Here's what we know about HIV in the Black community: Despite the hard work of community leaders, prevention experts and grassroots organizations, HIV infections are on the rise, and we bear the brunt of this epidemic. Black folks only make up 14 percent of the U.S. population, but we account for more than half of all new HIV infections that are diagnosed each year. While the U.S. government finally created a National HIV/AIDS Strategy that has a large focus on our community, there are some doubts that President Obama's goal of reducing new infections by 25 percent by 2015 is plausible given the funding and the overall plan.
Some are placing their bets on science. And in the past year, there have been some promising breakthroughs that could arguably be game changers--one of those being pre-exposure prophylaxis, or PrEP.
A few weeks ago, the Centers for Disease Control and Prevention announced that the results of two new African studies showed for the first time ever, that giving anti-retrovirals to people who are not HIV-positive can reduce their chance of becoming infected with HIV through heterosexual sexual intercourse with an HIV-positive partner.
In the first study, both of the newest trials took place in Africa. The smaller of the two was conducted in Botswana and involved more than 1,200 sexually active adults. Participants took a pill containing the medication Truvada every day, and their risk of contracting HIV dropped by 63 percent.
The second study looked at 4,758 couples in Kenya, in which one partner was HIV positive while the other wasn't. The infected partners took either Truvada, Viread (another ARV) or a placebo containing no medication. Compared with the placebo, Truvada lowered the risk of infection in the negative partner by 73 percent, while those taking Viread reduced transmission by 62 percent. The results were so promising that experts decided that it would be unethical to keep giving some people the placebo, so everyone enrolled in the study will now be offered active drugs.
But before we pop open the champagne and celebrate the possible end of the AIDS epidemic in Black America, we have to face the reality that PrEP isn't going to be an easy sell.
Who wants to take anti-retrovirals for their whole life to prevent a disease that they don't have? With a broken health care system, people can barely afford the medications for their existing diseases, so who would want to pick up the estimated $900 a month bill for Truvada? Will the reliance of PrEP mean the end of condoms?
Villarosa has her concerns as well:
There are also larger questions to consider. With no increased federal HIV/AIDS funding in the pipeline—and states cash-strapped by the economy—currently 86,855 HIV-positive Americans are stuck on waiting lists, unable to afford lifesaving medications. The bulk of those without access to treatment live in the South, and most are people of color. In sub-Saharan Africa, where HIV/AIDS has hit the hardest, only 37 percent of those eligible for lifesaving treatment receive it.
So in a time of tight resources and more demand than supply, who should get medication? Those who are sick—or those who want to avoid getting sick?
In the end, we need all the help we can get in fighting this epidemic. And PrEP shouldn't be downplayed, but more studies need to be conducted and more work around how it will be implemented in our community needs to be done in order to truly understand how it impact AIDS in Black America.
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