Half of deaths occur in 17-state region as federal, private money dries up
By Alex Johnson
Reporter
MSNBC
AIDS specialists are calling for a fundamental rethinking of HIV policy after a new report showed that infection with the virus was rising dramatically in the South even as it dropped everywhere else in the country.
The warning, issued this week by the Southern AIDS Coalition, a nonprofit partnership of government and private-sector programs based in Birmingham, Ala., concluded that AIDS was creating a health disaster in the South.
AIDS deaths fell or held steady in other parts of the country from 2001 to 2006, the last year for which complete figures were available, but they rose by more than 10 percent in the South, according to the report, titled "Southern States Manifesto 2008."
The report, an update to a landmark 2002 report that identified the disproportionate impact of HIV and AIDS in the South, was based .. compiled by the federal Centers for Disease Control and Prevention, state health departments and academic researchers. It defined the region as Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia and Washington, D.C.
Among the findings:
- Although the covered area is home to only 36 percent of the nation's population, half of all U.S. AIDS deaths in 2005 were in the South, and more than half of all Americans with HIV lived in the region in 2006.
- Nine of the 15 states with the highest HIV diagnosis rates are in the South.
- More than 40 percent of all new infections are in the South.
- Of the 20 metropolitan areas with the highest rates of AIDS cases in 2006, 16 were in the South.
"The South is faced with a crisis of having to provide medical and support care for increasing numbers of infected individuals without adequate funding," especially among the young and among minority Southern communities, the report concluded.
"African-American women are 83 percent of all [new] cases that we can document," said Bambi Gaddist, executive director of the South Carolina HIV/AIDS Council and a member of the AIDS Coalition board of directors. "And the new epidemic is young people. They're between 22 and 24."
'Specific problems here in the South'
AIDS specialists pointed to unequal government funding of anti-AIDS programs as a major problem in the South, where they said economic and cultural factors played unique roles in transmission of the disease.
"We have specific problems here in the South, especially because of our rural areas — transportation issues, translation, lack of access to proper health care," said Mary Elizabeth Marr, executive director of the AIDS Action Coalition of North Alabama.
Education plays a particularly important role in fighting HIV in rural communities, said Marr, who blamed the "it can't happen to me factor."
"Some of those are parents in denial that their children are sexually active [and] people not getting tested," she said. "People aren't getting proper health care early on and are transmitting the disease to others."
But "even though we have now seen this increase in the South, we are not seeing the increase in funding for the Southern states," she said.
The Southern AIDS Coalition blamed "rising infection rates coupled with inadequate funding, resources and infrastructures" for what it called "a disparate and catastrophic situation in our public health care systems in the South."
"There are vast geographic areas that encompass large cities, less urban areas, and rural areas that result in screening, care, treatment, and housing challenges," it said. "Historically, the South has also received the least amount of federal funding."
At the same time, "only 19 percent of U.S. philanthropic commitments for HIV/AIDS" go to the South, it said.
More funding, education, testing urged
The coalition called for more "age-appropriate, science-driven education for prevention of all sexually transmitted diseases," along with increased federal funding for "prevention, treatment, care, and housing in the southern United States to rectify the historical inequities embedded in the federal HIV and STD funding portfolios."
"Unless we act to correct funding and treatment disparities, we endanger not just isolated communities, but our states and our nation," the report said.
Specialists said people could not get treatment if they did not know they were infected, which the report said could represent as many as 25 percent of all HIV cases in the South. They added a plea for inexpensive testing for every sexually active person.
"People in the South will die for lack of a simple test that can cost under $8 to provide, so we must work together to provide early screening," said Evelyn Foust, a disease expert with the North Carolina Division of Public Health and a member of the AIDS Coalition's board.