Print this page    •   Back to Web version of article

Commentary & Opinion
"Sexual Silence" Contributes to Spread of HIV in Southern United States, Opinion Piece Says

July 25, 2003

"The South's inclination to avoid speaking about uncomfortable subjects" has helped make the Southern United States the new HIV/AIDS "epicenter" by encouraging "sexual silence," Michael Alvear, a syndicated sex advice columnist, writes in an Atlanta Journal-Constitution opinion piece. The South has the highest concentration of the two groups most likely to be infected with HIV -- African Americans and low-income individuals -- and silence surrounding sex has "amplifie[d]" these demographic factors, Alvear says (Alvear, Atlanta Journal-Constitution, 7/25). According to CDC figures cited in the "Southern States Manifesto," written by HIV/AIDS directors from various states and presented at a two-day conference in Tampa, Fla., in December 2002, more than 130,000 people in the South have AIDS, compared with about 100,000 people in the Northeast, 36,000 in the Midwest and 62,000 in the West. In addition, the officials said that the South has a bigger HIV/AIDS problem than elsewhere in the United States because of its racial and economic demographics and "a cultural conservatism that interferes with attempts to arrest the disease" (Kaiser Daily HIV/AIDS Report, 1/14). One of the most effective ways to prevent HIV transmission is for sexual partners to be aware of each others' HIV status and "the only way to know is ask," according to Alvear. However, many Southerners would consider such a question "too rude for words," Alvear says, adding, "There's a tradition here -- if you can't be kind, be vague. Problem is, you can't be vague with a plague." Alvear concludes, "The South, ever mindful of its manners, is killing itself with its own kindness" (Atlanta Journal-Constitution, 7/25).

Back to other news for July 25, 2003

Reprinted with permission from You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at The Kaiser Daily HIV/AIDS Report is published for, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2003 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.

This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. You can find this article online by typing this address into your Web browser:

General Disclaimer: is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, consult your health care provider.