The Human Rights Campaign (HRC) Foundation’s Historically Black Colleges and Universities (HBCU) Program mobilizes and supports HBCUs in enhancing policies and services that promote excellence in LGBTQ+ inclusion, equity, and engagement.

In the past few decades, LGBTQ+ advocates, allies, and dedicated health professionals have helped HIV perception and PrEP (pre-exposure prophylaxis) perception change for the better.

And while over 300,000 people are on PrEP and new HIV infections have decreased by 8%, progress only rings true for a small portion of the population.

Black men account for 75% of new HIV infections every year, according to the Centers for Disease Control and Prevention (CDC).

Although the Food and Drug Administration (FDA) approved PrEP 11 years ago, a whopping 69% of PrEP users are white while only 9% are Black.

But what accounts for this alarming disparity?

Sex-Education is Lacking

Leslie Hall, MSW, is the HBCU Program Director at the HRC. With a background in fundraising and development, Leslie transitioned to the advocacy space. He has been with the HRC for 8 years, spearheading the HBCU program from its inception.

In his experience, college-aged students don’t enter their university with the necessary tools for safe sex. And they don’t have adequate information about HIV.

“The HBCUs I have attended are not overtly toxic or negative towards LGBTQ+ identities. However, there was not public educational awareness or campaigns. Or, for that matter, just knowledge of the state of HIV when I was in school. I think the same is true now,” says Leslie.

“As a college student, I still didn’t know ways to prevent or protect myself outside of condoms or abstinence. That was the message that was preached at the HBCUs I attended. I think that has subsided over time and the stigma around sex has subsided. But, there is still a lot of work to do, and this is my passion project,” says Leslie.

The answer to this issue in Leslie’s opinion? Peer education.

Increasing access to PrEP through student engagement

Peer education is where student leaders teach their peers about aspects of health. It is an approach growing in popularity at colleges and universities.

The HRC’s HBCU initiative leans into this model to increase education around PrEP.

Through the program, 11 students each year serve as PrEP Peer Educators to eliminate HIV and AIDS-related stigma on HBCU campuses through public education.

Barriers to PrEP for people of color

As previously stated, new HIV infections have decreased overall, likely due to PrEP. But new HIV cases predominantly impact Black people.

“I think on the front end of some of the hesitancy of engaging with PrEP or getting on PrEP, Black folks particularly, certainly on the younger end of the spectrum, are just really not into taking pills every day,” says Leslie.

Other common barriers for Black people, according to the National Library of Medicine, include:

• Homophobia
• Mistrust of healthcare systems
• Negative attitudes from health care providers
• Lack of access to transportation
• Socio-economic status and insurance status
• Misinformation about PrEP

In addition, “A lot of it is just stigma. From the director of the wellness center, all the way down to student leaders. People still have a stigma when it comes to HIV and PrEP. School leaders and student leaders need to put in the work to educate themselves,” says Leslie.

Where the message of PrEP comes from is important, Leslie says.

“One of the interesting things about the black community is if we don’t hear it from a church or from a school, you’re already fighting with one hand tied behind your back. So being able to engage these institutions to show support of and endorse PrEP is important. That’s why having Peer Educators is so key: it’s students hearing from students that PrEP works.”

How Can Q Care Plus Help?

The collaboration between HRC and the HBCU campaign was “serendipitous” according to Leslie. He happened to walk by Q Care Plus’s booth at the 2022 NMAC Biomedical HIV Summit.

“The Q Care Plus team had a visual diagram of how an individual could be prescribed PrEP virtually. And the one needle we were trying to thread because we hadn’t quite launched the [PrEP] program just yet, is how are we going to get students connected to PrEP, connected to care, because [the HRC is] not a direct service provider? Q Care Plus really solidified this service for us to provide students confidentiality and reputable care,” says Leslie.

While the HRC provides all front-end education and awareness about PrEP, Q Care Plus is the final piece of the puzzle through quality, long-term, confidential care.

PrEP is Empowering

Giving students the tools to succeed, have meaningful relationships, and have good sex is a driving force behind Leslie’s messaging and programming for students.

“I always tell people: One of the ways you can have great sex is making sure that you are fully educated and aware on the tools that you can use to prevent whatever it is you need to prevent. Who wants to have sex and then 10 minutes later you got to, ‘Oh well, I shouldn’t have done that?’ I don’t approach it in a one size fits all tool. There are many tools out there for a person to utilize, but students should know what options are available to them and make that choice for themselves,” says Leslie.

Leslie says that Peer-to-Peer Educators also find their role in educating fellow students empowering.

In an age of influencers and online relationships, “Talking to people on campus and having even three individuals do something like take PrEP that you helped them do in real time feels so much different than having a million people like a random photo on Facebook. Making a real impact feels good.”

Leslie Hall’s, professional and academic values are informed by and rooted in the liberation of all marginalized people. A frequent speaker and panelist, Leslie has been highlighted in Black Enterprise, Blavity, Washington Post, & Reuters, among others. Leslie holds a B.S. in Sociology from Bowie State University, Master of Social Work from Howard University, and is a Ph.D. candidate in Higher Education Leadership and Policy Studies at Howard University.