PrEP and the Black Community

Abstract

New HIV infections are disproportionately concentrated among black Americans. Yet the most powerful new tool to reduce HIV acquisition, daily oral antiretroviral preexposure prophylaxis (PrEP), is inequitably accessed. While black men and women comprised 43% of new diagnoses in 2017, and 44% of persons estimated to have risk behaviors that indicate a need for PrEP, only 14.9% of PrEP prescription in 2017 were to black persons. To address this serious inequity, higher levels of knowledge of HIV status, awareness and knowledge of PrEP, access to clinicians willing and trained to provide it, and support for adherent and persistence use will be required in the black community. This is an urgent priority as the nation moves forward with the “Ending the HIV Epidemic: A Plan for America” initiative that has a goal of reducing new HIV infections by 75% in the next 5 years and at least 90% by 2030 (Fauci et al. JAMA 321(9):844–845, 2019).