01 Jul How I Learned About PrEP
CW: Mention of sexual assault
Sat in the waiting room of a sexual health clinic for the first time ever, I had the opportunity to reflect on my knowledge of and the personal stigma surrounding HIV and the PrEP treatment I was set to receive in only a few moments. Being brought up in a typical black, conservative, religious household limited my exposure to sexual health and reproductive education, ultimately shutting me off to the progression being made globally concerning the treatment of HIV and AIDs.
After a particularly traumatic sexual experience with a straight man, I was now stuck questioning any and everything I knew about HIV transmission. The need to take PrEP, the virus-preventing prophylaxis I had previously understood to be used solely within the gay community, alongside several vaccinations and tests, kickstarted my explorative journey into sexual health. The inequalities in access to sexual health services and the stigma still present in marginalised communities stood out to me more specifically, especially within the black community here in the UK.
Although the black community only accounts for 2% of the UK’s population, Public Health England reports that 1 in 6 people with a new HIV diagnosis are of Black African ethnicity. Despite the growth in HIV education and treatment efforts, we find the black community still being excluded, with less than 5% of a recent 20,000+ participant PrEP IMPACT trial concluded in England being of Black African descent. This systemic inequality is reflected in ethnically diverse populations across the UK, such as the London boroughs of Lambeth, Southwark and Lewisham which are reported to have the highest rates of HIV and STIs in England.
Another demographic commonly left out of the HIV transmission and prevention conversation is heterosexuals. A layperson might assume transmission to be typically between men who have sex with men (MSM). However, we are seeing an increase in transmission through heterosexual contact, with 54% of HIV diagnoses in the Lewisham area falling underneath this common exposure type.
It is with noting that there has been a notable decrease in new HIV diagnoses across England, aligning with the government’s aim to end HIV and AIDs as public health threats by 2030. With this being said, we must not ignore the issue of late diagnosis, currently and disproportionately affecting the black community, people having heterosexual sex and women. When tracking progression towards global HIV goals, we can see that positive growth is not being achieved equally across the UK’s population. Marginalised communities, mainly black and minority ethnic groups, still experience greater risk as a product of poor and unrepresentative sexual healthcare. It is important, therefore, that the government and society at large addresses these statistics in our efforts to tackle HIV; targeted education within relevant communities is needed to truly destigmatise virus testing and treatment.
The inclusion of educational conversations alongside my new PrEP medication regimen was essential not only in tackling stigma, but also in promoting the need for regular testing and visits to my local sexual health clinic. These conversations with GPs and other sexual health professionals helped reshape my understanding of who is at risk of contracting HIV and highlighted my lack of knowledge about the ins and outs of PrEP.
In encouraging more people, especially black and heterosexual people to take PrEP, we begin to expand their sexual health options and knowledge, empowering individuals to make safe decisions regarding their sexual health and wellbeing. In my case, the need to take PrEP within 72 hours of my sexual assault was something that was brought to my awareness by the lovely staff at my local sexual health referral centre (SHRC). Being able to access this service, especially in such emergency situations, should never be a privilege.
The LSL Sexual Health Partnership is one of the many organisations set up with the crucial aim of making sexual health across England inclusive and accessible. Through their different platforms you can find out about sexual health services and NHS trusts within Lambeth, Southwark and Lewisham. By contacting these services, you can access information about PrEP, which is free of charge on the NHS and available to anyone regardless of migration status or housing situation.
Although my first interaction with PrEP followed sexual trauma, I have since incorporated it into my sexual health regimen, as well as the need for frequent testing. I’m now in an informed position to stay updated on my overall sexual health and wellbeing. So regardless of your gender or sexuality, I implore everyone to reach out to their GP or local clinic and have a judgement-free conversation about HIV.
Written by Ife. O for Love Sex Life LSL in collaboration with SHAG