American Medical News (12.03.12)
The American South is having an HIVAIDS epidemic which did not receive attention until recently. The release of new HIV data in July has helped raise awareness of the epidemic’s shift from cities such as New York and San Francisco to the rural South. According to a July report by the Southern AIDS Coalition, approximately 37 percent of the nation’s population lives in the South, but half of the new HIV diagnoses and 46 percent of the new AIDS cases occur there each year. Southern health professionals and community members are implementing programs that target access to health care, low education rates, and the stigma of HIV/AIDS.
In Alabama, there are only five credentialed HIV medicine physicians. As a result, patients travel more than an hour to reach a treatment center, and those without transportation often go without care as there is no public transit in rural areas. To correct this problem, staff at Medical AIDS Outreach of Alabama used to drive 50 miles once a week from Montgomery to Selma to treat patients. In 2012, the organization introduced telemedicine as a more efficient way to reach patients in some of the state’s poorest and most rural communities. There are several remote sites where patients can meet virtually with their physicians in a one-to-one, real-time interaction. With a bluetooth stethoscope and digital dermascope, doctors examine virtually a patient’s heart, lung, and abdominal sounds as well as flushed skin, lesions, and thrush. A pharmacist is also available one a week through telemedicine to discuss adherence to prescribed medications. In Birmingham, Ala., cosmetology students learn basic information about the disease, its stigma, and prevention methods as part of Beauty in Knowing, a five-session program launched in 2010 with funding from AIDS United and other organizations. The stylists are then expected to use the information to help modify female clients’ risky behaviors and educate them on HIV/AIDS prevention.
According to CDC data, Florida had the nation’s highest rate of new HIV diagnoses—33 cases per 100,000 of population—which is almost twice the national rate of 17.4 per 100,000. The state has the country’s fifth-highest rate of new AIDS diagnoses—19.7 per 100,000 of population—and the most AIDS-related deaths (2,621), according to Kaiser Family Foundation 2010 data. The focus is on reducing the stigma of HIV/AIDS. For this purpose, the Florida Department of Health started the Faces of HIV project on December 1, 2011, which has been touring the state. The project is a mobile art exhibit displaying portraits of Florida residents with HIV/AIDS, journal excerpts from some of them, and video interviews about how they became infected and how it affects their lives. The goal is to show that these are ordinary people who have a disease and deserve care and compassion like anyone else—because they have HIV does not mean they are dirty, do drugs, or are gay. Also Marlene LaLota, MPH, of the Florida Department of Health, is working with others to develop and implement programs to increase HIV/AIDS testing, link more infected people to medical care, and reduce stigma about the disease.
Louisiana has one of the nation’s highest rates of new HIV infections—28.8 cases per 100,000 population. Louisiana’s focus is on misconceptions about the disease and reducing the stigma around it. One individual with HIV, who could not find a support group when she needed it, founded a nonprofit support organization for persons in her area who have HIV/AIDS. The organization, known as HEROES (Helping Everyone Receive Ongoing Effective Support), is trying to educate infected community members about the disease and how to care for themselves, with the help of volunteer physicians and nurses. The founder also organizes a statewide retreat to help people build meaningful friendships and learn techniques to manage stress. Members address teenagers about risky behaviors that make them susceptible to pregnancy, HIV/AIDS, and other health issues, and visit the community to provide information, dispel myths, and create a tolerant environment for those with HIV/AIDS.