Facing the Highest Risk of Infection and Death from HIV in the Country
The Southern region of the United States is experiencing an unprecedented HIV burden. Nearly half (49%) of all new HIV diagnoses occur in the South5,6 despite the region representing just 37% of the total U.S. population.7
Many people living with HIV face an array of challenges in their day-to-day lives. Barriers such as poverty, stigma, racism, heterosexism, and limited access to insurance impede receipt of treatment and necessary support.
Not only are Southerners more likely to become HIV infected, they are dying at higher rates too.
The death rate among people living with HIV is higher in Southern states* than any other U.S. region8 even after adjusting for age, gender, transmission category, and population density. Simply put, Southerners too often do not get the care they need.
What Is Causing the ‘Disconnect’ between Diagnosis and Care?
Researchers say the “disconnect” is due to several characteristics shared across the South. These include rampant stigma, racism, uneven access to education, poverty, and lack of insurance coverage—an issue exacerbated by the lack of Medicaid expansion.9, 10
The reality is that people with HIV often experience multiple levels of discrimination — whether that’s due to HIV-related stigma, racism, heterosexism, anti-immigrant sentiments, or the slow violence of other social or economic inequalities.
It’s an untenable situation that is ripe for human rights violations. And this potential for harm is exactly why investing in advocacy is so important.
Limited access to specialized prevention and care services also contributes to disparities. Due to shortages of public and private funding, many nonurban areas in the South do not have adequate HIV resources.11 More than one-quarter of people living with HIV in the South, however, live in nonurban communities,12 compounding challenges to obtain health care and social services.
Who Is Affected?
- The rate of new HIV infections was about 8 times higher for black/African Americans than for whites. And 3 times higher for Hispanics/Latinos.
- Black youths (ages 13 to 24) accounted for 34% of all new HIV infections among black/African Americans. Among black men who have sex with men (MSM), this age group accounted for 45% of new infections.
- Black women accounted for nearly two-thirds (64%) of new HIV infections among women.
What Is HIV Criminalization and How Is It Contributing to the Crisis?
In the U.S. South:15
- All states in the region that Southern REACH covers have laws that criminalize HIV exposure and transmission or use assault laws in a similar way to prosecute HIV exposure and transmission.
- 6 of the 9 of these states attach a felony sentence to the crime.
Criminalization of HIV exposure and transmission dilutes the public health message of shared responsibility for sexual health between partners. What’s more, it places the responsibility for HIV prevention exclusively on those already living with HIV.
There have been a number of inappropriate criminal prosecutions in the South of people living with HIV for non-disclosure of status, potential or perceived HIV exposure, or HIV transmission. These prosecutions serve to create greater barriers to testing and engagement in care and are in direct conflict with a human-rights approach to ending the HIV epidemic, as well as current public health messaging.
These laws perpetuate HIV stigma and discourage those living with and at risk for HIV from seeking the testing, care, treatment, and prevention services necessary to remain healthy.
Join with AIDS United to Turn Back the Tide
By building infrastructure, increasing capacity, injecting resources, and leading the way, AIDS United has stepped up to the charge and become part of the solution. Join us.
* Researchers studied five-year survival rates for people diagnosed with HIV or AIDS in 2003-2004 in nine Southern states (Alabama, Florida, Georgia, Louisiana, Mississippi, North and South Carolina, Tennessee, and Texas)
See AIDSVu.org for more information.