEP an option for me?”
- Consult a local clinic that is culturally responsible and Black-led
- Ask for cost and support programs, most especially if you have zero or limited insurance
- Stay consistent as soon as you start with PrEP, be it a daily pill or a shot option
- Support educational efforts to help get rid of the stigma
Don’t forget that PrEP doesn’t protect against STIs or pregnancy; it only reduces the risk of HIV. Hence, the use of condoms and regular STI screening remains essential. See PrEP as an additional layer of protection.
In all, Elevate Black Health affirms that the first step towards PrEP is having an HIV test to ensure you don’t already have the virus, then speak to your healthcare practitioner.
For Further Reading:
- Impact of HIV on Black Mental Health. https://www.elevateblackhealth.com/impact-of-hiv-on-black-mental-health/
- The Impact of HIV on Black People in the United States. https://www.kff.org/hiv-aids/the-impact-of-hiv-on-black-people-in-the-united-states/
- Tim Harrison and Nelly Gazarian Observe National Black HIV/AIDS Awareness Day and Black History Month. https://www.youtube.com/watch?v=ymSSpdg2vd8
- Condoms. https://my.clevelandclinic.org/health/treatments/9404-condoms
- 7 Things to Know About PrEP, the Medication That Prevents HIV. https://www.acog.org/womens-health/experts-and-stories/the-latest/7-things-to-know-about-prep-the-medication-that-prevents-hiv
- Preventing HIV with PrEP. https://www.cdc.gov/hiv/prevention/prep.html
- Revolutionizing HIV Prevention in Black Communities. https://www.elevateblackhealth.com/revolutionizing-hiv-prevention-in-black-communities/
- Patient Assistance Programs and Co-payment Assistance Programs: Resources for Accessing PrEP. https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis/accessing
- PrEP in Black America: A New Approach to Biomedical HIV Prevention Advocacy. https://www.gih.org/views-from-the-field/prep-in-black-america-a-new-approach-to-biomedical-hiv-prevention-advocacy/
- Black Americans still struggle to access PrEP, a medication that could lower HIV rates in the community. https://edition.cnn.com/2023/12/01/us/access-to-and-use-of-hiv-prevention-drug-a-hurdle-for-black-americans
- Impact of Trump’s HIV Medication Ban. https://www.elevateblackhealth.com/impact-of-trumps-hiv-medication-ban/
- Revisiting HIV/AIDS Prevention in Black Community. https://www.elevateblackhealth.com/revisiting-hiv-aids-prevention-in-black-community/
- Finding a Support Network After an HIV Diagnosis. https://www.elevateblackhealth.com/finding-a-support-network-after-an-hiv-diagnosis/
