SASI’s new Report, HIV Stigma Study in the Deep South: Descriptive Findings, documents HIV-related stigma in the Deep South by surveying persons living with HIV at HIV medical care facilities and social services organizations in Alabama, Mississippi, North Carolina and South Carolina. HIV-related stigma, particularly internalized stigma, was found to be associated with negative health care outcomes, which has implications for quality of life, mortality, and the spread of HIV.

Among other findings, the study found that persons with higher internalized stigma were more likely to have missed a medical appointment in the last 6 months, to report poorer medication adherence, and to not have an undetectable viral load. These findings add to the growing evidence of the need to address stigma to improve the well-being of individuals living with HIV and to reduce HIV transmission. 

SASI also released two tables related to the literature around HIV-related stigma. The first table, Stigma Intervention Review Summary (2003-2015), summarizes literature reviews that examine interventions designed to reduce HIV-related stigma. Significant gaps in types of interventions, populations studied, and research methodologies remain.

The second table, Interventions to Address HIV-Related Stigma: Literature Summary, describes articles in peer-reviewed journals that discuss evidence-based interventions to reduce HIV-related stigma. The studies are predominantly conducted in the US and include interventions to reduce stigma at the intervention level, at the community level for health professionals, and at multiple levels including individual and group level.

Stay tuned as SASI releases further analysis related to its HIV Stigma Study. SASI will also be working on adapting existing stigma reduction interventions and/or creating new strategies that are suited to the culture of the Deep South and to advocating for resources for the implementation of these programs.

SASI’s new Report, State of HIV in the US Deep South,[Full text] [Abstract] is co-authored by Susan Reif, Donna Safley, Carolyn McAllaster, Elena Wilson and Kathryn Whetten and published in the Journal of Community Health on February 28, 2017.

Recent SASI research has documented that the US Deep South region (AL, FL, GA, LA, MS, NC, SC, TN, TX) is a significant driver of the US HIV epidemic with especially high HIV and AIDS diagnosis rates and HIV-related death rates from 2008-2013.

This new paper examines recent data on HIV epidemiology, HIV care and prevention financing, and research literature on factors that predispose the Deep South region to experience a greater HIV burden. In 2014, the Deep South region continued to have the highest HIV diagnosis rate and numbers and the highest HIV-related death rate of any US region. African Americans have been hard hit by HIV and represent a majority of new diagnoses as well as a majority of people living with HIV in the Deep South. New diagnoses among African American gay and bisexual men who have sex with men continue to increase.

Despite the heavy HIV burden in the US South and Deep South, SASI’s research demonstrates that federal funding for HIV care and prevention continues to lag behind in the region, primarily due to lower levels of CDC funding. According to a study by Funders Concerned about AIDS, private foundation grants also lag behind with only 12% of private foundation funding for HIV going to the Deep South in 2014.

The Report also highlights recent research identifying contributing factors to the disproportionate HIV burden in the US South and Deep South, including pervasive and multi-layered HIV-related stigma, poverty, high levels of sexually-transmitted infections, racial inequality and bias, and laws that further HIV-related stigma and fear. The Report recommends closing the gap in federal and private funding for HIV prevention and care, along with additional strategies to address the factors fueling the epidemic. These strategies should include the enhancement of current HIV care and prevention models and innovative interventions to reduce the impact of stigma. Continue reading →

Join the SASI and the Southern AIDS Coalition

at the United States Conference on AIDS:

 Southern Pathway Workshops: September 15-17, 2016

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SASI releases new report: WE HAVE THE TOOLS TO END HIV- Benefits, Barriers, and Solutions to Expanded Utilization of Pre-exposure Prophylaxis (PrEP) in the US Deep South

The benefits of PrEP to prevent HIV transmission are well established. It is critical that we overcome the multi-faceted barriers to achieving widespread PrEP utilization among vulnerable populations. The barriers are especially prohibitive in the US South where rates of poverty are higher than the national average, conservative attitudes about sex and HIV may heighten stigma concerns, where few states have expanded their Medicaid programs under the Affordable Care Act, and health outcomes are generally poor.

