We MUST Not Be an Afterthought: (Re)Centering Black Women in HIV Prevention
By: Drs. Brit M. Williams (Professor & PrEP User and Advocate) & Marissa N. Robinson (Infectious Disease Epidemiologist & Educator)
Posted: August 26, 2026
In 2026, we must acknowledge that one thing remains true: Black women are facing an HIV crisis in America. The data and science suggest that Black women account for nearly 57% of the new HIV diagnoses despite accounting for only 13% of the female population. Although we are 45 years into the HIV epidemic and almost 15 years into the biomedical advancement of biomedical HIV prevention medications like pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), the PrEP-to-need ratio is five times higher for women than men. This indicates there is a significant gap in PrEP prescriptions. Moreover, while over 400,000 women could benefit from a PrEP prescription, Black women specifically have been left out of the big picture, leading to their PrEP uptake remaining low.
We believe Black women’s lower PrEP uptake is in part because, for far too long, people have talked at Black women instead of with Black women about PrEP. Others have made a bold choice to speak FOR Black women rather than amplifying Black women on their own terms. As two Black women committed to centering Black women in PrEP research, advocacy, and community, we felt it was essential to come together to speak up and to act on this harsh reality. Regardless of the environment around Black women and HIV, we have decided to make noise and hold space in an effort to create some much-needed change. In our forthcoming co-edited book, Black American Women and the Fight for PrEP: “All We Got is We and Us,” more than 28 unique Black women researchers, clinicians, policy advocates, and champions have illuminated their contributions, advocacy, and leadership in the fight for PrEP.
The cadre of individuals who contributed to the book’s 19 chapters represents a small but influential snapshot of how Black women are not waiting for others to save us and are taking direct action, individually and collectively. What we’ve created is so vital because, as we write in the book, “[these chapters] exist as a curated body of knowledge for medical educators, faculty, and HIV training leaders to consider in their continuing education and practice”. Moreover, we continued, “[these chapters] also serve as evidence-based data, storytelling, and first-hand accounts that are somewhat accessible and, most importantly, available to Black women in need of additional information who wait until the cover of night to search for better information from the comfort and privacy of their own homes and screens.” Put plainly, we felt compelled to coordinate and facilitate this volume even without financial backing, and solely as a labor of love, because if not us, then who?
It’s a catch-22. If we stayed silent, folks might think we’ve become complacent on this issue. When, on the contrary, we felt it imperative to use our reality as motivation for something better. With this in mind, we can firmly say: We no longer need another pamphlet or document telling us that Black women need to see themselves in PrEP campaigns. No longer do we need to say “hey, they [Black women] aren’t really at risk, so what’s the issue?” The short and plain of it is that Black women are tired; we show up for everyone else, and yet when it’s our turn, far too often the crowd goes silent. Well, the time is up! If we are really going to make waves in the HIV epidemic, we need to pause, listen, and make some changes. What we need, and what is exemplified in and across our volume, is a reality the broader health community has long ignored: Black women are already here.
Black women are not just in PrEP campaigns, but we are also creating them. Black women researchers are already conducting studies and consistently highlight the persistent gaps we’ve been successful at addressing over the last 15 years; however, there is still much more work to be done! Black women are not a monolith; we are sisters, aunties, mothers, baddies, and everything in between, yet when it’s finally time for us to see the change, all of a sudden there’s no budget, or there’s a lack of support… In truth, though, these campaigns, research projects, and efforts often go dark due to low or inconsistent funding, unsustainable strategies, and a lack of succession planning. To make a long story short: Black women are the leaders we’ve been waiting for… Leaders who are ready to continue mobilizing communities, but we can only do so effectively when given opportunities, broader platforms, and sustained funding.
As a duo, we are honored to have facilitated this process to canonize Black women’s contributions. It is important to chronicle these contributions because it is no secret that Black women have been viciously attacked by anti-DEI rhetoric and policies, downsizing, and other senseless acts. And as the Institute for Women’s Policy Research recently revealed, Black women have accounted for roughly 600,000 individuals being pushed out of the workforce since January 2025. The work cannot stop here. We can’t just highlight disparities in HIV or in mass firings and leave them where they are. As two Black women who understand that nobody is coming to save us, we are the solution we’ve been waiting for… And we still need allies and accomplices on that journey. We still need institutional and financial backing. We still need support–especially when it’s unpopular or otherwise difficult.
These realities are also why we are making our voices heard and fostering community at 2026 USCHA!
On Friday afternoon during the conference, we’re excited to join host and colleague Malachi Stewart on The Playbook podcast, which will be livestreamed, to speak unapologetically about and as Black women. Join us & listen in for a powerhouse dialogue you won’t want to miss, tentatively scheduled for Friday at 4:30 pm! On Saturday, during the affinity session conference blocks from 4:30-5:30 pm at Redondo – Concourse Level/4th Floor, we will facilitate space for Black women, on Black women, and with the support, lived experiences, and expertise of Black women and our allies. Empowered by BAI, this session will feature a candid conversation about where we’ve been, where we are, and where we need to go. This year’s USCHA theme is United and Unbreakable: The HIV Movement at 45. Be part of helping us shape what the next 45 years will look like as we begin to demand change, sustainability, and support so that Black women are not an afterthought but rather integral partners and coconspirators in the work.
Author Bios
Dr. Brittany “Brit” Williams is an internationally recognized, award-winning researcher, educator, consultant, personal PrEP user, and advocate. Her work focuses on shifting narratives around whose stories, lives, and experiences matter, are rendered visible, and are addressed. You can find her online at @drbritwilliams on social media or at drbritwilliams.com.
Dr. Marissa Robinson, also known as “Your Sexual Health Girly,” is an infectious disease epidemiologist, public health educator, and Founder and CEO of Real Health Impact, LLC. She brings science, real talk, and a little fun to conversations about sexual health, HIV, public health, and infectious disease. You can find her online on social media at dr.marissa_rob or at drmarissarob.com.