Sex is Evolving. Some Are Being Left Behind.

In partnership with

In July 2012, a popular anti-retroviral medication called Truvada was officially approved as pre-exposure prophylaxis (PrEP) to help prevent HIV infections. It was a game changer; for the first time, sexually active people could engage in condomless sex without worrying about contracting a potentially life-altering virus. It also seemed as though the end of the AIDS epidemic might finally be within reach. While infection rates have steadily declined since the advent of PrEP, some groups are lagging behind significantly in the recovery. 

Much of the early AIDS epidemic, when the exact causes of infection and the risk factors that hastened or slowed sickness were a mystery, is barely a memory to the younger half of the population. Its aftermath however, in which a deep-seated fear of the repercussions of unprotected sex–especially between men who engage sexually with men–still lingers today. That fear has led to an indeterminate, but potentially significant portion of the population's practice of abstinence. As a preventative strategy, it is the most effective, as outlined by the CDC many years ago, but it can also rob adults of a sex life that some of their peers–often with the assistance of medication and professional consultation–enjoy in spades. 

Barriers to Treatment

Black Americans struggle with a deep distrust of the healthcare system at large. Although not all are conscious of it, much of this distrust stems from the revelation of the Tuskegee experiment, in which men in the Alabama were unknowingly injected with syphilis to study its effects on the human body. That, combined with the systemic racism that often goes unchecked in medical communities, is undoubtedly a part of the reason that the most vulnerable groups in the US are also the least likely to use PrEP. Some people have even been outright denied access to PrEP, either by their insurance or by their primary care physicians, even when specifically requested. Below are some tips for what to do if that happens to you.

1. Ask the doctor to add to your notes that they refused to prescribe or share information about PrEP. Some patients have reported that this may lead to backtracking on the decision.

2. Try calling or visiting your local planned parenthood instead of a general physician. Typically, they are better informed and equipped to handle your sexual health inquiries.

3. There are also online options, such as Nurx or MISTR.

The Pill and the Program

What many people may not understand is that PrEP is not always just a pill, but an entire program structured to educate you on your risks and your sexual relationships. First, depending on your provider, you’ll be given one of three different medications.

1. Truvada [emtricitabine/tenofovir]

The first pill approved for PrEP, Truvada is at least 99% effective in preventing the transmission of HIV through sex. The “at least” is important, because while breakthrough infections are possible, they are extremely rare. As of 2024, only 15 cases have been reported worldwide, out of millions of PrEP users.

Truvada is both the most common and the least favored of the group; it comes with the potentially serious side effects of kidney or liver issues. Typically, these side effects subside when the medication is discontinued. Your provider may also switch you to one of the other options if you report even mild side effects

2. Descovy [emtricitabine & tenofovir alafenamide]

A similar medication to Truvada, but with a formulation that is slightly safer and more effective. If you’re concerned about Truvada’s side effects, this is likely where you will land. The pill is also much smaller and easier to swallow.

3. Apretude [cabotegravir]

The first injectable option for PrEP, Apretude is administered every 2 months after 2 initiation injections administered 1 month apart. This one is pretty new, signaling even greater strides toward a true vaccine.

The Perks

In addition to the pills, you’ll also receive quarterly HIV and STI testing. If you test positive for an STI, many providers will treat you in-office, though some may incur a fee, which is often discounted. Finally, you’ll receive professional counseling, and some providers may even offer therapy. Each of these perks are crucial to not only personal and public health, but also to educating a population about their options. 

What’s important in your decision to abstain is that it’s fueled by information, rather than a lack thereof, or worse, fear. How you have sex, or how you decide not to, should always be your own well-informed decision. In the event you decide to engage with another person, be aware of the options you have to protect yourself and your partners. 

Your Groom's Wedding Look Is Handled (And Free)

Planning a wedding means a thousand decisions. Here's one you can cross off the list: your groom's attire. The Black Tux delivers perfectly fitted tuxedos and suits right to your door, with free home try-ons so he looks flawless on your big day. Or visit one of our showrooms nationwide for hands-on styling. No awkward rental store visits, no mystery fit issues, no stress.

Plus, grooms get their wedding look completely free when the groomsmen rent with us. One less expense, zero compromise on style.

Get His Wedding Look Free →