PrEPare Black Women Health Inequity in PrEP Access

my father

john franklin nathan was one of the

only black pharmacists in the city of

columbus

in the 1970s and 1980s

and man was my daddy special

i know this because i had a front row

seat

to his practice he was compassionate

empathetic and committed to the work

of our community i watched my dad

explain to patients how medications work

long before this was required by law

he knew the nicknames and birthdays of a

lot of his regular customers

and literally watched a community of

children

grow up right before his very eyes

he was a gatekeeper of health and

wellness

in our community and my biggest

inspiration in becoming a pharmacist

my journey in the profession started at

spelman college where

i majored in biology i then moved cross

country

to attend the university of california

san francisco

for pharmacy school and let me be honest

with you that

i struggled in pharmacy school as one of

the only

black women in my cohort

and i struggled trying to find my sense

of identity

and purpose in this profession

but then something very unique happened

my fourth year of pharmacy school on a

clinical rotation

i was introduced to my very first

patient and i will never forget her

for the purposes of our discussion today

let’s call her

shuri shuri was young

black popular on ig and came from a very

loving family but unlike me

shuri was very sick she was experiencing

night sweats

and chills skin rash

and shuri was had been recently

diagnosed with hiv

i explained to shuri that day that hiv

stands for the human

immunodeficiency virus

and that once infected the body’s immune

system

the germ fighting system does not fight

off infections

properly if left untreated

during that patient interaction that day

with shuri

she shared with me that she was not in a

monogamous relationship

she used condoms but not consistently

and she had a sexually transmitted

infection

within the last six months and

these three behavioral markers would

have indicated shuri for

hiv prevention and specifically

a drug that i want to talk to you about

today called prep

prep stands for pre-exposure prophylaxis

pre-meaning before exposure meaning

coming in contact with hiv

and prophylaxis meaning treatment to

prevent

an infection simply put

prep is a medication that you can take

every day

to prevent acquiring hiv

through sexual transmission

it’s kind of like putting on a mask to

prevent covet 19.

but as a pharmacist i rarely

dispense bottles of prep from my hands

into the black and brown hands

of the people who need it the most and

shuri is a prime example of this

she knew nothing about prep

she never talked to her health care

provider

about prep at all and this deeply

concerned me because one conversation

one decision one

google search about prep and shuri could

have prevented

acquiring hiv through sexual

transmission

shari’s problem shuri’s story highlights

a very

important problem that the lack of

information

and awareness about your sexual health

can lead to hiv

and this problem disproportionately

affects the black community but

specifically

a group of people who look just like me

black women so let’s look at some of the

data to support this

the rates of new hiv diagnoses in black

women

are 14 times the rate than white women

and black women make up for 57

of all new hiv diagnoses

when only representing 13 of the

population

and prep prescriptions less than one

percent of them

go to black women so not

only are black women disproportionately

contracting hiv we are not utilizing the

one drug that can be used to prevent hiv

through sexual transmission and i

see this every day in my practice

and it is a huge weight to carry

so now that you know a little bit more

about prep what can we do to ensure

that our community is utilizing prep

well to start we have to normalize

conversations

surrounding sex and sexual health in the

black community

black people tend to discuss collard

green recipes

and pass down quilts from generation to

generation

but we rarely have these structure

conversations

about our sex and sexual health and this

must change

we also need to know where we stand and

as there are

several high-risk groups at risk of

acquiring hiv

today i want to focus on black women

if you are a black woman and you are

having sexual intercourse with the

hiv-positive partner or you are having

sexual intercourse with multiple

partners and are unclear of their hiv

status

or use condoms but inconsistently

i want you to visit the following

website

www.cdc.gov

and type in prep in the search bar as

you are indicated for prep

immediately and i know some of you may

be thinking

prep isn’t for me but what powerful

information to pass along to your

friends

and family members and loved ones about

this

life-saving drug

still speak with shuri today and let me

tell you that

she is a fighter and although she

contracted hiv through sexual

transmission

and was not indicated for prep she

still advocates for prep in our

community

both shuri and my dad taught me that

the wellness of our community

is our collective responsibility

black girls and women deserve better

and i join you to help me in the fight

to end hiv in the black community

thank you