Black Cis-Gender and Trans Women, HIV Treatment, and PrEP Health Centers On The Front Lines

Guests featured in this episode:

Keosha Bond, M.D., Assistant Medical Professor, City University of New York School of Medicine

Tori Cooper, Director of Community Engagement for the Trans Justice Initiative, Human Rights Campaign

Latesha Elopre, M.D., Associate Professor, Division of Infectious Diseases, University of Alabama at Birmingham


Moderator: Alexandra Walker, Director of Digital Communications, National Association of Community Health Centers

Alexandra:. Welcome to Health Centers on the Frontlines, the podcast of the National Association of Community Health Centers. Today is the third and last in a three-episode series we've been doing about an epidemic that the nation's health centers have been battling for decades: HIV and AIDS. PrEP access and use remain unequal in the United States, with women overall accessing it at a fraction of the rates of men. Meanwhile, one in five new HIV cases annually occurs in women. The overwhelming majority of Black women. Transgender women specifically, are at an even greater risk for HIV acquisition and oftentimes lack access to competent care to access primary care. When we think about health centers and all the work that is done with Black communities, we cannot leave HIV prevention and care for Black women out of the conversation.

To discuss today, we are joined by a panel of experts, Dr. Keosha Bond, Assistant Medical Professor at the City College of New York. Tori Cooper, Director of Community Engagement for the Trans Justice Initiative at Human Rights Campaign, and Dr. Latesha Elopre, Associate Professor in the Division of Infectious Diseases at the University of Alabama at Birmingham.

We start this conversation about ways that health centers can improve the engagement of Black cisgender and transgender women in HIV testing, prevention, and care. So if we could start with you, Latesha, how can we improve messaging about HIV prevention and care to improve acceptance of services among all Black women?

Latesha: Thank you. So, my name's Latesha and my pronouns are she and her, and I am really excited to be able to talk about this topic. I think that when we’re talking about access and we’re talking about it for specific populations, we have to do it in the framing and the understanding that access is not equitable to begin with. So number one, there is a system-level barrier in regards to who's able to receive the services. So when we’re understanding why, we’re seeing inequalities in regards to certain geographic locations. We're talking about things like being in a non-Medicaid expansion state, having poor public transit opportunities available to you where you live, being impoverished, and being a victim of systemic racism, those are all barriers that communities of color face a lot of times on a day-to-day basis that make access difficult.

But when we're talking about specifically, how do we improve messaging and understanding around PrEP and HIV testing and prevention, I think that we have to do it from a framework where we're not talking about risk, but we're talking about health. And that's something that we haven't been doing well in regards to public health in general. So I've been very excited, I think, where a lot of conversations have been moving and shifting, because right now if you were to ask many people in America right now, do you think you're at risk for HIV? Should you be tested? They would say no. And based on how we've defined risk from a public health standpoint, you know, the answer actually would be not based on CDC guidelines and recommendations, a lot of times would put people, quote-unquote, at risk is nothing more than where you live. And that's social determinants of health that are currently impacting you.

So, I think we just have to change our messaging, be more sex-positive, be more...