The US South: Policy Failures Fuel HIV/AIDS Among Women and People of Color

World AIDS Day may be just behind us, but the battle to combat the epidemic marches on. And believe it or not, one of the places it marches on most ferociously is in the US South, where women and communities of color are increasingly affected by HIV/AIDS.

"Forty-six percent of all new AIDS cases come out of the South," says Patricia Eng, Vice President of Program at the Ms. Foundation for Women, "and of the 10 states with the highest number of women with HIV, seven of them are in the South." Southern communities of color have also been particularly hard hit: as a recent Human Rights Watch report notes,

In southern states such as Alabama, Louisiana, Georgia and Mississippi, blacks comprise approximately 30 percent of the population but 65-75 percent of the cases of HIV. Of the 10 states with the highest rates of new HIV diagnosis for Latinos, seven were in the South. Florida and Louisiana have the second and third highest rates of HIV diagnoses for Latinos in the country.

Those are staggering statistics, by any measure. A recent article on PBS.org has described the South as nothing less than "ground zero for the domestic AIDS epidemic" -- and numbers like these make it hard to argue with that assertion.

What makes the South so vulnerable? Think poverty. Think isolation. Think about the long-term effects of a pervasive culture of silence and the predominance of abstinence-only-until-marriage curricula. "Very few social investments ever make their way to the South," Eng points out, creating an environment that leaves already vulnerable populations (the poor, the female, the disenfranchised, and communities of color) ever more at-risk. "The Southeast region of the U.S. has the most poverty, the weakest safety net programs, the most uninsured people, the most prisoners, the fewest needle exchange programs, and the least HIV/AIDS funding," writes Lisa Biagiotti, author of the article on PBS. Moreover,

Government AIDS drug assistance programs are closing because of state budget deficits. Federal funds tend to be distributed to big cities because funding streams focus on high concentrations of infections and count only cumulative AIDS cases from the beginning of the disease, including all of those who have died. The South has a newer epidemic and more HIV cases that have not yet progressed to AIDS. So, by not counting HIV cases, the South is being punished. Also, the sprawling, rural landscape of the South makes infection concentrations an issue.

Awareness campaigns have dwindled and don’t address the root causes. Rather, they focus primarily on testing and treatment for HIV, not preventing it. “Dead zones” — places cut off from access to care and services — remain. And because of all this, there are intergenerational consequences of an epidemic everyone ignores.

Building on our work in the aftermath of Hurricanes Katrina and Rita, and our commitment to supporting progressive grassroots organizations in the South, the Ms. Foundation is now funding groups working to address the various failures of policy and program -- particularly in the area of sexuality education -- that have rendered the South so susceptible to the spread of HIV. These groups bring important and often ignored perspectives to policymaking tables, and are crafting unique approaches to address the epidemic's particular impact on the South.  They include organizations like AIDS Alabama, an AIDS advocacy group that will be launching a statewide media campaign to build support for comprehensive sexuality education, and the Alabama Campaign to Prevent Teen Pregnancy, which provides leadership on teen pregnancy prevention and other sexuality education issues through collaboration, education, training and advocacy.

At the national level, the National Women and AIDS Collective (NWAC) -- a project first incubated at the Ms. Foundation for Women and now an independent nonprofit made up of current and former grantees -- continues to advocate for critical federal HIV/AIDS policy changes needed to meet the unique and unmet needs of women living with, or at risk of, HIV/AIDS. This includes addressing social and economic factors (like poverty, incarceration, domestic violence, to name a few) that place some people at greater risk of infection -- many of which are particularly heightened in the Southern US.

The policy failures that have left the South so dangerously central to this epidemic (the lack of comprehensive sex ed; the lack of access to safe, sterile needles -- among others) are daunting, to be sure. The good news is that with groups like our grantees working to make things right on the HIV/AIDS front, the South may yet live to rise again.