Some Men Are Still Hesitant to Take the HIV Prevention Pill

Even though the HIV prevention pill drastically reduces their risk of the potentially deadly infection, many men — especially Latinos and African Americans — don't.

If you take the drug PrEP (Truvada and Descovy) every day, you have a tiny chance of getting HIV even if you have unprotected sex. Although more people take the pill every year, the total is still less than a quarter of all the people the Centers for Disease Control and Prevention (CDC) estimates would benefit from it.   

Some natural candidates for PrEP (Pre-Exposure Prophylaxis) are ambivalent or critical of it. Others don’t know it exists.

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That is especially true among Latino males, who have been slow to get prescriptions, even though they are four times as likely as white men to become infected and twice as likely to die of HIV. Well under 1 percent of Latino men take the drug, even though their risk may be as high as 11 percent.

About one in five gay and bisexual Latino men don’t know they are HIV-positive, the CDC reports, or that they could infect others. Because of those conditions, there were five clusters of rapid HIV transmission among Latino men who had sex with other men in Atlanta.

They are more likely to come from traditional Catholic families and may be uncomfortable talking openly about sex and homosexuality, even to their doctors, says Richard Zaldivar, who runs The Wall Las Memorias, a Los Angeles nonprofit with a support group for gay and bisexual Latino men. 

The stigma may lift as more gay men hear stories about friends who take PrEP and realize the drug is saving the lives of people they know.

Cost and availability come into play. Insurers and Medicaid in many states cover the drug, but Latinos often lack insurance and may not know about other funding from local governments and the manufacturer, Gilead Sciences, Inc., which offers assistance to the uninsured or people with large copays. 

Latino men also tend to avoid medical care unless they’re really sick; going to a doctor is an admission of vulnerability and a request for help. Fewer medical visits mean they are less likely to hear about the drug from a physician or nurse. If they do get HIV and aren’t taking the medication, they increase their chance of spreading the virus. 

Black men are also less likely than white men to take the drug, despite being more at risk.

You can learn whether PreP is right for you here. Condoms are still the best prevention method, assuming you’ll use them every time you run the risk of infection. The medication doesn’t protect against other sexually-transmitted diseases (There are more cases than ever before.), and some users can develop kidney problems.

Critics say it’s a bad idea to give anyone a way to feel safer having sex without a condom. There’s evidence, however, that people who get a prescription and take the drug become more cautious. They’ve put the risk of HIV at the forefront of their minds, rather than ignoring it. 

Beyond Latinos and blacks, younger men of all ethnicities are also a high-risk group.

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