“If you’re a Black cisgender woman, you should be on PrEP”

A master class in manipulation

I think that I have seen enough about PrEP by now to be able to say with complete certainty: PrEP promotion is almost entirely racial targeting. Yes, it is marketed to the gay community as well, but thanks to the early AIDS activists, most of that community is under some kind of trance-like Stockholm syndrome, so there was never really any worry about uptake of PrEP among gay men. No, the prime targets of this gruesome campaign promising chemotherapy for life are Black Americans; specifically, Black “cisgender” women (I’m putting that in scare quotes because I really hate that word—its origins are creepy; I had thought it was a nerdy organic chemistry reference, but no).

PrEP prevents HIV infections, but it's not reaching Black women

Alexis Perkins thought her OB-GYN's office in Atlanta would be just the place to get a prescription for the type of drug that reduces a person's risk of contracting HIV.

But during a recent visit, the medical assistant who greeted her had not heard of the medicines known as preexposure prophylaxis, or PrEP, and she seemed uncomfortable discussing it, Perkins says. Her provider had heard of it but didn't feel confident prescribing it.

"She was at least honest enough to say that she was interested in it, but she didn't really know that much about it," says Perkins, a 25-year-old nurse, who decided to get on PrEP after participating in a sexual health education class and thinking more about her own risk. She's still trying to find a provider to write her a prescription.

Why do I find it very hard to believe that she can’t find a provider to write her a prescription? I won’t quote too much more from the article, but I will say that it reads like a how-to manual for manipulating and coercing people into an intervention they don’t need and that might harm them.

But more than a decade after the first PrEP drug was approved for the U.S. market, one of the groups that would benefit most from the medications isn't taking them: Black women, such as Perkins, whose gender identity align with their sex assigned at birth.

Maybe because they have a healthy skepticism? The article goes on to basically say that this is a real problem in the South, where “new HIV infections” are highest. They say this like the epidemiology of “HIV” is some ever evolving phenomenon, when in reality, “HIV” positivity has always been the highest in the South, of all geographical locations in the United States. As Henry Bauer pointed out, this is likely because the phenomenon of “HIV” positivity is racially linked in a manner that does not vary from one risk group to the next, most likely reflecting endogenous phenomena rather than an infection by a sexually acquired pathogen. People of African descent test positive at a higher frequency than do other racial groups, and this is the case even in groups at no risk, such as repeat blood donors, therefore is cannot reflect an infectious phenomenon. This explains the high positivity rate in the South, which has a significant African American population. What they fail to mention is that this has always been the case, because the incidence—0.3% of the population—as well as the areas of greater geographic concentration of “HIV” positivity have stubbornly refused to budge in forty years.

They then mention that women make up “20% of new diagnoses.” I’ve noticed this phenomenon that occurs when citing a statistic about “HIV,” and that is that whoever cites it has to have the intimation that this is a brand! new! thing! From when I can remember from the early 1990s, they have been saying some variation of “women are the fastest growing group of people with ‘HIV’!” for years. They’re not saying anything new, they’re just trying to make it sound scary. It amazes me how we’ve fallen for this collectively for forty years at this point.

There is then some hand-wringing about the lack of testing of these drugs on people “assigned female at birth,” which I’ll leave to your imagination. There’s some real mental gymnastics involved with all this newspeak.

Taking PrEP requires regular testing and doctor visits to check for HIV infection, which can present a "tremendous barrier" to access because of cost and logistics, says Michael Fordham, a program manager at the University of Alabama at Birmingham's 1917 Clinic, the largest HIV care facility in the state.

"We're actually seeing PrEP patients more frequently than we see our patients living with HIV that are stable," he says.

I really just wanted to highlight that bolded (by me) statement. It says everything you need to know. Why only retain in care people that have actually been diagnosed with a condition when you can just retain everyone in care? They come in even more often, apparently. This is like the Crazy Scheme version of the Big Lie—come up with the most ludicrous, dangerous scheme possible and see how many people you can reel in. It would be impressive if it weren’t such a medical disaster.

This very long article finally winds its way to a close, stopping along the way to suggest that “Black cisgender women” in the South are afraid to take PrEP because they fear that their partner might use it against them. If this is true, that’s horrible, but has nothing to do with taking a medication to treat a condition you don’t have.

Here is their conclusion. You’ve been warned.

Failing to ensure cisgender Black women have access to — and are actually interested in taking — PrEP will undermine the fight to bring the HIV epidemic under control, Diallo warns.

There's "damage that has to be undone," she says. "If we're not centering Black women in this epidemic, we are getting nowhere to the end."

The victim blaming here is really something else, as well as the intentionally threatening language. Forty years later, not much has changed. It is fear and coercion that allowed this phony paradigm to take hold, and fear and coercion are what keep it in place today.

What do you think? Have you noticed this weird victim blaming, and some very specifically targeted coercion, in the campaign to get everyone on “HIV” drugs?

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