By Pranav Thokachichu C'24
HIV has grown to be a prevalent disease both globally and nationally, and HIV/AIDS is currently a dominant part of 1.2 million American’s lives. The most daunting fact is that about 1 in 7 Americans living with HIV do not know their status, and this will only increase rates of infection in the future. Marginalized communities, who don’t have the same access to resources or governmental support as other communities have been shown to suffer the most. Specifically in the context of the HIV/AIDS epidemic, key affected populations include sex workers, people who identify as LBTQ+, people who inject drugs, people of color, and many more. Therefore, in order to improve HIV preventative and treatment measures, it is valuable to look at rates of infections in a geographic context. This will allow us to implement the right strategies to reduce the disproportionate impact on marginalized communities in certain geographical regions.
Geographic View of HIV Rates
As indicated by this visual, while people in almost every U.S. state have a relatively high chance of contracting the disease, the southern region has the overwhelmingly highest risk. Prior research has shown that the southern states currently contain approximately 45% of all of the United States citizens who are currently living with HIV. Looking at this breakdown allows us to effectively realize that such areas require the most implementation of preventative measures and treatment options.
The CDC also created the following table, which provides a more specific community breakdown in each region of the United States.
In every region, although white people represent the highest percentage of the population, they accounted for less than 35 percent of those who actually contracted the disease. In regions such as the south (which as previously mentioned has the highest overall rate of HIV infection), marginalized communities, represent the majority of cases. This poses a link between access to resources and equal medical treatment and rate of HIV contraction.
If we look more closely at the local level, many of us may be surprised to find out that the city of Philadelphia also has a particularly high HIV presence. With an HIV infection rate of 114 per 100,000 people, Philadelphia’s case rate is five times the national average.
This microscopic view of the public health threat further shows how marginalized communities are affected the most.
Over the span of 5 years, Philadelphia has seen an overwhelming majority of HIV cases (84%) from those who are a part of a marginalized community.
Causes of HIV Prevalence in the South and Marginalized Communities
Though more research needs to be done in order to truly explain causes of HIV prevalence in the South and marginalized communities, there are many elements that are likely contributing to it.
One factor is that the culture of the South has created a pervasive HIV stigma which has led to less people stating that they have the disease or seeking care.
Another likely cause is connected to how the South contains the “highest poverty rate and lowest median household income” in the United States. Moreover, it contains about half of the total Americans who live without health insurance. Combined, these factors likely lead to a decrease in accessibility to effective healthcare, which could cause less detection and awareness and thereby more spread.
Marginalized communities all over the country face similar inequities in terms of medical care or socioeconomic status, so they too aren’t able to effectively combat the virus.
These are all factors that need to be addressed.
Conclusion
Solutions for combating these disproportionate rates of HIV all revolve around being more inclusive and supportive of marginalized communities and decreasing the stigma associated with HIV so that more people are comfortable with being treated. Governments need to spend more time identifying geographically the specific areas that have higher than normal rates, and then they need to act upon this data by providing more resources and focused support to these areas so that these communities are not further marginalized.
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