A Q&A About HIV and Black Women & Birthing People
In partnership with NMAC for HIV prevention and awareness
Q: You don’t hear as much about HIV these days as you used to. Is it still a problem?
A: HIV remains a major public health issue, even if it sometimes seems you don’t hear as much about it. In the three cities where New Voices for Reproductive Justice works (Cleveland, Philadelphia and Pittsburgh), more than 1,000 people were diagnosed with HIV in 2021. Among Black females between 20 and 44 years, HIV remains among the top 10 causes of death.
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Q: I’ve seen public service advertisements for HIV testing. But I’m afraid of what my test results will be. If I test HIV-positive, would there be much my doctor could do for me?
A: Yes! People living with HIV who go on treatment can live a fully healthy, normal life span. And the drugs people take for HIV can also prevent newborns from becoming infected if their mother is HIV-positive. HIV drugs are available in a single pill you take once a day or, if the person prefers, in a single injection every two months. Unlike the very earliest HIV drugs developed nearly 30 years ago, today’s HIV drugs have few, if any, side effects and are easy to take. HIV medicines help suppress the virus in the body. People on medicine who have suppressed viruses are unable to pass along the virus to another person, including during sex.
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Q: Even if I want to learn my HIV status, I am not sure I want to go to a public testing site or talk to my doctor about getting the test. Is there any other option?
A: Yes. You can test at home with an HIV self-test. In Philadelphia, for example, you can ask that an HIV self-test be mailed to you at your home by going online at http://www.phillykeeponloving.com. Many community-based organizations in all three cities would be able to help you get a kit for HIV self-testing.
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Q: Are Black women at risk of HIV?
A: Black women are one of the groups at highest risk of getting HIV. Black women are 11 times more likely than white women to be newly diagnosed with HIV. In 2021, Black women accounted for the majority (54%) of women diagnosed with HIV in the U.S.
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Q: Are trans women at risk of HIV?
A: Yes, a growing number of trans women are becoming HIV-positive. In 2021, more than 800 trans women nationwide tested HIV-positive, and the number of trans women diagnosed with HIV increased by 24% from 2017 to 2021. Roughly 90% of all trans women diagnosed with HIV got the virus during sex. Black and Latinx trans women make up 75% of all trans women diagnosed with HIV in 2021.
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Q: If I’m HIV-negative, how can I protect myself from getting HIV during sex?
A: A cheap, convenient way to prevent getting HIV is to use a condom during sex. Depending on your circumstances, women can sometimes find it hard to talk to their partners about using a condom. In all of the three cities where New Voices works, community organizations are available to help you think through how you can talk to your partners about condoms in a way that is safe.
In addition to condoms, the same drugs that are used to treat HIV are also now used to prevent people from getting the virus in the first place. You can take HIV medicines before you have sex, an approach known as PrEP. In addition, if you have sex without a condom and fear you may have been exposed to HIV, you can also take HIV medicines soon after sexual intercourse, an approach known as PEP.
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Q: I’ve heard that PrEP is for gay men. Is PrEP right for women as well?
A: PrEP is an important prevention option for cis men and women as well as for trans men and women. PrEP can be taken either orally or by injection. It reduces the risk of getting HIV during sex by 99% and it also lowers the risk of getting HIV after sharing syringes or injecting equipment by 84%. Medicaid and most private insurers cover the costs of PrEP. But it is true that PrEP is prescribed most often for white gay men. Many women and people of color aren’t aware that they could benefit from PrEP, and many providers of health services don’t counsel women or patients of color about the potential benefits of PrEP. Relatively few women are currently taking PrEP, and white people made up 78% of people receiving PrEP in 2021.
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Q: Please tell me about PEP. How does that work?
A: PEP significantly reduces the risk of getting HIV after you have been exposed, but it doesn’t necessarily prevent 100% of all infections. With PEP, you take HIV medicines for 28 days. You need to start PEP within 72 hours (3 days) of your possible HIV exposure (during sex or sharing injecting equipment during drug use or for hormone treatment). Your local health agencies as well as many community organizations are available to help you get PEP when and if you need it. In Philadelphia, you can call the city’s 24/7 PEP hotline, 833-933-2815. In Cleveland, you can call the Ohio HIV/STI hotline at 800-332-2437. In all cases following a potential exposure to HIV, you can visit an emergency room, where you can be started on PEP.