Dazon Dixon Diallo: Why Minority Ethnic Women Need PrEP
Dazon Dixon Diallo is a celebrated advocate of women's rights and the fight against HIV, based in Atlanta, Georgia. She is the Founder and President of Sisterlove Inc., the first women’s HIV/AIDS organisation in the
Dazon Dixon Diallo is a celebrated advocate of women’s rights and the fight against HIV, based in Atlanta, Georgia. She is the Founder and President of Sisterlove Inc., the first women’s HIV/AIDS organisation in the south-eastern United States. She is also the convener of the U.S. Women & PrEP working group, a national advocacy group made up of HIV and women’s rights researchers, government and industry representatives interested in women’s biomedical prevention options.
Pre-Exposure Prophylaxis (PrEP) involves HIV negative people taking an antiretroviral drug to avoid acquiring HIV.
Women have never had an HIV prevention option which is female controlled. Even the female condom is not considered female-controlled because it still involves either negotiating with someone, or a partner would automatically know that you’re already engaging and then it still elicits some need to have a conversation. That’s not necessarily the only option that works for a lot of people.
In a sense, PrEP is still just one of those options, and it might not be for everybody. But the important thing is making sure there are options. Making sure that women have options that are leaning more and more towards their autonomy and their own agency in terms of preventing HIV for themselves.
A lot of people will say, if their HIV positive partners are on treatment and are virally suppressed then they are at reduced risk. That’s absolutely true, but tell me how that’s different from a condom? You are still talking about relying on someone else to take action and to make decisions that would protect yourself. You’re not in control of giving that person their treatment every day.
Many of the positive women that we work with thought they were in safe relationships, and that they were not at high risk. I even talk with women now, and they don’t think that their risk is risky enough to take a pill every day. PrEP education is still a really good way of bringing us back to the conversation around risk assessment.
The biggest challenge around minority ethnic women having PrEP is making sure that they’re informed, that they’re educated and that they are aware of where the services are provided. There’s also this really serious situation around acknowledging and owning our risk. We are a disproportionate representation of those who are most impacted by HIV. In the U.S., less at risk white heterosexual women are more likely to seek out PrEP than black women with multiple partners, multiple pregnancies and STDs.
We have to do more around being able to talk with one another about sex and sexuality in a way that’s uplifting, in a way that’s celebratory, in a way that’s affirming. I’ve been talking a lot about how medical providers, especially around sexual health, have to flip the script. Our goal is to get people to reduce their risks, and slow the incidence of HIV. When you talk to patients, their goals are really about having quality of life, and having a happy sexual lifestyle. As a patient, I will listen to you more if you tell me about getting better orgasms than preventing diseases. I don’t want you to talk about my sexual health from a disease avoidance perspective, I want you to talk about my sexual well-being, of which avoiding disease is just one factor. I think that the public health medical professional field has totally missed that point, almost wholesale.
When it comes to accessing PrEP, there should not be this litmus test that you have to pass through to see if you can take it or not. If I think I am at risk or I think my partner is at risk and I know that I have the efficacy to take a pill every day, who are you to not offer it to me? You will sit there and talk to me about whether I need to take birth control or get an IUD. In all case, once you’ve told me what my options are and I choose an option, you give it to me – period!
The idea that PrEP is a lifestyle drug is a bullshit, bogus, homophobic stance to take. There’s nothing that’s really meaningful around addressing the epidemic with that type of response. They don’t care about this epidemic because the very populations who would need PrEP the most are the populations that they want to judge based on their lifestyle. Whether they are living that lifestyle or not they are still human beings who should have access to it – that’s a human rights issue. No matter what – it’s a human rights issue. It is wilful neglect to deny people PrEP in your health system when you can make that available.
PreP is not currently available on the NHS. There is an ongoing legal battle to determine who is responsible for commissioning PrEP. Click here to read more.