In 2009, it was estimated that three to five percent of Washington D.C.’s population was living with HIV, a number comparable to to that of many African nations. Up to 4 percent of the black population in D.C. carries HIV, and the number one demographic is black homosexual men. The second highest is African-American women, who make up half the female population in D.C., and comprise 92 percent of the women infected with HIV.
An official HIV epidemic was declared, and thanks to target prevention efforts to stop the spread of the disease, HIV diagnoses in D.C. have dropped by nearly 60 percent. However, the problem is not solved.
D.C. has the highest HIV rates in the country, which still exceed the World Health Organization's definition of a generalized epidemic. And African-Americans are affected by it the worst. The next step in combatting D.C.’s decades-long battle with HIV, is a two-year, $1 million initiative by the MAC AIDS Fund to promote and educate African-American women on the antiretroviral pill PrEP.
Originally targeted to gay men, the FDA-approved drug has been deemed “life-saving” for its effectiveness in preventing the spread of HIV, and if consistently taken every day, the treatment can reduce a person’s risk of contracting HIV by over 90%.
The problem is that many people still don’t know about PrEP, and those who do often assume it is only for men. According to D.C.’s public health department, African-American women make up 20% of all new HIV infections, making the MAC AIDS Fund initiative more important than ever.
Education and awareness is one thing, but access to PrEP is another issue MAC AIDS Fund aims to tackle through its program. PrEP must be prescribed by a doctor, so individuals who don’t have private doctors generally don’t have access to the drug. Even those who do still may struggle to attain it. Many healthcare provider still lack knowledge on the drug, perceive it to be only for gay men, or may even refuse to prescribe it for “moral” biases due to stigma and its association with HIV.
“[Stigma] has undercut the value of every donor dollar that we’ve put out there,” says Nancy Mahon, MAC AIDS Fund’s global executive director. “The biomedical advances [in terms of PrEP] have moved much more quickly than our ability to address the underlying inequities. We don’t want to have the unavailability of PrEP perpetuate those inequities.”
The initiative’s investment could also drastically reduce medical spending. The lifetime medical costs of caring for an individual with HIV is around $400,000. Considering the number of people on Medicaid or Medicare, making PrEP accessible would save millions in taxpayer dollars.
But the ultimate goal in the end is about protecting and improving the lives of women. PrEP is the “first female-controlled HIV-prevention method,” and like various forms of contraception, it allows women to take full control of their sexual lives. Michael Kharfen, the senior deputy director for the D.C. Health Department's HIV/AIDS, Hepatitis, STD & TB Administration says,
“We just want to convey that this is empowering for women, an opportunity for them to take charge and dominate their sexual health.”