ATLANTA — HIV rates remain extreme in Georgia, specifically among minorities.
The state ranks the highest in new diagnoses in the U.S. and third highest in HIV risk behind Ohio and Nevada, according to a new study released by Health Testing Centers, a nationwide network of health screening centers based in Fort Lauderdale, Florida.
African Americans and Latinos far exceed the rates of diagnosis for all racial and ethnic groups. In Georgia, African Americans show wide disparities in HIV diagnosis; in 2016, 68.5% of all individuals in Georgia living with HIV were black, according to data from AIDSVu, an online mapping tool maintained by Emory University’s Rollins School of Public Health.
Daniel Driffin, an HIV activist with a focus on black, gay men, said the numbers are not surprising and not going to change unless long-term steps are taken. Driffin became involved in public health in 2008, after college, while going to nursing school, when he learned his HIV status. In 2015, he co-founded THRIVE SS, a nonprofit organization that supports and connects black, gay and bisexual men living with HIV.
“I am a public health advocate. I am a public health worker. Atlanta specifically is the intersection of anything that is wrong with anything,” Driffin said. “From housing issues to transportation to not having Medicaid expansion to not having a livable wage. When all those things combine, you will always see health disparities. And the disparity we are talking about in this moment is HIV but it’s any health disparity.”
According to the Centers for Disease Control and Prevention, in 2017 black, gay and bisexual men accounted for 26% of new HIV diagnoses nationwide. In Georgia in 2016, more than 77% of males living with HIV had it transmitted to them through same-gender sexual contact.
Racial disparities in access to medical care, prevention programs and community resources, Driffin said, are driving these rates.
“Those communities who are most marginalized are left behind,” he said. “We are in the South so of course the first thing you think of will be race: black and brown people. The people in charge need to put resources in black and brown communities.”
Lowndes, Colquitt and Tift are among the group of Georgia counties with the highest rates of HIV — Baldwin and Thomas counties fall just beneath.
The South Health District of the state Department of Public Health is tapping into many different community resources to provide HIV outreach and prevention. The district serves residents in 10 counties including some with the highest HIV rates and most diverse communities. The district is spreading outreach to churches and even migrant worker camps.
Althea Daniels, health care program consultant supervisor, said most of their outreach targets African American and Latino communities as well as gay and bisexual men who are disproportionately affected by HIV.
The team analyzes where popular hangout spots are or specific events where they can advertise their services to "meet people where they are," she said. For homeless populations they collaborate with shelters and food banks — bringing testing and prevention services to community members who may not have access.
The current political climate surrounding immigration issues makes reaching out to the Latino community specifically tricky, Daniels said. Some people are weary of putting their personal information down on confidentiality forms necessary to receive treatment. When attending cultural events, an interpreter is present.
"Building trust is really important, really with anyone," she said, "but especially with Latino and African American populations."
Sharah Denton, prevention program manager, said the district is looking to partner more with faith-based communities but beliefs sometimes hinder prevention outreach.
"Some churches might allow us to give out HIV tests, but not give out condoms or prevention materials," Denton said. "So that can put a roadblock, especially if you have young adults in the church that are very active. Sometimes they allow us to do the condoms and not the HIV testing. But we are trying to build stronger relationships with churches so we can touch more people who are affected or possibly could be affected by HIV."
Religious and cultural stigmas surrounding HIV diagnosis remain a leading factor in not seeking diagnosis and lack of prevention.
“We have never seen any disease with this much societal stigma as HIV,” Driffin said. “Stigma keeps individuals from learning HIV status, keeps people from getting care, it keeps them from medication. It’s a round and round and round cycle.”
Stigma leads to death, he said. In 2016, there were 772 deaths of individuals with HIV.
The issue of Medicaid expansion has been touched upon in many conversations surrounding the high rates of the uninsured in Georgia and the high rates of maternal mortality. The HIV epidemic in the state, Driffin said, should be included when considering some version of coverage expansion.
“If we can provide medical care for people with HIV first, that will go a long way,” he said.
Riley Bunch covers the Georgia Statehouse for CNHI’s newspapers and websites.