The original face of AIDS was that of a middle-class, often white, gay man living in New York or San Francisco. That picture has changed over time as people of color have become disproportionately affected by the epidemic. Today, the face of AIDS is black or Latino, poor, often rural and Southern.
Southern states now have the highest rates of new HIV diagnoses, the largest percentage of people living with the disease and the most people dying from it, according to Rainey Campbell, executive director of the Southern AIDS Coalition, a nonprofit serving 16 Southern states and the District. Fifty percent of all new HIV cases are in the South. And the HIV infection rate among African American and Latina women in the South now rivals that of sub-Saharan Africa. In some Southern states, blacks account for more than 80 percent of new HIV diagnoses among women.
States in the South have the least expansive Medicaid programs and the strictest eligibility requirements to qualify for assistance, which prevents people living with HIV/AIDS from getting care, according to a coalition report. In the South, Campbell said, people living with HIV have to reach disability status before they qualify for aid. This is significant, because nationally the vast majority of HIV/AIDS patients rely on Medicaid for their health insurance, according to research conducted by the Morehouse School of Medicine in Atlanta.
None of the nine Deep South states with the highest rates of new HIV/AIDS diagnoses Alabama, Georgia, Florida, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Texas has opted to expand Medicaid under the Affordable Care Act. Those states also have the highest fatality rates from HIV in the country, according to the coalition.
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