Maybe We Should Be Talking About HIV In The Beauty Shop

There are so many reasons Black women — a vulnerable population in this context — don’t talk about PrEP. Here’s how that might change.
Willie B. Thomas via Getty Images

Beauty and barber shops have always been crucial spaces for us, essential to more than just helping us look and feel good. Like church and grandma’s house, salons are safe havens, respected institutions occupied by trusted members of the community, where Black people can express themselves and tend to their well-being. Recently researchers (both Black and non-Black) have realized that the trust fostered in these places might be the key to preventing HIV infections among Black women.

Recent data shows that of all new HIV infections in U.S. women, Black cisgender women account for nearly 60% ― and only 10% of U.S. women who could benefit from PrEP are being prescribed it. A small but important study that just dropped suggests that fostering discussions about PrEP to Black women at hair salons may increase their awareness and knowledge of how the drug can help prevent them from contracting HIV ― while also addressing the misconception that HIV is only a gay men’s issue.

The findings, published in the Journal of the Association of Nurses in AIDS Care, highlights the need for an uptick in familiarity with and usage of PrEP by Black women through an initiative called UPDOs Protective Styles: Using PrEP and Doing It for Ourselves. The beauty salon-based intervention, led by Duke researcher Schenita D. Randolph, provides stylists training on how to foster conversations about HIV and PrEP.

This training will include a workshop specifically for stylists with predominantly Black clientele (as well as continuing education credit), and “Ask Me about PrEP” signage for their salons. They’ll have online resources to refer to and access to an established community advisory council “designed to entertain while conveying key messages about HIV, PrEP, and Black women’s social contributors to health,” according to the Eurekalert report.

While it might seem a little invasive to bring conversations about intimacy and sexual health into a salon, the initiative could not come at a better time. One of the stats from Randolph’s research that stood out to me showed that 45% of participants believed they had no risk of an HIV infection, while another 50% thought they were at low risk. These statistics contradict the disproportionate amount of Black women who have contracted HIV after heterosexual sex.

And, not wanting to engage in conversation about taking a new drug — regardless of its purpose — makes sense. This country has a vast and ugly history of screwing over Black women, so medical mistrust is absolutely justified. But this initiative is about informing Black women about their options during a time where we have the opportunity to protect ourselves with a pill if we so choose.

Randolph’s team’s survey included data from a small group of 44 participants who typically visit the salon every two weeks. The women were 89% heterosexual and, on average, 42 years old. According to the findings of pre- and post-surveys taken by participants, awareness and trust of PrEP and PrEP providers increased significantly after receiving intervention and resources during their salon appointments. Women also expected less disapproval from people in their inner circles about PrEP, but PrEP user stereotypes and stigma remained unchanged.

Randolph’s study and findings are essential because, historically, Black women and how their experiences make them vulnerable to contracting HIV have been left out of conversations about HIV prevention. To add fuel to the fire, many of us remain completely unaware of how at risk we are for HIV exposure. In her study, Randolph also identified that while participants became more educated and aware of PrEP, the disillusionment around the risk of infection is one of the biggest hurdles.

Access to knowledge is extremely powerful in this fight to address how HIV is impacting Black women. I have never had a physician (or anyone) recommend PrEP as a safe way to approach my reproductive health, and that’s alarming. I had to do my own research to find out that PrEP is simply another form of protection that is highly effective and minimally invasive. This is why Black women need safe spaces to share this information.

To provide a little more context, this separate study from 2021 also explores the need for more culturally responsive HIV prevention strategies tailored to Black women, particularly those impacted by the justice system. Researchers found that aside from Black women’s misconceptions around their risk of contracting HIV, leading barriers that keep Black women from accessing PrEP include overt and systemic racism and bias, clinicians’ lack of knowledge, intimate partner violence, a lack of access to health care, and prescription costs. That’s heavy.

While beauty salon interventions may not be able to address all of these things, it’s clear that community plays a part in filling the voids that the medical system leaves. We urgently need to invest in HIV prevention strategies that align with Black women’s cultural identities and real-life experiences. Walking out of the salon with a new look and a better understanding of PrEP sounds like a radical act of self-care we should all get behind.

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