Alexis Perkins thought her OB-GYN's office in Atlanta would be just the place to get a prescription for the type of drug that reduces a person's risk of contracting HIV.
But during a recent visit, the medical assistant who greeted her had not heard of the medicines known as preexposure prophylaxis, or PrEP, and she seemed uncomfortable discussing it, Perkins said. Her provider had heard of it but didn't feel confident prescribing it.
But more than a decade after the first PrEP drug was approved for the U.S. market, one of the groups that would benefit most from the medications isn't taking them: Black women, such as Perkins, whose gender identity align with their sex assigned at birth. "If we don’t figure out how we can change the system, we're just going to continue to keep failing Black women," said Tiara Willie, an assistant professor of mental health at the Johns Hopkins Bloomberg School of Public Health.
Gilead Sciences, the company that makes Descovy, later announced it would conduct a trial focused on the drug's use among cisgender women. The company said that study is ongoing, with data expected in late 2024. The CDC, for its part, earlier this year announced an $8 million grant to fund studies on strategies to increase PrEP uptake among Black cisgender women.
The CDC updated its PrEP guidelines in 2021 to reflect the latest science and drug approvals, but the agency has heard complaints from providers that they're still too onerous, said Robyn Neblett Fanfair, acting director of the agency's Division of HIV Prevention. She added the CDC is "moving toward" guidelines that are more "timely and nimble."
Social stigma not only can prevent Black women from talking about PrEP with their friends, neighbors, and doctors, but it can seep into their domestic relationships, said Mauda Monger, an assistant professor at the School of Population Health at the University of Mississippi Medical Center.
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