What HIV-Prevention Drug Means for Blacks

Truvada is a historic breakthrough -- but some activists remain concerned about access and proper use.

Posted:
 
truvada_071312_400jrw
Justin Sullivan/Getty Images

(The Root) -- On Monday the U.S. Food and Drug Administration approved the first pill to prevent HIV infection in adults who do not have the virus -- but are at risk of becoming infected. Studies have shown that Truvada, a little blue tablet taken once a day, can dramatically reduce transmission of the virus.

This development, known as pre-exposure prophylaxis, or PrEP, adds to a growing list of recent breakthrough medical strategies that reduce the spread of the disease. It also comes as a good-news curtain raiser to the International AIDS Conference, which kicks off in Washington, D.C., this weekend -- the first time on U.S. soil in more than 20 years.

African Americans have been slammed by HIV since the beginning of the epidemic 30 years ago, and desperately need new ways to stop the virus. More of us are living with HIV/AIDS, newly infected or dying of the disease than any other ethnic group in this country. Of the 1.1 million Americans infected with HIV, 510,000 are black.

Still, as HIV advocates across the country called the FDA approval of Truvada for prevention "historic," "groundbreaking" and "lifesaving," African-American activists reacted with much more guarded optimism and a healthy dose of caution.

"Yes, this is an important advancement for African Americans and gives us another prevention option," says Ronald Johnson, vice president of policy and advocacy at AIDS United in Washington, D.C. "But it's not a magic bullet. This isn't something that you can take every once in a while when you're going out. It does not replace safer sex and must be used in conjunction with consistent practices, including condom usage. "

Phill Wilson, president and CEO of the Black AIDS Institute, is more blunt. "The FDA got this one right, but here's what I'm worried about," he said in a statement. "We do not know if our community will embrace this new tool. Will we get the information that will allow us to learn what PrEP is and what PrEP is not, who should be taking it and who should not, where to find it and how to use it?"

Even with these caveats, Wilson and other activists hope the medication can provide added protection for the two groups most at risk of contracting the virus in the U.S.: heterosexual black women and black gay and bisexual men.

Of all the women living with HIV in this country, approximately 66 percent are African American. In fact, one out of every 32 black women will be diagnosed with HIV infection during her lifetime -- a rate higher than in many African countries. The vast majority of these women become infected with HIV by having unprotected sex with a man, often in what they consider to be a "committed relationship."

Truvada may also slow the spread of HIV among black gay and bisexual men. According to a new report released this week by the Black AIDS Institute, black gay and bisexual men make up nearly one in four new HIV infections, though they account for only one in 500 people living in the U.S. By the time a black gay man reaches age 25, he stands a roughly 1-in-4 chance of being infected with HIV. "For the most at-risk population on the planet -- black gay and bisexual men -- this approval is not a moment too soon," says Wilson.

The challenge will be reaching them. Many have been driven away from health care and other services by negative experiences and are isolated from family and other support because of homophobia. "We now need to find a way to deliver this drug to where they are," Wilson adds.