Here’s why Southern HIV/AIDS Awareness Day is critical

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The South is the current epicenter of HIV in the US, so it comes as great importance that Aug. 20 is designated Southern HIV/AIDS Awareness Day (SHAAD). It highlights a unique set of cultural and systemic attributes that contribute to the Southern HIV epidemic.

Launched in 2019 as a two-day, in-person event in Birmingham, Alabama, SHAAD blossomed from the work of the Southern AIDS Coalition and their partners. Their mission: to promote high-quality systems of HIV and STI prevention, treatment, care, housing and support services throughout the South.

In 2020, only a year after its inception, the CDC recognized SHAAD as a national awareness day, spreading its intention and purpose across the country.

Why the South?

The South’s HIV epidemic is a part of the greater syndemic, or synergistic epidemic, in the region. A syndemic occurs when two or more health disparities create a larger epidemic. The South hosts a confluence of HIV, opioid and substance use disorder epidemics. Each epidemic ties deeply to racial discrimination, poverty, housing instability and other socio-economic ills.

In a syndemic, disparities converge in a way that one unilaterally-designed response could not dismantle the multitude of barriers prohibiting full health equity.

Populations predisposed to these conditions are more vulnerable to HIV. In the South, that primarily means people in the African American and LGBTQ+ communities, people experiencing poverty, people lacking transportation and access to medical services, and populations intersecting all the above.

These determinants and disparities culminate in a stigmatized life experience in which individuals are disincentivized from using public health preventions. They are more likely to skip or lack access to preventions in primary (educative/lifestyle), secondary (testing), and tertiary (treatment) care.

Georgia had the highest rate of new HIV diagnoses and the fourth highest total number of diagnoses in the United States in 2019, according to the CDC’s most recent HIV Surveillance Report. That same year, Georgia Department of Public Health cited 2,504 newly diagnosed individuals, bringing the total number of Georgians living with HIV to 56,000.

In Southwest Georgia – including Doughterty, Sumter, and parts of Bibb and Muscogee counties – roughly 200 people received a new HIV diagnosis in 2019. Although 71% of people living with HIV in Southwest Georgia are initiated into respective medical care, only 55% maintain that care.

Maintaining care is essential for optimal health. It helps people reach a level of care that makes HIV no longer transmittable to others (also known as “Undetectable = Untransmittable” or “U=U”).

 

SHAAD 2021

On July 19, the Biden Administration signed guidance requiring health insurers to cover the full price of Pre-Exposure Prophylaxis (PrEP), the drug deemed epidemiologically necessary to decrease HIV transmission rates. The guidance also covers PrEP’s accompanying labs, which have been one of the most significant detractors of widespread PrEP usage.

Still, uninsured people do not benefit from the new guidance. On top of that, Southern state governments like Georgia refuse to expand their Medicaid programs, so the South bears the highest number of people not covered by health insurance, according to the Kaiser Family Foundation.

If Georgia were to expand Medicaid, as 39 other states already have, more individuals from key populations would become eligible for necessary preventative services such as PrEP. Even more, an estimated 6,700 Georgians living with HIV who are currently without insurance would be able to access HIV care.

It is due to real, current issues like these that the South’s HIV epidemic needs significant attention. Southern HIV/AIDS Awareness Day places these issues at the forefront and encourages local individuals and organizations to take long-needed action.

Visit Georgia Equality’s HIV Advocacy Network at for tools and resources, and SouthernSolution.org for more information on awareness day events.

Guest columnist Taylor Brown (he/him) is an Ending the Epidemic Fellow for Georgia Equality. He is a recent graduate of Kennesaw State University with a degree in Public Health Education. His foundation is in infectious disease through his HIV work with the Georgia Department of Public Health and COVID-19 work with the Fulton County Board of Health. Taylor is passionate about social epidemiology, sex education, nutrition and mental and behavioral health. He lives in Atlanta and hopes to make it a healthy and equitable place for all.

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