SASI Publishes New Paper: State of HIV in the US Deep South

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

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Join the Southern HIV/AIDS Strategy Initiative and the Southern AIDS Coalition at the US Conference on AIDS

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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/Recommendations re: PrEP

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.


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New SASI Report: Medicaid Expansion in the South

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.


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SASI Releases the HIV/AIDS Care and Prevention Infrastructure in the U.S. Deep South Report

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

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Deep South States continue to drive the HIV epidemic in the US

SASI Releases: HIV/AIDS in the US Deep South: Trends from 2008-2013With 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.

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25 Bipartisan Members of Congress Urge CDC & White House to Expand HIV Prevention Funding for Rural & Suburban Areas in Deep South

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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SASI at the US Conference on AIDS

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.


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Deep South Needs Prevention Resources to Address High Prevalence of Undiagnosed HIV in the Region

According to the recently released CDC Morbidity and Mortality Weekly Report (MMWR), Prevalence of Diagnosed and Undiagnosed HIV Infection – United States, 2008-2012persons 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.

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Seventy-six organizations signed on to SASI’s letter to ONAP calling for increased HIV prevention funding to hard hit areas

Today, SASI and 75 national, regional, state and local organizations called on the White House Office of National AIDS Policy (ONAP) to expand the National HIV/AIDS Strategy (NHAS) to add the following critical actions necessary to further reduce HIV infections and to achieve an AIDS-free Generation in the United States:

  • Adopt a more effective and nuanced approach to HIV Prevention by ensuring that:
    • HIV prevention resources are also targeted to rural and suburban, under-served areas with high HIV diagnosis rates, high death rates, and low survival rates, among people diagnosed with HIV or AIDS;
    • HIV prevention efforts in rural and suburban areas are informed by the epidemic profile of each state and tailored geographically by the social and cultural context in each state;
    • HIV prevention efforts targeted to rural and suburban areas support and evaluate capacity to provide HIV prevention and care at the state, local and community-based organization levels.

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