Are you a cisgender woman who wants to stay well in communities with high rates of HIV, like Tampa, Fort Worth and Columbus? The Centers for Disease Control and Prevention (CDC) wants you to follow the Twitter hashtag #ShesWell.
#ShesWell is a long-abandoned hashtag used for wellness seminars and general self-care tweets by women, particularly Black women. Now, the CDC has adopted it to promote awareness and use of the HIV prevention pill—known as pre-exposure prophylaxis (PrEP)—among women in communities where HIV continues to go untreated despite effective and safe antiretroviral treatment.
In addition to traditional risk factors for acquiring HIV, like having multiple partners whose status you don’t know or having other sexually transmitted diseases, HIV rates are driven by the rates of untreated HIV in the community. Antiretroviral treatment actually prevents transmission of HIV to other people through sex, so in communities where people have HIV but are on treatment, there’s just less of it around to transmit. The same isn’t true in communities where access to services, including limited access to Medicaid and poor public health funding, limit people’s ability to take antiretroviral treatment. Indeed, the new science of HIV treatment means you can be both healthy and living with HIV. In areas where treatment rates are high, there’s less chance that people with HIV can transmit the virus. PrEP can prevent people from getting a preventable chronic condition like HIV that requires ongoing interaction with a health care system that can be hostile to the needs of Black women in particular.
While cisgender women (women assigned female at birth) make up only a minority of people in the United States who acquire HIV every year, around 6,700 women still acquire the virus annually, according to the CDC. Most of these cases occur among Black women.
The PrEP pill, available under the brand name Truvada as well as generic versions, contains two antiretroviral drugs, tenofovir disoproxil fumarate and emtricitabine (sometimes known as TDF/FTC). The pill is available for free through the Ready, Set, PrEP program. Federal regulators recently reminded insurance companies that the Affordable Care Act requires them to cover it at no cost to the client.
For cisgender women, taking PrEP consistently every day can protect against acquiring HIV, even if they’re exposed via vaginal or anal sex.
In 2019, the Food and Drug Administration approved another HIV prevention pill, Descovy (tenofovir alafenamide/emtricitabine), but not for people who have vaginal sex, as Gilead Sciences didn’t test the drug for such people before asking for approval. Gilead is conducting these studies now. Another form of PrEP, long-acting cabotegravir injections every other month, is highly effective for cisgender women; it could be approved early next year.
Despite the fact that cisgender women make up about 18% of new HIV cases every year and that Truvada has been available for HIV prevention since 2012, only 7% of women who could benefit from the HIV prevention pill took it in 2018, according to the CDC. And women are more likely to discontinue PrEP swiftly than gay men.
While organizations run by Black women, like SisterLove and Black Women’s Health Imperative, have their own campaigns to help women stay well, the CDC program aims to have a broader reach. It includes scientifically vetted information about taking PrEP with birth control, at the time of conception, during pregnancy and while breastfeeding (spoiler: it’s safe!) and how women can get the pill and related services for free.
Plus, the CDC campaign has another purpose: to reach women’s health care providers so they aren’t the barrier between women and ongoing good health. That part of the campaign aims to “encourage and empower clinicians to talk to their female patients about whether PrEP is right for them and prescribe PrEP if appropriate,” according to a government press release.
Click here to read the full press release.