The Driver of this Epidemic
Loss of family. Loss of friends. Loss of faith community. Loss of love, children, job. Loss of dignity. Loss of power and of hope.
These are the byproducts of stigma… of living with HIV, of having a son or daughter living with HIV. Of homosexuality.
Homophobia may be the single greatest driver of this epidemic, especially in the Bible-belt South. What is going on here?
HIV is a Southern Epidemic. The map above (aidsvu.org) illustrates the shape of HIV in America. What we know is that the South is home to the most undiagnosed HIV and the most new HIV diagnoses. Why the South?
Poverty is at home in the South with many states having the highest rates of poverty in America (More than 18.5% falling below the poverty line.) Learn more about poverty in the South at talkpoverty.org.
Religious Fundamentalism creates barriers for uncovering stigma and sharing public health information. The Bible Belt, while home to many wonderful religious people, is also a place where shame, ignorance, and intolerance thrive.
Many southern states restrict access to sex education and family planning. This is a particular concern in public schools where many southern states restrict student access to public health information by statute. Ignorance around sex and sexuality, sexual identity, and “abstinence only” policies are issues that help to drive the HIV epidemic. What we need is a comprehensive approach to sex and sexuality, where abstinence as a choice is valued and respected, and where the reality of early sexual debut is acknowledged along with competent messages around safer sex and disease prevention.
Access to Healthcare is a major issue in the South as well, with many southern states electing not to participate in Medicaid Expansion. According to healthinsurance.org, expanding Medicaid in Tennessee would make coverage newly available to roughly 352,000 of the state’s poorest residents. But it hasn’t happened, and it is not likely to happen all across the South.
To end the epidemic in the South will require a full frontal assault on HIV, with politics and moralism set aside. HIV is not a moral or political problem; it is a public health problem.