The Who, Why, and What of HIV in the South

The WHO of HIV in the South

16 Southern states and Washington DC share the greatest burden of HIV and the highest mortality from HIV-related complications. Nine states in the Deep South [Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Texas] comprised 29% of the U.S. population in 2019, but accounted for nearly 44% of all new HIV infections that year. That means the Deep South has the highest rate of new HIV cases. Pointedly, Georgia leads in new HIV infections, followed by Florida and Louisiana.  52% of new HIV infections are among African Americans in the South. By gender, Black women account for 67% of new infections among all women in the South, while 6 out of 10 Black men account for new HIV infections in the South. Moreover, the majority of new infections among Black men are those who have had sex with men.

The WHY of HIV in the South

From a fiscal perspective, high rates of poverty, unemployment, and lack of insurance are underlying socio-political issues in the South that directly impact HIV. Medicaid expansion has not been adopted in the majority of the deep South which exacerbates the critical needs of those who should be screened, diagnosed, and treated for HIV. Constrained resources suggest that people who are positive and may reside in a more rural setting have even more barriers to seeking care.

Stigma is synonymous with HIV in the South. Due to the overall conservative nature of those who reside in the south, the religiosity and other cultural norms, make people who are infected with HIV seem like pariahs. Furthermore, residents of the south often disparage people who engage in sexual behaviors that are not heteronormative and engage in injection drug use from seeking care. As a result, people are ashamed to visit local healthcare providers, continue to engage in these behaviors, and contract and even unknowingly spread HIV.

The WHAT of HIV in the South

It’s not an easy task to change the inherent discrimination faced by those who live with HIV in the South. However, there are a few things that you can do to change the way that society responds to people living with HIV. Recommendations include:

Education– learn about HIV, how it is transmitted and treated. It is not a death sentence (it is a chronic disease) and you cannot acquire HIV from casual contact with an infected person.

Grace– extend grace to people who live their lives differently from yours. Reserve your judgment, and if you are a provider, treat the whole person as a human being.

Advocate– high rates of poverty and unemployment are not happenstance. Work with your local community-based organizations to change the system that continually oppresses those who have very little.

Motivate– people to get tested for HIV. Resources are constrained, but by partnering with local allies doing the work, you can manage the spread of HIV in your community.

https://southernaidscoalition.org/wp-content/uploads/2021/08/HIVintheUSDeepSouth.pdf

https://www.cdc.gov/hiv/pdf/policies/cdc-hiv-in-the-south-issue-brief.pdf