RECOMMENDATIONS FROM THE REPORT TO INCREASE PrEP UTILIZATION IN THE SOUTH AND IN THE U.S.: 

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SASI’s new report, Medicaid Expansion in the South, examines efforts in nine Deep South states to expand Medicaid under the Affordable Care Act. Thirty-two states have expanded Medicaid. Many of the remaining states are located in the Deep South: Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, Tennessee, and Texas. Louisiana plans to expand Medicaid in July 2016.

In states that have not expanded Medicaid, people remain uninsured because they do not qualify for traditional Medicaid under the states’ rules and cannot afford to purchase insurance on the ACA Insurance Marketplace.  These people fall into what is known as the “coverage gap.” According to the Kaiser Family Foundation, 90% of people who fall in the coverage gap live in the South. *

SASI’s report looks at the impact in the Deep South states that have failed to expand Medicaid and examines the politics and advocacy efforts surrounding the movement to bring Medicaid expansion to the South.

* http://kff.org/health-reform/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid-an-update/ 

SASI’s HIV-AIDS Care and Prevention Infrastructure in the U.S. Deep South is co-authored by SASI research team, Susan S. Reif, Kristen Sullivan, Elena Wilson, and Miriam Berger of the Duke University Center for Health Policy & Inequalities Research.

Recent research from SASI documented that nine states in the US Deep South (AL, FL, GA, LA, MS, NC, SC, TN, TX) had especially high HIV diagnosis rates and death rates due to HIV from 2008-2013.[1]

This new Report examines HIV care and prevention infrastructures and factors that contribute to poorer outcomes in the Deep South. Researchers studied four metropolitan statistical areas MSAs) with pronounced HIV and AIDS diagnosis rates (Baton Rouge, LA; Columbia, SC; Jackson, MS; Jacksonville, FL) and compared them to two metropolitan areas with similar demographics but less severe HIV epidemics (Birmingham, AL and Cincinnati, OH).

All four study areas had HIV epidemics that are predominantly affecting Black/African American people with high HIV and AIDS diagnosis rates and HIV death rates.  There were differences among the MSAs, however. For example, Baton Rouge and Jacksonville had some of the highest proportion of new female diagnoses in the US, whereas Jackson and Columbia had high proportions of minority men who have sex with men (MSM) among those diagnosed with HIV. Continue reading →

SASI Releases: HIV/AIDS in the US Deep South: Trends from 2008-2013. With six years of HIV/AIDS related data, new SASI Trends Report confirms that nine Deep South states are driving the HIV epidemic in the US.

The trends documented in SASI’s recent Report have been consistent over the last six years of data and indicate a critical need to strengthen efforts to reduce HIV transmission and mortality within the region. These trends may reflect barriers to timely HIV testing and treatment such as HIV-related stigma, lack of transportation and housing and inadequate availability of HIV medical providers. It is important that the Deep South region receive an equitable share of HIV care and prevention funding and that funding is distributed consistent with the geographic distribution of the epidemic.

Continue reading →

See the Press Release below from Rep. Alma Adams (D-NC) announcing the request by 25 bipartisan members of Congress for expanded HIV prevention funding from the CDC for rural and smaller urban areas in the Deep South.

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The Southern HIV/AIDS Strategy Initiative is excited to be working with the Southern AIDS Coalition to sponsor two events at this year’s US Conference on AIDS.

PLEASE JOIN US AT THESE EVENTS.

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According to the recently released CDC Morbidity and Mortality Weekly Report (MMWR), Prevalence of Diagnosed and Undiagnosed HIV Infection – United States, 2008-2012, persons who are unaware of their HIV+ status contribute to nearly one third of ongoing HIV transmission in the United States.[1]  “[The] data demonstrate[s] the need for interventions and public health strategies to reduce the prevalence of undiagnosed HIV infection.” The CDC reports that only 5 jurisdictions met the National HIV/AIDS Strategy objective of increasing the percentage of persons living with HIV who know their serostatus to ≥90% (Colorado, Connecticut, Delaware, Hawaii, and New York).  Only two jurisdictions met this goal for the important target population of MSM.

Continue reading →