Black Women Need PrEP too! | HIV Prevention & PrEP for Black Women

By: Jay Dee, MPH

Black Women Need PrEP too!

Girls, let’s talk.

All men do not value sex as a lot of women do.

This is a fact that needs to be kept at the frontal lobe of your brain. Simply because in the event your male partner cheats on you sexually, there’s a stronger possibility he did not use a condom. Unprotected or raw sex is not exclusive to you—unfortunately!

For starters, before sex, especially raw sex, begins, both of you need to exchange sexually transmitted infections (STIs) test results. This will include Chlamydia, Gonorrhea, and HIV. Note: You must inform your provider that you want an HIV test. By law, they cannot test you without consent.

This practice should continue at least annually, but throughout your relationship and whenever new partners enter your relationship. While this is best practice, this is still risky! A person can absolutely produce a negative test result in January, cheat on you in March, and infect you with HIV in March!

Everyone shuns others for contracting STIs, but the truth of the matter is, most Black women are infected in their monogamous relationship. CLOCK IT!

People love to perpetuate that STIs and HIV are reserved for the whores and the gays. That is false! The most common symptom of all STIs and HIV is no symptom at all. It’s not often a person will have sex while experiencing genital irritation, itchiness, burning, odorous discharge, etc. Again, some will, but most will not.

Can sex be enjoyable under those conditions? Probably not! This is why it is easy to pass along STIs and HIV. The carrier does not know they’re infected!

Black Women Versus Whores

Back to Black Women versus whores!

According to the book, Stolen Women: Reclaiming Our Sexuality, Taking Back Our Lives, by Dr. Gail Elizabeth Wyatt, in the text, Dr. Wyatt highlights a few key differences between Black women and whores:

1. Black Women are too trusting, which results in raw sex without knowing their partner’s sexual history. Knowing meaning proof!

2. Black Women view raw sex as a deeper level of connection.

3. Black Women highly value sex with a partner. It holds too much emotional power.

4. Whores understand the importance of STI and HIV prevention, so they opt for condoms.

5. Whores view sex as an activity that feels good and/or they receive a monetary gain.

6. Whores keep sexual relationships on the surface level.

   
   

Maybe Black Women should learn from whores as opposed to shaming them.

You trust that man, they don’t!

If He’s Cheating, Protect Yourself

Let’s address the elephant in the room: Black Women will still participate in raw sex knowing their partner is cheating. That’s insane!

I’ve witnessed this too many times amongst women.

Think about your sex life. Did he ask for your test results before you all decided to remove the condom?

Exactly!

He didn’t ask the other person he’s having sex with for their test results either.

Even when the cheating is addressed, Black Women still don’t require testing!

Sis, don’t be that naïve or passive. This information is necessary for your health and well-being.

Even with STIs, do you know if an infection is left untreated for too long, you can suffer health challenges: infertility, deafness, blindness, joint pain, and, if pregnant, the fetus is at risk for developing physical deformities. More can occur.

A lot is on the line, and you’ve chosen silence?

Many people “trust” the other person doesn’t have an STI or HIV. Many people’s biggest fear is pregnancy, and even then, they trust the “pull out” method.

So, if your man is cheating or has cheated, assume he didn’t use a condom and that he’s doing it again.

Remember, he was CAUGHT once or twice!

Imagine what you don’t know!

We can’t be the same ones yelling “Niggas ain’t shit” yet still allowing these same “ain’t shit ass niggas” to have sex with us unprotected.

Condoms First. PrEP Too.

I’m not telling you to leave your cheater. I’m telling you to protect yourself.

Consider getting on PrEP.

Let’s be clear: condoms are your first line of defense.

When used correctly and consistently, condoms significantly reduce the risk of HIV and certain STIs. For heterosexual vaginal sex, studies estimate that consistent condom use reduces the risk of HIV transmission by about 80%. However, condoms do not provide the same level of protection against every STI, especially infections that can spread through skin-to-skin contact. Human error also matters. Condoms can break, slip, or be used incorrectly or inconsistently.

Then there’s PrEP.

PrEP, or Pre-Exposure Prophylaxis, reduces the chances of getting HIV through sex by about 99% when taken as prescribed.

Yes—it is an HIV medication.

However, you must test negative for HIV to be a candidate for PrEP.

And no, you don’t have to know for certain that your partner has HIV before considering PrEP.

Exposure to HIV can mean having condomless (raw) sex with someone whose current HIV status you have not verified. It can also mean having condomless sex with someone who is having—or may be having—condomless sex with another person.

In the grand scheme of things, HIV exposure can occur when your body comes into contact with certain bodily fluids from a person with HIV, including blood, semen, vaginal fluids, rectal fluids, and breast milk, when those fluids enter your bloodstream or contact mucous membranes or damaged tissue.

That means your risk is not only about the person you are sleeping with.

It can also be about the people they are sleeping with.

And this is exactly why I want Black women to think differently about PrEP.

