Atlanta (GA), is in the midst of an HIV/AIDS crisis.
Each time new HIV/AIDS statistics for Atlanta (GA) are released, the numbers seem to be worse than before. In a time where medical advancements are such that someone with HIV can take medication to reduce their viral load to zero (thus non-transmittable per studies), and someone who doesn’t have HIV can take Truvada (or use condoms) and have up to 99+% protections, we are seeing 1980’s New York City numbers of new infections. Think about that.
This is, in fact, something that keeps me up at night. I am President of Joining Hearts, an Atlanta-based Non-Profit that has recently expanded our Mission and Strategy to more directly impact and lower the transmission of HIV/AIDS in Atlanta. Joining Hearts is an all volunteer 501(c)(3) with 29 years dedicated to helping people with HIV/AIDS in Atlanta(until recently the focus has been HIV/AIDS-related housing assistance). With deep roots in the community, it is logical for Joining Hearts to help lead the conversation on HIV/AIDS in Atlanta and we have stepped up to fulfill the need.
Joining Hearts started looking deeper at the HIV/AIDS crisis last summer after it became evident Atlanta’s numbers were getting worse as nearly every other major city outside of the South was seeing significant improvement. Why is it Atlanta has rising rates when most major cities (San Francisco, Washington D.C., New York City, etc.) are seeing a decline in their rates with some all but stopping transmission? What makes Atlanta different?
Since we started down this path, I have spoken with representatives from CDC, Emory, Yerkes, Fulton County, medical professionals, ASO’s (Aids Service Organizations), PrEP advocates, religious leaders, Pharm reps, and anyone else who had a story or thought about the current state of HIV/AIDS in Atlanta. I have done extensive solo research, and I have looked at other cities for case studies.
I offer the following assessment of the factors contributing to the current state of HIV/AIDS in Atlanta:
I am proud of my southern roots. The South has a charm I haven’t found anywhere else.
Unfortunately, frank discussions on real topics like HIV/AIDS, homosexuality, addiction, mental illness, etc. don’t make it to the dinner table or pulpit. We tend to stick to the surface in the South and not delve into any topics that may make some uncomfortable. This phenomenon is what I refer to as the “Southern Silence”.
I recently visited San Francisco on vacation with my family. I took the opportunity to look a little deeper at what SF is and has been doing to lower the transmission of HIV/AIDS since they have had tremendous success. Even without digging, I was embraced by a culture of open, commonplace, dialogue about status, use of PrEP, and what the community is doing together to get transmissions to zero. (Which I believe is achievable)
Conversely, you have Atlanta where there is no public dialogue. Unless you are a concerned party, HIV/AIDS probably isn’t on your mind. You don’t see posters about PrEP; it isn’t brought up at parties, and the media coverage is minimal. The general population, particularly those under 25, thinks HIV/AIDS is no longer a topic of concern. Meanwhile, the statistics paint a different picture.
Stigma is perhaps the biggest issue to overcome and the hardest to define or trace the origins.
In San Francisco, it is “cool” to be a part of the solution to HIV/AIDS. We need to make it “cool” here in Atlanta. We have to get beyond the stigma of a positive diagnosis to see we are all in this together. Hopefully, by discussing HIV/AIDS more openly, the community will see this as an opportunity to come together for the health of our city/state. If everyone sees HIV/AIDS as an issue we collectively need to address perhaps it will be easier to have a discussion on status. Maybe then we can reduce stigma?
I grew up Southern Baptist, so I know all too well the difficulties of being religious and homosexual. I was brought up to believe homosexuality is a sin.
The only way to tackle HIV/AIDS in the South is with the help of the Church. Only by reducing the stigma associated with homosexuality, HIV/AIDS, etc. will we be able to come together as a community to overcome our challenges. We can’t do this in the South without buy-in from religious leaders.
The CDC, headquartered in Atlanta, recently issued a press release simply titled: Half of black gay men and a quarter of Latino gay men projected to be diagnosed within their lifetime. I still can’t even wrap my head around that.
It is hard to talk about race, particularly in the South, but in this instance, we have to. Why are certain demographics at higher risk than others? Is it a cultural thing? If so, how do you change that?
Addiction and Mental Health:
When you are dealing with addiction or mental health issues (or a combination of the two), safe sex, getting tested, taking your HIV meds, etc. may not be a realistic expectation. Only through discussion and community support can we come up with a plan to address the needs of people who may be struggling and those most at risk. We need to create forums for discussion and embrace programs such as needle exchange.
In all my research, perhaps the most troubling chart I came across related to the HIV Care Continuum, released by the CDC (see chart).
What I find most interesting is the gap between “Diagnosed” (86%) and “Engaged In Care” (40%). What that means is 46% of the population of people with HIV know they have it and are not engaged in care.
Why? Are they actively disengaging? How do you get someone to participate in care who actively disengages in care? These are perhaps the most difficult questions to answer.
Only by openly discussing HIV/AIDS as a community will we be able to lower transmissions. We need to have the discussions that aren’t being held. We need to run the campaigns that aren’t being run. We need to find a way to get people PrEP. We need to do whatever it takes.
Joining Hearts is in the process of establishing the Joining Hearts Community Advisory Board composed of HIV/AIDS experts and concerned parties who will advise Joining Hearts on how we can best leverage our platform and resources to make the most direct impact on HIV/AIDS in Atlanta.
I am proud to be part of Joining Hearts, an organization embracing the community and working to end HIV/AIDS transmissions in Atlanta. Our city deserves to be healthy, and we are going to do everything we can to help. Our goal to reduce transmissions to zero is achievable.
For more info on how to get involved: www.joininghearts.org