Opinion: World AIDS Day and breaking the silence on Black women in HIV prevention

World AIDS Day is a day to honor and commemorate those whose lives have been impacted by HIV/AIDs. This day serves as a poignant reminder that knowing your status is critical in the fight for a world free from AIDS, where new infections are rare and those who are diagnosed with HIV receive an early diagnosis and treatment.

At Planned Parenthood of Southern New England, we diagnose one out of every 10 new HIV infections in the state of Connecticut and prevent countless new cases through HIV testing, education, and prescribing of pre- and post-exposure prophylaxis (PrEP and PEP). World AIDS Day is a reminder that the fight against HIV/AIDS is a collective journey and as we take stock of the status of the HIV epidemic, it is imperative to acknowledge and address the disparities faced by a group often overlooked in conversations about HIV—Black women.

Despite the progress made in HIV awareness, prevention, and treatment over the past four decades, Black women continue to be disproportionately affected by HIV. In 2021, according to the Centers for Disease Control and Prevention, about one in five new HIV infections were women, with Black women making up a disproportionate percentage of these new cases. In fact, 40% of all new infections occurred in Black people—three times their proportion in the U.S. population. This disparity is no coincidence—it is a reflection of systemic issues that demand our focus and attention.

Black women face unique challenges in HIV prevention efforts, largely being overlooked and left out of prevention campaigns and health care initiatives. The same barriers to quality care that are so prevalent in the Black maternal health crisis extend to the HIV epidemic. The compounding stereotypes and stigmas surrounding HIV only lead medical professionals and public health officials to further perpetuate these disparities. Too often, doctors fail to talk with Black women about the tools we know to be effective, such as testing and PrEP. Pharmaceutical companies have all but erased Black women from the research and marketing about PrEP and HIV prevention, minimizing the value of the Black women who lost their lives to HIV and AIDS.

No doubt this is why when I, as a family doctor, ask my Black female patients and Black women in my community if they have ever talked with a doctor about PrEP, the answer is almost universally “no”. For health care professionals, recognizing how our own implicit biases contribute to the disparities in HIV rates, and making a commitment to do better, is an essential step toward a more inclusive and effective approach to HIV prevention.

To my fellow Black women, I challenge you to ask your health care provider about PrEP and about getting tested for HIV. Tailored, culturally competent outreach, increased accessibility to testing, and destigmatizing conversations around HIV are crucial components to short-circuiting the spread of HIV. It is long overdue that we break the silence and ensure that Black women are not an afterthought but rather central in our fight against HIV.

HIV does not discriminate based on labels of race, color, gender, or sexual orientation. If we want to end the HIV epidemic, neither can we. On the 2023 World AIDS Day, let us collectively commit to amplifying the stories of Black women in the HIV prevention narrative. It is time we move past faulty assumptions and adopt prevention strategies that normalize the conversation about HIV in ways that are inclusive, accessible, and effective to help us address HIV in all our communities. As we commemorate World AIDS Day, let us remember a world with no new cases of HIV is possible, but the only way there is together.

Dr. Ayiti Maharaj-Best is Medical Director, Planned Parenthood of Southern New England

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