To improve HIV prevention uptake among cisgender Black women in New York, the Centers for Disease Control and Prevention (CDC) awarded a $1.4 million grant to Melonie Walcott, MPH, DrPH, an assistant professor at the University of Albany, according to a university news release.

 

African Americans have been disproportionately impacted by HIV since the early days of the epidemic.

 

Less than 2% of eligible Black cisgender women use pre-exposure prophylaxis (PrEP) to prevent HIV. PrEP is a safe and effective antiretroviral medication taken to reduce one’s risk of contracting HIV. Available as daily pills as well as a long-acting injectable, PrEP can reduce the risk of acquiring HIV by 99%.

 

“This population experiences unique vulnerabilities, including living in communities with higher HIV viral loads, systemic inequities and socioeconomic challenges, yet they are often overlooked in HIV prevention efforts, which tend to focus on same-gender-loving men,” Walcott said in the news release.

 

Stigma, discrimination, limited access to health care, higher rates of poverty and lack of awareness of HIV status contribute to the troubling statistics with respect to Black Americans and HIV.

 

“This can result in engaging in transactional sex, forming relationships with partners that sell drugs or even selling drugs to gain access to resources,” Walcott said. “These behaviors increase the likelihood of being incarcerated, which further impairs one’s ability to be employed in the future and increases vulnerability for HIV acquisition. This vicious cycle can significantly undermine both HIV prevention and treatment efforts.”

 

Walcott will used this CDC grant to lead a four-year study titled PrEP-WISE (short for pre-exposure prophylaxis for women in charge of sexual decision making and engagements) that will develop and test a culturally relevant behavioral intervention to encourage Black women to use PrEP and learn more about their personal health.

 

The study aims to help Black women reduce their risk for HIV with support from a team of researchers, HIV prevention experts, faith-based organizations and community members. Walcott will also visit popular community spaces, such as salons and churches, to spread the word about the study.

 

During the first phase of the study, researchers will interview 25 cisgender Black women and 10 health care providers, including pharmacists, medical professionals and peer navigators, across New York.

 

Researchers will ask about experiences in HIV care and prevention, including barriers to care, to identify gaps in care and potential opportunities to improve PrEP uptake.

 

Using insights from interviews, Walcott and her team will hold peer-led intervention sessions to address inequalities and educate Black women about their health and wellness.

 

Proposed topics for the upcoming sessions include:

 

  • Assessing HIV vulnerability: Helping participants evaluate their personal risk, considering environmental and social factors as well as the risk level of their partner(s);
  • Gender norms and power dynamics: building skills to communicate effectively with health providers and sexual partners about HIV prevention;
  • PrEP basics: combating stigma, understanding the medication and reducing barriers to its use;
  • Financial literacy: providing tools to enhance financial stability and overall health security. 

“Our goal is to empower women holistically,” Walcott said. “By addressing systemic inequities and providing resources beyond medication, we aim to develop an educational program that enables achievable, sustainable care and overall well-being.”