Why black gay men need to talk about PrEP

Today’s gay black men, according to one estimate, have a 60% chance of contracting HIV by the time they reach the age of 40. Overall, the rate of United States HIV infections has decreased by two thirds, but this group remains disproportionately affected. As of 2010, they account for the highest number of new HIV infections among all gay and bisexual men.

Unless black gay men push for advance awareness about HIV prevention and treatment, revision of public policy on funding, and better access to reliable health care, they will continue to exceed statistics—and not in a positive way.

“As hard as we’re fighting for an end to police and vigilante killings of black people in the #BlackLivesMatter movement, we need to take our health care just as serious,” says Kenyon Farrow, U.S. and global health policy director for Treatment Action Group, an independent AIDS research and policy organization.

“Will we disrupt brunches, block traffic, storm the stages of presidential hopefuls to demand Medicaid expansion?” Farrow asked.

Even with more bio-medical interventions coming down the pipeline, today’s gay and bisexual men just aren’t aware of available prevention and treatment methods.

Policy makers, particularly at the state and local level, are largely clueless.

One of the newest prevention methods highlighted in a recent White House policy report was Pre-Exposure Prophylaxis, or PrEP, in which HIV-negative individuals use antiretroviral medication (Truvada) to reduce the risk of acquiring HIV if exposed to the virus.

Kaiser Family Foundation released a study, which found only 26 percent of its participants knew about PrEP.

There is still also work to be done to understand barriers and adherence issues.

“PrEP, while effective, is not for everyone,” said Christopher Chauncey Watson, research director at George Washington University Milken Institute of Public Health. “As a person who struggles with hypertension, taking a pill once daily for prevention does not work for me personally. We should empower men to have realistic conversation with themselves to make informed decisions about what options are available to them to live a healthy and happy life.”

Research has shown that PrEP works well if taken as prescribed. Studies released earlier this year (IPERGAY, PROUD) revealed if the drug is taken at least four days per week, protection is shown to be 86 percent effective.

Watson also referenced “promising data” from active research about PrEP among black men who have sex with men.

During the early years of the HIV epidemic, there was much panic rooted in a deep misunderstanding. Devin Barrington-Ward, a consultant and HIV policy expert, says health literacy still remains low not only for black gay men, but also policy makers.

When it comes to PrEP, critics raise red flags around unclear medication adherence and how PrEP promotes “riskier behavior” that will supposedly increase other sexually transmitted infections. There is also apprehension around the possibility of PrEP increasing the likelihood of a person developing drug-resistance to HIV.

For the past two years, Barrington-Ward has worked with the Georgia Legislative Black Caucus to host a series of summits and hearings aimed at educating elected officials about the reality facing their constituents as it concerns public health.

“Policy makers, particularly at the state and local level, are largely clueless on the plight facing black gay men and the seriousness of the HIV epidemic in our communities,” Barrington-Ward said.

With black gay men reporting poorer-quality experiences in receiving health care than white gay men, quality access to care continues to be a barrier for people of color. To address these health disparities that contribute to new infections and death rates of black gay men, we must acknowledge systemic issues relating to inequity, racism and social exclusion.

“We have to stop saying black gay men won’t go to the doctor if we haven’t made sure that they have access to one in the first place,” said Farrow.

For Farrow, hearing about black gay men showing up in hospitals and clinics across the country with single digit T-cell counts and other AIDS-defining illnesses is reminiscent of the polarizing images back in the ‘80s.

He wonders what would happen if those images replaced the ones of black men gunned down by police officers?

Drew-Shane Daniels is a D.C.-based freelance writer who has contributed to Slate, Take Part, VIBE, and Huffington Post, among others. Follow him @drewshane.