South now experiences the greatest burden of HIV infection

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Staff Report

A new study released in May revealed the shocking news that of the 25 metropolitan areas with the highest rate of diagnosed HIV, 21 are in Southern states. Two areas in The Gayly’s area – Little Rock, Ark. and Tulsa, OK – are included in the list.

Fewer people living with HIV in the South are aware of their infection than in any other region. Arkansas, Oklahoma and Texas fall into the group of states with the lowest percentage of people living with HIV who are aware of their status. Kansas and Missouri are in the next lowest category.

Consequently, fewer people in the South who are living with HIV receive timely medical care or treatment, fewer have their virus suppressed, and a disproportionate number are missing out on the opportunity to preserve their health and avoid transmitting HIV to their partners.

A CDC Issue Brief released in conjunction with the study said, “In the decades since the first AIDS cases were reported in Los Angeles and New York City in 1981, the epicenter of the nation’s HIV epidemic has shifted from urban centers along the coasts to the 16 states and District of Columbia that make up the South. The South now experiences the greatest burden of HIV infection, illness, and deaths of any U.S. region, and lags far behind in providing quality HIV prevention and care to its citizens. Closing these gaps is essential to the health of people in the region and to our nation’s long-term success in ending the epidemic.”

Southern states today account for an estimated 44 percent of all people living with an HIV diagnosis in the U.S., despite having only 37 percent of the overall U.S. population. The majority of HIV diagnoses across the country are in urban areas. That’s true of the South, but the region has higher HIV diagnosis rates in suburban and rural areas as compared to other regions nationwide. This poses unique challenges to HIV prevention efforts.

Many people in greatest need are not benefiting from access to health care services, and southern states generally continue to have the highest numbers of people without health insurance. Texas, with 18.8 percent uninsured, and Oklahoma, with 18.1 percent, top the list. Arkansas has 10 percent uninsured, Kansas has 11 percent, and Missouri has 9 percent. Of these five states, only Arkansas elected to expand Medicaid under the Affordable Care Act.

The CDC reports that cultural factors may also play a key role. Issues such as homophobia and transphobia, racism, and general discomfort with public discussion of sexuality may be more widespread in the South and can lead to higher levels of stigma, which may limit people’s willingness to seek HIV testing, care, or prevention services. These challenges can also limit access to accurate sexual health information, which people need to protect themselves from infection.

According to ABCNews’ coverage of the CDC press conference introducing the study, “To stop the spread of HIV in the U.S., we have to understand how, where, and among whom the epidemic is striking the hardest,” said Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, during the news conference.

Mermin said that a major focus of HIV prevention programs will be expanding access to HIV testing, treatment, and pre-exposure prophylaxis (PrEP), especially among gay and bisexual men of color and transgender individuals. The CDC earmarks targeted funds as a supplement to state and local health departments.

“According to one CDC study, these programs could prevent up to 70 percent of new infections over the next five years.”

To read the full CDC Issue Brief, visit www.tinyurl.com/jsukglt. To read the study, visit www.publichealth.jmir.org/2016/1/e22/.

The Gayly – June 24, 2016 @ 7:30 a.m.