Black gay and bisexual men are far less likely than their white counterparts to take PrEP.
Since the introduction of PrEP, HIV incidence in white gay and bisexual men has fallen greatly, but the fall in black men hasn’t been as big.
There are many reasons that contribute to this, which include structural racism, homophobia, discrimination, cultural norms valuing masculinity, poverty, concerns about confidentiality during HIV testing or treatment and the lack of targeted HIV prevention campaigns. As a gay black man, I’ve experienced nearly all of these issues and I know that many others like me have had similar experiences.
Why is it that when it comes to sexual health, most of the time the intersection of being both black and gay isn’t taken into consideration? We are a unique group that has very specific concerns and we need to be communicated with in our language.
We need to step up our advocacy and campaigning for HIV prevention tools including PrEP and treatment as prevention, especially within countries and within communities that are not only disproportionately affected by HIV, but also by stigma, lack of awareness and inadequate access to treatment for the condition. Should these people become HIV-positive they might struggle to find support that other people who are not like them could get easily. Having a strong support network is a privilege that not everyone has.
There are many black gay men who might not be out to their families because they might not accept their sexuality, let alone a HIV-positive diagnosis. The potential for rejection and isolation is significant. Many of us are disproportionately affected by stigma and that prevents many of us from getting the tools and support we need.
This is about equity not equality – it might take longer, it might be more difficult, it might even be more work to get more black men talking about PrEP, embracing PrEP, taking PrEP and telling their friends, but just because it takes extra work doesn’t mean that we shouldn’t do it.