Research

February 23, 2013: Housing Opportunities for Persons with AIDS (HOPWA): Distribution of Funding to the Southern States

SASI releases new research report: Housing Opportunities for Persons with AIDS (HOPWA): Distribution of Funding to the Southern States. This report analyzes the HOPWA entitlement grant funding formulas.  Specifically, HUD uses a formula based on cumulative AIDS cases to distribute approximately $225 million of the $300 million entitlement grants to cities and states for short-term and long-term housing.

SASI’s analysis of this HOPWA funding stream concludes that the South is receiving 4.1% less of this funding than it would receive if the formula was based on living HIV/AIDS cases.

Nov. 22, 2012: HIV Diagnoses & Prevalence in the Southern Region of the US

HIV Diagnoses and Prevalence in the Southern Region of the United States, 2007-2010, a new paper published in the Journal of Community Health by CDC authors documents the high HIV burden borne by the Southeastern United States.  According to the paper, “the southern region is home to the largest percentage of new diagnoses and the largest percentage of people living with a diagnosis of HIV infection of any region in the United States..”:

  • “In 2010 46.0% of all new diagnoses of HIV infection occurred in the South.”
  • “Compared to other regions, a higher percentage of diagnoses in the South were among women (23.8%), blacks/African Americans (57.2%)…”
  • “…a greater percentage of the estimated diagnoses of HIV infection in the South were among suburban…and rural residents…”
  • “…the estimated rate of diagnoses of HIV infection in the two youngest age groups of men (13-19 and 20-29) increased significantly…”
  • “…after diagnosis individuals in the South have worse outcomes….the percentage of persons surviving 36 months after a diagnosis of HIV infection is worse in the South than in all other areas…”

November 28, 2012: SASI Update–The Continuing HIV Crisis in the US South 

SASI releases updated report, SASI Update: The Continuing HIV Crisis in the US South.  Report highlights include:

  • 8 of the 10 states with the highest HIV diagnosis rates were in the South*; 7 were in targeted southern states (AL, FL, GA, LA, MS, NC, SC, TN, (East) TX).
  • 48% of new HIV diagnoses were in the South, while the South contained only 37% of the population.
  • 32% of new HIV infections in 2010 were in the 9 targeted southern states, which contain only 22% of the US population.
  • The targeted southern states had the highest new diagnosis rates in the US.
  • 7 of the states/district with the highest AIDS diagnosis rates were in the South; 4 were in targeted states (FL, LA, MS, SC).
  • 9 of the 10 metropolitan areas with the highest HIV diagnosis rates were in these targeted southern states, including Miami, FL and Jackson, MS.
  • 9 of the 10 metropolitan areas with the highest AIDS diagnosis rates were in the South; 7 were in targeted states.
  • 6 of the 10 states with the highest HIV prevalence rates in the US were in the South (FL, GA, LA, DE, SC, MS).
  • Southern states/DC represented 6 of the 10 areas with the highest AIDS prevalence rates (DC, MD, FL, GA, DE, LA).
  • 9 of the 10 US states with the highest rates of death due to HIV are in the South, and all 9 targeted southern states are among the 15 states with the highest HIV death rates.

January 2012: HIV/AIDS Epidemic in the South Reaches Crisis Proportions in the Last Decade

In January 2012, SASI released the report, HIV/AIDS Epidemic in the South Reaches Crisis Proportions in the Last Decade, prepared by the Duke Center for Health and Inequalities Research.  The Executive Summary of this report was released in November 2011.  Some of the report’s highlights are included below.

