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HIV/AIDS Resource Center for African Americans
Kai Chandler Lois Crenshaw Gary Paul Wright Fortunata Kasege Keith Green Lois Bates Greg Braxton Vanessa Austin Bernard Jackson


HIV Health Literacy in the South: A Work in Progress

November 4, 2014

Nearly half of all Americans with HIV live in the South, with prevalence rates in Georgia, Florida, and Louisiana now at 200 per 100,000 people -- a rate surpassed in the U.S. only by the heavily populated Northeast. According to the Southern AIDS Coalition's 2009–2010 HIV/AIDS Health Care Policy Brief and Recommendations, Southern states also continue to have "the highest newly reported HIV cases and the smallest decrease in deaths due to AIDS," and "Providers have become increasingly concerned and frustrated at the prospect of having to provide increased care to meet increased need with fewer dollars."

Unfortunately, as HIV rates in the region have continued to rise -- especially among young, poor, black, and Latino men who have sex with men -- government resources for people with HIV have decreased dramatically. As a result, people with HIV, their caregivers and service providers, and others face significant challenges in gaining access to accurate, up-to-date information about HIV treatment and prevention, as well as in receiving quality care.

Given the overwhelming needs in the South, ACRIA has given the region priority in its work providing desperately needed HIV treatment and prevention information, especially in rural areas where health care and other services are scarce. Over the past five years, our HIV educators have delivered training and capacity building services in Tennessee, Alabama, Mississippi, Georgia, South Carolina, Arkansas, Florida, and Louisiana -- states with some of the highest HIV rates in the country. This work has given us an up-close look at how barriers to care have devastated the region, but it has also shown us what is possible when communities come together to improve the health and lives of those most in need.


ACRIA has brought together diverse groups of service providers that include social workers, medical providers, correctional facility personnel, faith-based outreach workers, and others on the front lines of the epidemic. Our educators help them learn how to reach those with and at risk for HIV and to improve the health literacy of the people they serve so that they are better able to navigate our very complicated health care system. Although the national average reading level is 8th grade, many of the individuals who receive services in the South read at a much lower level. We provide tips, tools, and techniques that service providers can use to translate the jargon of health care into plain language.

Although ACRIA has helped improve services across the South, serious challenges remain. Our educators have encountered quite striking examples of homophobia and HIV stigma -- devastating barriers to stopping the epidemic -- during training sessions. In some cities, participants reacted to the subject of working with LGBT clients with more vehement negativity than we have encountered in two decades of providing trainings in a variety of communities across the country.

Fortunately, we have found ways to engage participants to explain the importance of providing culturally competent care without judgment and effectively appealed to their urge to do well and right by those they aim to serve. Indeed, some of these very same participants have thanked our teams for opening the door to conversations around sexuality and gender identity and acknowledge that they are "a work in progress." We're pleased to have helped them take the first step toward greater understanding as we each work together to end the HIV/AIDS epidemic for all.

This year, thanks to the generosity of the Elton John AIDS Foundation, The Elizabeth Taylor AIDS Foundation, the H. van Ameringen Foundation, the MAC AIDS Fund, and Janssen Therapeutics, ACRIA has expanded its work to include three cities in Florida -- Jacksonville, Orlando, and Miami -- as well as Biloxi, Mississippi; Atlanta, Georgia; and Memphis, Tennessee. This support is making it possible for us to reach hundreds of service providers who in turn serve thousands of people with and at risk for HIV.

The HIV epidemic is far from over, and it continues to plague the most vulnerable and marginalized. With HIV rates among young, poor gay and bisexual men of color in the South increasing while they decline among the rest of the population, ACRIA is committed to its ongoing work with committed providers in the region by helping to ensure that people with and at risk for HIV receive the quality care and services they need and deserve.

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This article was provided by AIDS Community Research Initiative of America. It is a part of the publication Achieve. Visit ACRIA's website to find out more about their activities, publications and services.

See Also
HIV/AIDS in the South

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