AIDS IN THE SOUTH: FACT SHEET
Seven of the 10 states with the highest AIDS case rates in the nation are located in the South.

In late 2002, a coalition of health department officials from 14 southern states issued a study and a call to action noting the increasing crisis of AIDS in this region of the United States. The Southern States AIDS/STD Directors Work Group’s document, "Southern States Manifesto: HIV/AIDS & STDs in the South," identified the disparate impact of this health emergency on southern citizens, particularly poor and disenfranchised populations. Little has changed since then in terms of funding, programs, and public policy. Calling on the federal government to "realize that individuals in rural areas of the South, especially African-Americans, do not have the safety net available in most urban areas," the manifesto urges immediate action to prevent the situation from worsening.

"If we are to sustain the lives of individuals currently living with HIV/AIDS and STDs, we must provide a standardized and coordinated delivery system in the southern states, encompassing a comprehensive range of services…to meet their health care and psychosocial service needs throughout all stages of illness. If we are to sustain the lives of individuals currently not living with HIV/AIDS and STDs, we must provide prevention interventions proven effective in the southern states, taking into consideration the cultural norms of the South which prohibit southern citizens from speaking openly about sexual issues, even age-appropriate prevention messages."

In an effort to meet this challenge, AIDS Survival Project has launched the Positive Action Network, designed to train individuals throughout Georgia to become their own self-empowered advocates, thereby increasing the voice of disenfranchised populations in the formation of public policy (see attached release on Positive Action Network). These advocates will be able to provide health advisory councils, policy-making panels, review boards, and health departments with a clear perspective on the following issues and challenges outlined in the manifesto that make the HIV/AIDS and STD epidemic unique in the South:

Rapid Increase in Reported AIDS Cases
• The estimated number of new AIDS cases diagnosed each year in the South rose from 40% in 1996 to 46% in 2001. Estimated cases in the Northeast, West, and Midwest either decreased or remained constant for this same period.
• More people have AIDS in the South than in any other US region, according to the Henry J. Kaiser Family Foundation.
Poor Health Infrastructure
• In some states, due to limited resources and access to health services, persons with HIV become considerably ill before obtaining access to necessary care.
• Predominantly rural states are generally poorer, have higher unemployment rates, and are less educated than their counterparts with predominately urban populations.

Lack of Health Insurance
• The South is home to the greatest numbers of uninsured people, an estimated 17 million.
• Latinos and African-Americans are most at risk for being uninsured. Nearly one-half (46%) of working-age Latinos lacked insurance for all or part of 2001, as did one-third of African-Americans.
• Lack of health insurance is linked to less access to care and more negative experiences seeking care.

Changing Demographics
• The face of AIDS is increasingly becoming rural, female, black, and heterosexual.
• Seven of the 10 states with the highest AIDS case rates in the nation are located in the South.
• The South represents little more than one-third of the U.S. population (38%) but accounts for 40% of people estimated to be living with AIDS and 46% of the estimated number of new AIDS cases.
• Among the 25 metropolitan areas (pop. 500,000+) with AIDS case rates above the 2001 national average for this size, 18 are in the South. In addition, six of the metro areas with the 10 highest case rates in the nation are in the South.

Racial Disparity
• Almost 38% of the cumulative cases and an average of 49% of newly reported cases in 2000 and 2001 were in the African-American community.
• The South includes almost 19 million African-Americans, almost 19% of the region’s population. The region with the next highest number of African-Americans is the Midwest, with almost 6.5 million (about 10% of the population).

Lack of Affordable Housing
• HIV disease is disproportionately represented in communities where stable housing environments are sorely lacking.
• Homelessness promotes continuation of risky behaviors for survival on the streets, where sex is traded for food and shelter.
• Without stable housing, those already infected with HIV are not able to comply with dosage and timing requirements for maximum efficacy of their medications.

Socioeconomic Factors
• Eight of the 10 states with the highest percentage of population living below the Federal Poverty Level are located in the South, ranging from 15 % to 19.1% living in poverty (compared to the 12.1% national average).
• Nine of the top ten states with the lowest percentage of high school graduates are in the South.
• Seven of the 15 states with the highest rate of unemployment (2002) were southern states.
Funding
• Southern states have historically received less federal funding for HIV/AIDS care: $5,184 per AIDS case averaged across the southern states, compared to $5,625 per case for the U.S. as a whole (2001).
• Southern states have received fewer federal dollars for HIV/AIDS prevention: an average of $1,579 per AIDS case in the South against $1,766 per case for the U.S. as a whole.