We need to do a better job of including black women in conversations about HIV and PrEP

In an era of rising sexually transmitted infection (STI) rates, it is important to consider the preventative tools that can and should be used to reduce STIs and HIV acquisition.

There are four tools that we can all use to stop the transmission of HIV (human immunodeficiency virus); consistent condom use, regular STI testing, HIV treatment and PrEP, also known as pre-exposure prophylaxis.

PrEP, is a drug given to HIV negative people to reduce the risk of HIV. If taken as prescribed, PrEP is up to 100 per cent effective at stopping HIV transmission. But even in the face of clear evidence of PrEP being hugely beneficial to those who use it, access to the drug is still capped in England.

The national PrEP Impact Trial, which includes 26,000 participants, is oversubscribed in many parts of the country, resulting in people being unable to access this game-changing drug.

In Wales, where there has been uncapped access to PrEP for nearly two years, there has not been one single HIV infection. We need to see the same access in England, particularly for communities who have an increased risk of HIV acquisition.

Working as a sexual health advisor for the NHS, I regularly see patients who take sexual risks, which increases their possibility of acquiring an infection. In line with positive health promotion and safer sex messaging, I agreed to be a part of Terrence Higgins Trust campaign to promote PrEP use and access to those who are at risk, particularly black women like me, who are often left out of the PrEP conversation.

Data taken from, the Naz Project London reveals that 82 per cent of women living with HIV in the UK are from BAME communities, 75 per cent of women newly diagnosed with HIV are from BAME communities and 67 per cent of women living with HIV are Black African, all the above place black women at higher risk of sexual and reproductive health inequalities.

Unfortunately, as mainstream sexual health campaigns about HIV prevention often solely feature white or gay men, in addition to black women not knowing enough about PrEP to protect themselves, those who may be at risk tend to believe they are not.

The high prevalence of HIV among black women prove this to be false. Low uptake of PrEP via the Impact trial also highlights a gap in information and awareness for women of this demographic despite its likely effectiveness in decreasing HIV transmission, which would effectively lower the numbers of black African Women being diagnosed.

Josina Calliste, Strategic Lead for Women at PrEPster, an organisation that aims to educate and agitate for PrEP access in England and beyond, believes that “for women who belong to communities which are more affected by HIV, PrEP can give peace of mind during and after sexual encounters, enabling pleasurable experiences and facilitating good communication with sexual partners, and sexual health services.” In my experience of speaking to women who have benefited from the drug, I agree.

The latest statistics from Public Health England revealed that there are over 100,000 people living with HIV in the UK. Although these are small numbers in comparison to the picture in other parts of the world such as Africa, where nearly 1 in every 25 adults (4.1 per cent) are living with HIV, both knowledge and access to PrEP in the UK is crucial to ending HIV transmissions, which the UK government has committed to achieving by 2030.

Dr Anabel Sowemimo, Sexual and reproductive health doctor and founder of Decolonising Contraception, a not for profit, community interest group formed by people of colour working within sexual and reproductive health who are devoted to improving the outcomes for marginalised groups, said:

“PrEP is a really exciting advancement and we need to start considering those that could benefit more broadly. For example, women who experience intimate partner violence, women who are forced into sex work or women who are unaware their partners are having other sexual partners.

“In these instances, PrEP is beneficial in preventing HIV risk, particularly as these women may be unable to use barrier methods to protect their sexual health.”

One of the ways in which those barriers can be broken down is through public awareness campaigns. The Terrence Higgins Trust’s PrEP initiative, for example, launches later this summer with the aim of starting a much-needed conversation about the drug.

In line with this work, the Terrence Higgins Trust have also introduced a selection of interactive films titled Their Story, Your Choice, in which viewers can help characters navigate everyday dilemmas of people living with HIV.

Through a combination of photo campaigns interactive videos and discussions about safer sex, those who are most at risk of HIV can get the protection they need to maintain a negative status and lead pleasurable sex lives.

We have a long way to go before black women are sufficiently represented in the fight to make PrEP more accessible, but that doesn’t mean we won’t get anywhere. Hopefully, with the help of the aforementioned practitioners, bodies and individuals, fewer women will be left behind.

You could benefit from PrEP if you are considered to be at high risk of HIV. For more information, access the PrEp Impact Trial website here

Find out more information about PrEP on the It Starts With Me website here