August 20th has been established as Southern HIV/AIDS Awareness Day (SHAAD), a day to bring direct attention to the South’s struggle with the HIV epidemic, as well as highlight the region’s unique set of cultural and systemic attributes. In 2019, SHAAD was launched as a two-day, in-person event held in Birmingham, Alabama, which continues to be its home base to this day.
SHAAD blossomed from the lively work of the Southern AIDS Coalition (SAC), SAC’s mission being: “to end the HIV and STI epidemics in the South by promoting accessible and high-quality systems of [HIV and STI] prevention, treatment, care, housing, and essential support services.” And in 2020, just a year after its inception, the CDC recognized SHAAD as a national awareness day, its intention and purpose now being known around the country.
The South’s HIV epidemic results as part of a greater syndemic, “syndemic” meaning two or more epidemics synergistically created by health disparities. The South is undergoing a confluence of the HIV, opioid, and substance abuse epidemics, each deeply tied to racial discrimination, depression, poverty, unstable housing, as well as other socio-economic ills. These health crises converge in such a way that one unilaterally designed response will not dismantle the multitude of barriers blocking full health equity. Southern populations predisposed to health disparities, and the previously stated socio-economic ills, are more vulnerable to the HIV epidemic. These populations primarily include African American and LGBTQ+ populations, those experiencing poverty, people who lack transportation and access to medical care, and populations at the intersections of the aforementioned. These health determinants and disparities culminate into a stigmatized life experience where individuals are disincentivized to utilize public health preventions of the primary (educative/lifestyle), secondary (testing), and tertiary (treatment) order.
Overall, the South has an infamous history of abstinence-only, heteronormative sex education. Because of this, HIV, STIs, and non-heterosexual relationships can become stigmatized. Life experiences centered around these items become less likely to be discussed or disclosed. This leads to fear of being tested, less awareness of one’s own HIV-positive status, delayed responses in receiving medical care, and increased HIV Stage 3 diagnosis. The Southern states are also those still bound by dated HIV criminalization laws that not only target communities disproportionately affected by the legal system, but also disincentivize HIV testing… since simply knowing one’s status may lead to greater penalization than not knowing.
It is due to real and current issues like these that the South’s HIV epidemic needs significant attention. Southern HIV/AIDS Awareness Day places these issues at the forefront, and encourages local individuals and organizations to take long-needed action. Keep an eye out for the work of the Southern AIDS Coalition and Georgia Equality on August 20th. Visit https://southernsolution.org/ for more information.
Taylor Brown
Ending the Epidemic Fellow