In 2008, CDC statistics showed Jacksonville had the fifth- highest number of AIDS diagnoses among US cities. While the state says this could have been a statistical aberration due to changes in Florida's reporting laws in 2007, local advocates say the problem is real and acute.

Social issues lie at the core of Jacksonville's epidemic. "Here in Jacksonville, we're kind of the buckle in the Bible belt," said Donna Fuchs, director of the Northeast Florida AIDS Network. "HIV carries a huge stigma in our city." "You can go to Miami and you can put up a billboard, you can talk about condoms, AIDS, and sex. You can't do that in Jacksonville," said Todd Reese, associate director of Health Care Center operations at AIDS Healthcare Foundation (AHF). "People will be offended. They don't want to talk about it or see it." When AHF opened a Magic Johnson clinic in the city to serve HIV/AIDS patients a decade ago, organizers moved the ribbon- cutting ceremony indoors because visitors feared being associated with the disease. The clinic no longer bears Johnson's name: "The only way we can get people to come through the door is to create a fictitious name," Reese said. "No one walks into any building or floor that has any association with HIV." Dr. Bob Harmon, director of the Duval County Health Department, said the local population profile "is more like Georgia, Alabama, Mississippi than it is central and south Florida. That generally means higher rates of poverty, lower rates of completing high school and college, and higher percentage of African-American population." In the first half of 2011, Duval County saw a 33 percent increase in HIV cases. "This disease is ruining lives, and it's still killing people, especially low-income people who don't get tested enough and who don't get treated early," Harmon said.

"Denial is the biggest problem," Reese said.

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