HIV in the Southern United States

  1. New HIV diagnoses:
  • In 2009, 50% of individuals newly diagnosed with HIV infection resided in the Southern USi and the rate of diagnosis of HIV infectionii in the South was the highest of all the US regions.1,2  Seven Southern states (FL, GA, LA, MS, NC, SC, TX, VA) were among the 10 statesiii with the highest rates of diagnosis of HIV infection in 2009.1
  • 9 of the 10 metropolitan areas with the highest rates of diagnosis of HIV infection in 2009 were in the Southern US.1  Two of these Southern cities (Miami and Atlanta) are part of the 12 Cities Project.3
  1. Individuals living with HIV (HIV prevalence): Forty-three percent of people who are HIV-positive live in the Southern US while the South comprises only 37% of the population.1,2 Southern states account for 7 of the 10 statesiii with the highest HIV prevalence rates in the US in 2009 (FL, GA, LA, MS, SC, TX, VA).1
  1. Death Rates: Data on deaths among individuals with HIV that occurred from 2001-2007 indicated that nine of the ten states with the highest age adjusted HIV case-fatality rates were located in the Southern US (AL, MS, FL, GA, LA, OK, NC, TN, SC).4
  1. Rural HIV/AIDS: 64% of individuals living with an AIDS diagnosis in rural areas reside in the Southern US.5 In the South, 22% of individuals living with HIV resided in rural areas or metropolitan areas with populations under 500,000 in comparison to 11% nationally. Providing HIV care in rural areas may be particularly challenging due to barriers such as lack of transportation, shortages of medical providers, and fear of discrimination and confidentiality breaches.6,7
  1. Race/ethnicity: African Americans are disproportionally represented among new HIV diagnoses (2005-2008) in the South, as 50% of men and 71% of women diagnosed with HIV in the South were African American.8 African Americans with HIV have been identified as having higher levels of morbidity and mortality.4,9

i The Census Bureau defines the Southern US as including Alabama, Arkansas, Delaware, DC, Florida, Georgia,  Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia

ii Rates are calculated as new HIV cases per 100,000 population

iii Among the 40 states with mature HIV reporting systems (CDC technical notes1).

REFERENCES:

1. Centers for Disease Control.  Diagnoses of HIV Infection and AIDS in the United States and Dependent Areas, 2009. HIV Surveillance Report, Volume 21. Available at http://www.cdc.gov/hiv/surveillance/resources/reports/2009report/index.htm. Accessed October 2011.

2. U.S. Census Bureau, Population Division. Table 1, Annual Estimates of the Resident Population for the United States, Regions, States, and Puerto Rico: April 1, 2000 to July 1 2009. Released December 2009.

3. Gomez M. The 12  Cities Project. 2011. Available at http://blog.aids.gov/2011/02/the-12-cities-project.html.

4. David B. Hannaa, Richard M. Selikb, Tian Tangb and Stephen J. Gange. Disparities among States in HIV-related mortality in Persons with Hiv Infection, 37 U.S. States, 2001–2007. AIDS, 2011, published ahead of print.

5. Centers for Disease Control. HIV Surveillance in Urban and Nonurban Areas. 2011. Available at http://www.cdc.gov/hiv/topics/surveillance/resources/slides/urban-nonurban/. Accessed October 2011.

6. Sutton M, Anthony MH, Vila C, McLellan-Lemal E, Weidle PJ. HIV Testing and HIV/AIDS Treatment Services in Rural Counties in 10 Southern States: Service Provider Perspectives, The Journal of Rural Health. 2010;26: 240-247.

7. Reif S, Whetten K, Raper J. Characteristics of HIV-Infected Adults in the Deep South and their Utilization of Mental Health Services: A Rural Vs. Urban Comparison. AIDS Care, 2006;18(Supp 1):10-17

8. Centers for Disease Control. Disparities in Diagnoses of HIV Infection Between Blacks/African Americans and Other Racial/Ethnic Populations – 37 States, 2005—2008. Mortality and Morbidity Weekly Report, 2011.60(4):93-98.

9. Meditz A, Mawhinney S, Allshouse A, et. al, Sex, Race, and Geographic Region Influence Clinical Outcomes Following Primary HIV-1 Infection, Journal of Infectious Diseases, 2011: 203(15); 442-451.