For the very first time, the United States South will be in the HIV community spotlight.
A collection of local and national groups have designated Aug. 20, 2019, as the very first Southern HIV/AIDS Awareness Day (SHAAD), a companion to the many annual HIV awareness days that occur throughout the year. However, SHAAD will be the first awareness day to focus on a particular region in the United States. Most awareness days focus on populations: National Black HIV/AIDS Awareness Day on Feb. 7 and National Native HIV/AIDS Awareness Day on March 20, for example. The Southern AIDS Coalition, an Alabama-based organization working across several states to end the epidemic in the South, launched SHAAD along with AIDSVu, which stores data about the U.S. HIV epidemic, and drug manufacturer Gilead.
"We have an HIV/AIDS crisis in the South," Dafina Ward, J.D., the interim director at the Southern AIDS Coalition, said Friday on a phone call. "We have to engage in a collective strategy, with bold and innovative approaches to reduce disparities." Ward said that SAC wants to "create a South where every person impacted by HIV has access to quality health care and support services and lives in a community free from stigma and discrimination."
The U.S. South does shoulder a disproportionate burden of the United States' HIV epidemic. Despite holding only 38% of the United States population, the South accounts for 45% of all people living with HIV and 52% of new HIV diagnoses. The South also experiences the country's highest rates of new HIV infections, AIDS diagnoses, and death from AIDS-related illness.
The South is also an epicenter of the Trump administration's Ending the HIV Epidemic plan. As part of the plan, the United States government has offered grants to the 48 counties -- as well as Washington, D.C. and San Juan, Puerto Rico -- that have the highest HIV incidence rates in the country. Of the 48 counties given grants, almost half are in southern states, and five of the seven states also receiving grants are in the South. As part of our Eyes on the End series, TheBody has already profiled several of the counties chosen for additional funding, including Orleans Parish, Louisiana, Shelby County, Tennessee, and the several counties chosen in Georgia.
If the southern U.S. bears the brunt of this health epidemic, it's also because it is the epicenter for so much structural inequality in the United States. While the North and East have the highest concentration of affluence in the U.S., the South has the largest concentration of distressed communities, and several states in the South are listed among those with communities where the inequality gap has gotten worse: Alabama, Arkansas, Mississippi, Louisiana, and West Virginia.
Much of the current inequality in the United States is rooted in slavery. Though slavery was outlawed in 1865, structural inequality endured in the U.S. South in the form of Jim Crow laws, redlining, mass incarceration, and more. Recently, TheBody reported on structural inequality facing those living with HIV in the South, specifically in Atlanta, where people with HIV faced eviction and homelessness due to a funding issue with Housing Opportunities for Persons With AIDS (HOPWA), the program that subsidizes housing for HIV-positive people.
"HIV infection does not happen in a vacuum," Ward said on a conference call. "New cases occur when you look at the intersection of an array of phobias and structural barriers that exist in the South."
She continued, "We must draw national attention to this problem. It is not just a southern challenge, but one we must work toward together."