Phil Samba @IdiosyncraticXL British-Sierra Leonean, Social activist/writer/speaker, Health improvement specialist@THTorgUK
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. We are also only enrolled on to PrEP trials around the world in tiny amounts.
WHY WE NEED PrEP
This is why that’s not good enough: HIV rates in England continue to be higher among black men compared with white British men. There’s also been a year-on-year increase in new UK HIV diagnoses among black African men for over a decade. Black Africans in the UK are also more likely to be diagnosed late with advanced HIV because they either don’t test regularly enough or at all, and this means that by the time they are diagnosed their immune systems are already badly damaged. In fact, a 2014 Public Health England report said that black British men who have sex with men (MSM) are 15 times more likely to be HIV-positive than the general population.
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.
Let’s not forget mental health. In the UK, compared with the white British majority, black men are more likely to qualify as depressed and report suicidal thoughts. Poor mental health also leads to sexual risk taking. I can say from my own experiences that poor mental health leads to poor sexual health. There have been many times in the past where I have taken risks sexually as a result of feeling depressed and using sex as an unhealthy coping mechanism.
A WORLDWIDE FAILURE
Black men not having proper access to PrEP isn’t even a travesty that’s exclusive to England. It’s worldwide. The iPrEx study (which covers Peru, Ecuador, Brazil, South Africa, Thailand and the United States) was to determine whether PrEP could safely and effectively prevent HIV acquisition through sex in men who have sex with men and transgender women. It had 2499 participants. Only 10% were Black. The French IPERGAY study had 400 gay men participate and only 7.2% were black.
Then there’s England. The Proud Study which measured the effectiveness of daily PrEP for MSM in England, recruited 545 gay men in their thirties who were predominantly white, university educated and employed. Only 3% of the participants were black. Read more via GMFA