If you have a partner who has cheated, if you don’t know whether he is using condoms with other partners, or if you simply don’t have confidence in his sexual health decisions, you have the right to protect yourself without waiting for him to make better decisions.

How Long Does PrEP Take to Work?

This is important.

If you are taking daily oral PrEP, the CDC says it reaches maximum protection from HIV at about 7 days for receptive anal sex and about 21 days for receptive vaginal sex. How quickly protection builds can depend on the type of PrEP and how it is taken, so talk with your healthcare provider about which option is right for you.

And remember: PrEP protects against HIV—not pregnancy or other STIs.

That is why I’m not telling you to choose between condoms and PrEP.

Use the tools available to you.

Condoms can help protect against HIV, certain STIs, and pregnancy. PrEP adds another layer of protection specifically against HIV.

Your man may not protect you.

You still can.

PrEP Isn’t Just a Pill Anymore

PrEP is also available as an injectable medication.

Apretude is administered after an initial dose and a second injection one month later, followed by injections every two months.

There is also Yeztugo, an injectable form of PrEP administered every six months after the initial dosing schedule.

That means you have options.

You don’t have to take a daily pill if that isn’t the best option for you. Talk with your healthcare provider about your sexual health, your relationship, your potential HIV exposure, and which PrEP option may be right for you.

Black Women and HIV in Jacksonville

In 2022, Duval County reported 334 new HIV diagnoses—261 men and 73 women. In 2023, there are 8,280 people living HIV according to AIDSVU.org with black heterosexuals aged 25-44 having the second highest prevalence after men-having-sex-with men.

The numbers should make you pause.

Not because you should be afraid of sex.

Because you should be informed about sex.

And because being in a relationship does not automatically protect you from HIV.

I’ve Been That Woman

But then it clicked:

Why am I compromising my health for someone who clearly doesn’t care about their health—or me?

We owe it to ourselves to stay vigilant, to prioritize our health, and to do everything we can to stay HIV and STI negative.

You cannot control whether somebody cheats.

You cannot control whether somebody tells you the truth.

You cannot control whether someone else uses a condom.

But you can control how you protect yourself.

So, Black women, look in the mirror.

Look at your relationship.

Look at your sexual health.

Ask yourself whether the person you trust with your body is actually making decisions that protect your health.

And if the answer is no—or even “I don’t know”—that is enough reason to start asking questions.

Talk to your healthcare provider about HIV testing, condoms, and PrEP.

Protect yourself before you need protection.

Because it only takes one time, one contact with semen.

Just think about It.

Until Next Time,

The Vagina Liberator

FAQs: Black Women, HIV & PrEP

1. What is PrEP and how does it prevent HIV?

PrEP stands for Pre-Exposure Prophylaxis. It is medication taken by people who are HIV-negative to reduce their chances of getting HIV if they are exposed to the virus. When taken as prescribed, PrEP can reduce the risk of getting HIV from sex by about 99%. PrEP is an HIV prevention medication—it does not prevent pregnancy or other sexually transmitted infections (STIs). (HIV Risk Calculator)

2. Should Black women consider taking PrEP if their partner is cheating?

Yes. A woman does not have to know that her partner has HIV to discuss PrEP with her healthcare provider. If your partner has cheated, has other sexual partners, does not consistently use condoms, or you simply do not know his current HIV status, you may want to consider PrEP as an additional layer of HIV protection. PrEP is specifically recommended for people who may be exposed to HIV through sex. (CDC Stacks)

3. What are the side effects of PrEP?

Most people do not experience significant side effects from PrEP. Some people taking oral PrEP may experience nausea, headache, vomiting, loss of appetite, or abdominal discomfort, particularly when they first begin taking it. These symptoms usually improve within the first month. Some oral PrEP medications can also affect kidney function or bone mineral density, which is why medical monitoring is important. (CDC)

Injectable PrEP can cause pain, tenderness, redness, or swelling where the injection is given. These reactions are generally mild and temporary. (CDC Stacks)

If side effects are severe, unusual, or do not go away, contact your healthcare provider.

4. Does PrEP protect against STIs and pregnancy?

No. PrEP protects against HIV, not pregnancy or other STIs. Condoms remain an important prevention tool because they can reduce the risk of HIV, pregnancy, and certain STIs when used correctly and consistently. Using condoms and PrEP together can provide additional protection against HIV while condoms help address other sexual-health risks. (National Prevention Information Network)

5. How long does PrEP take to work for women?

For daily oral PrEP, the time needed to reach maximum protection depends on the type of sexual exposure. CDC guidance has historically estimated about 21 days of daily use for receptive vaginal sex and about 7 days for receptive anal sex. Talk with your healthcare provider about when protection is expected to be established for the specific PrEP medication you are taking. (CDC)

Bottom line: If you are a Black woman who has questions about HIV exposure, cheating partners, condomless sex, or PrEP, talk to a healthcare provider. You do not have to wait until something happens to start protecting yourself.