The South's Secret Epidemic

The South's Secret Epidemic

By Nat Roe


Because even the most progressive need a wake-up call.

By Nat Roe

Atlanta, the self-proclaimed capital of the South, is renowned for the music of André 3000 and Ludacris. It tastes like the grease pooling off the side of your Waffle House All-Star breakfast. It’s home to the world’s busiest airport. And it also leads the nation in another way: HIV infections.

One out of every 51 Georgians will be diagnosed with HIV over the course of their lifetime.

CDC researchers calculated the lifetime risk of HIV through diagnoses and death rates from 2009-2013 in the United States by sex, race and ethnicity, state and HIV risk group. According to its findings, Georgia is also second as a state in new HIV diagnoses, while the South, in total, now accounts for an estimated 44 percent of all people living with HIV in the United States. (The CDC did not respond to request for comment in time for publication.)


Source Natalie Roe/OZY

That’s a shift. In the early days of the epidemic, which started in 1981, Los Angeles and New York were the epicenter. The South not only faces the largest burden of HIV diagnoses today but also lags the furthest behind in providing prevention mechanisms to its population. The numbers actually aren’t new, and, unfortunately, neither is the funding model. Many of the formulas that fund programs for people living with HIV were developed in the 1980s. The money allocated to programs was based on the number of people with AIDS, which favored the states of New York and California, not on the new cases or rates of infection. Instead of relying on this outdated algorithm, experts say living HIV cases should be counted.

Not only have half of the people who have had AIDS died since the beginning of the epidemic, but fewer and fewer people are being diagnosed with AIDS, the final stage of HIV infection, because of better treatment. Despite the fact that people are surviving long term with AIDS, funding remains disproportionately distributed. This year, New York and California had only 19 percent of the new diagnoses, but they still received 36 percent of the federal money — more than the entire South combined. The system, with its “out-of-date funding formulas,” is a shackle to HIV prevention, says Carolyn McAllaster, director of the Southern HIV/AIDS Strategy Initiative. “The epidemic has changed, and the money needs to follow.”

Another shift in the epidemic is the approach people are taking to join the global conversation surrounding HIV. Social media is advancing the way narratives are being told and data is finally being amplified, according to Charles Stephens, a Black LGBT activist and community organizer in Atlanta. Whereas previously, the impact of HIV on vulnerable communities — and particularly the South — might have been ignored, he says, “I think that there are a lot of folks who refuse to be ignored.”

While the Southern epidemic is rooted in absent monetary investment, public investment is also lacking in communities that have always been a part of the HIV epidemic. JD Davids, managing editor of and a longtime prominent AIDS activist, says that beyond expanding heath care, the best way to combat this epidemic is by turning to the people who have been fighting HIV for decades.

“We see that people who are at risk of HIV or living with HIV, when provided with information and resources, are the best resources for actually helping the epidemic end,” Davids says. “They know what to do. Giving them the resources to do it — that’s our best hope.”