Often times in public health conversations there is one portion of the community that is left out. It is assumed that they are not interested in the conversation or their health when in actuality they are interested but do not know how to insert themselves into the conversations and make their voices heard. This portion of the community is black males.

Here are a few of the many reasons why black men should be at the table and leading the conversations about PrEP (Pre Exposure Prophylaxis) as well as taking control of their health.  These are in no particular order.

1)      Because we remember the Tuskegee Syphilis Study. That study involved 600 black men and allowed a sexually transmitted disease (syphilis) to progress in participants even after a new treatment (penicillin) was available and being used. Though it was 40 years ago, black men still remember this as one of the largest studies to have an adverse effect on our health. Moreover, we remember that the study did not inform its participants of the risks associated with what researchers were doing nor were participants informed that they had the option of withdrawing from the study. This study placed fear and mistrust in the hearts and minds of many black Americans, even today. This is especially true in the south which is also one of the regions of the United States that has the highest burden of HIV and other STDs.  If we want to make a change with black men and the use of PrEP, we must involve them in the initial planning of clinical trials so that they can truly understand the process and know exactly what it means to be involved in clinical trials. (It is because of the Tuskegee Syphilis Study that we now have Institutional Review Board (IRB) to ensure all studies are ethical and all participants are fully informed.)

2)      Because most black men are not educated around the latest medical advancement with HIV prevention and care. Black men are curious to know how a medication that is used to help suppress the virus in someone who is HIV positive can be used to help someone who is HIV negative stay negative. Black men need to know what PrEP is and how it works. They need to know that PrEP alone isn’t enough. In addition, we must remind black men that HIV is not only a virus that affects the gay community; it affects the black community. As the Centers for Disease Control and Prevention (CDC) reports, blacks represent 12% of the population but accounted for 44% of the new HIV infections in 2011.

3)      Because black men are looked at as the leaders of their community. Even in the 21^st century one of the greatest roles of the black man is to serve as protector and take on the burdens of his community. Black men also serve as the main gatekeepers of the community and the primary educators in most families. If we want other segments of the black community to engage in PrEP use, we must start with the head.

4)      Because black men care about their health and well-being. What more of a way to make black men accountable for their sexual health than to involve them in the process. Doing this will give black men a greater sense of pride and ownership. And, this ownership, will lead to black men realizing that protecting themselves from HIV is important regardless of their sexual identity.

5)      Because black men are still dying from AIDS related complications. Sometimes I feel like we’re returning to the 80’s; every week on my timeline I see some black male’s picture tagged with RIP, RIH, or gone too soon. Rates are still rising among black gay men. According to the CDC, from 2005 to 2014, HIV diagnoses among both black and Hispanic/Latino gay and bisexual men ages 13 to 24 increased about 87% in comparison to a 56% increase among young white gay and bisexual men. The sad part is that everyone knows what happened but no one wants to have the conversation. At least not in a public forum.

6)      Because black men need to see and experience something good. In 2016, some would say that the United States has transitioned backward and not forward. Many black men feel that they are not valued. Engaging black men in this conversation is part of allowing their voices to be heard.

7)      Because PrEP alone isn’t enough. We need to allow black men to tell their story and to be unapologetic. We need to learn why black men engage in high risk behaviors directly from the source. We need to know about their social determinants of health such as depression, internalized homophobia, homophobia, and poverty. And we need to hear it from them.

8)      Because now is not the time for us to remain silent about HIV and other STD treatment and prevention efforts for black men. If we want to make the change, we have to be the change. Black men have to make our voices heard now.

*Anonymous is a black male who has worked in the field of Public Health for 17 years. He currently works in public health management in one of the southern states most impacted by HIV and other STDs.