Audre Lorde Health Program Medical Director: We Must Do Better to Educate Women and Girls About HIV Prevention

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National Women and Girls HIV/AIDS Awareness Day is an occasion observed each year on March 10. The Center’s Audre Lorde Health Program Medical Director Kaiyti Duffy writes about much-needed progress in the areas of prevention and awareness.

Over the past several years, there have been significant advances in medications available to prevent and treat HIV. We are now at the point where an end to the HIV endemic is possible. But we must engage allthose at risk for or living with HIV in services, including women and girls, in order to achieve this.

HIV continues to carry significant stigma and preconceived notions in regard to who does, or doesn’t, get infected. This has prevented women from having honest, open discussions about HIV transmission and their prevention options. This is especially true in primary care offices. A few years ago, I became the primary care doctor of a woman who was recently diagnosed with HIV. In reviewing her chart, I came to realize that she had been seen at a local clinic 10 times over a two-year period due to a variety of flu-like symptoms. At no point did anyone ask her about her sexual history or conduct an HIV test. It was not until she showed up at an emergency room one night that she finally received her HIV-positive diagnosis.

Women and girls face many barriers to HIV prevention and treatment. Many health care providers are uncomfortable talking about sex and sexuality with patients while others consider HIV a gay man’s disease and, therefore, have no concern for their female-identified patients. As a result, highly effective means of HIV prevention, including pre-exposure prophylaxis (PrEP), are utilized at a much lower rate by women than their male counterparts.

This is especially true with Black women. A survey conducted by the pharmaceutical company which makes PrEP highlights that 49,158 individuals started this preventive medication between 2012 and 2015. Women represented only 11% of the prescriptions written for PrEP, and Black women were more than four times less likely than white women to have started PrEP.  This is incredibly disappointing because, according to the Centers for Disease Control, Black women accounted for 6 in 10 new HIV infections among women in 2016.

We must do better.

At the Los Angeles LGBT Center, we are committed to having those important, necessary conversations with all those who find a medical home with us. Our medical providers are trained to discuss healthy sexuality with all patients, including proactive ways to prevent STDs and HIV. And we believe PrEP is an option for everyone, regardless of insurance or ability to pay, and it can often be started on the very same day of a medical visit.

The Center currently provides care to a significant number of women living with HIV. Engaging in care with a team that is knowledgeable about the ways in which gender can impact health outcomes is essential to adequate treatment. The medications now available to treat this virus are incredibly effective and can bring a patient’s viral load down to undetectable in a short period of time. As we now know, undetectable = untransmissible so developing strategies to engage people living with HIV in care is essential to prevention efforts.

To say the least, 2020 was an intense year. The COVID-19 pandemic forced all sectors of the American public to turn inward and socially isolate. Access to important services like HIV testing and access to PrEP became restricted in an unprecedented way. In these early days of 2021, we must reconnect people, particularly women and girls, with the vital services and health care they need.

For more information about the Center’s Audre Lorde Health Program for lesbian and bi women, visit lalgbtcenter.org/ALHP

The Center accepts most insurance plans and can help people who are uninsured or underinsured qualify for assistance programs. Visitlalgbtcenter.org/insurance_plans for more information. 

 

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