Fewer people are contracting AIDS in traditional hotbeds for the disease like sub-Saharan Africa and Southeast Asia. But in the U.S., AIDS is on the rise, and in a surprising place.
You might think AIDS growth would be highest in America’s densely populated urban areas, places like New York, Los Angeles or Chicago.
But data from the Centers for Disease Control suggests that AIDS is growing most rapidly in rural Southern states. USA Today reports that roughly half of all new diagnoses occur in Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee.
We were curious what rural southerners thought about this, so Latitude News went to the twin cities of Auburn and Opelika, Alabama. We asked people why AIDS is becoming more prevalent in the South — and what we can do about it.
A decline in morals?
Several people we interviewed argued that old-fashioned values are disappearing in Alabama and around the nation. Kimberly Gorham of Opelika said she believes “we just aren’t teaching our children the same morals that we used to.” Many others were surprised by what they saw as a “big city” problem invading their small towns.
Hutchison: “It’s like you’re playing Russian roulette with your life…”
But perhaps the growing prevalence of AIDS in the South makes sense. According to a recent report by the Guttmacher Institute, people who live in low-income rural areas usually know less about prevention methods for sexually transmitted diseases (other than abstinence) or are more likely to have religious objections to them.
They are also more likely to resist treatment for fear of stigmatization, reports say. Many do not even know they’re infected. The CDC estimates that one in five Americans with HIV are unaware they carry the disease.
A well-rounded education
Several people we talked to pointed to the data about AIDS in the South as proof that sexual education isn’t working.
“I mean, I feel like that’s what they taught us in health class when I was in high school,” said Natalie Steltenpohl of Auburn. “So they have been teaching it to us but I guess people just aren’t practicing it.”
Oscar Bright agreed that education isn’t always the answer, arguing that similar programs like DARE (an anti-drug program) have been ineffective in the past.
Bright: “It might make kids more curious…”
The Anniston Star writes that sex education in Alabama is heavy on abstinence, and a state law dating from 1992 requires teachers to inform students that “abstinence from sexual intercourse outside of lawful marriage is the expected social standard.” Teachers are also obliged to tell their pupils that homosexuality is illegal — even though the Star reports that homosexuality is legal in Alabama — and immoral (a bi-partisan effort to repeal the 1992 law is currently in the works).
Teaching teens how to use condoms or how they might contract HIV/AIDS isn’t an easy sell in conservative places like Alabama. The Guardian reports that sex education in traditional Thailand faces similar challenges.
But some people in Auburn and Opelika, like Laura Williams, see the value of expanding sex education beyond abstinence.
Williams: “People down here are kind of small minded…”
More sickness, less treatment
Despite the growing rate of AIDS in the South, the region as a whole remains woefully underprepared to treat HIV-positive patients. Most treatment centers are located in urban areas or in states with big populations like California and New York. Amongst southern states, Florida (114) and Georgia (43) have the most HIV specialist clinics, followed by Alabama with 33. But Mississippi only has four, and Arkansas has none.
In general, it appears rural African-Americans and Latinos are bearing the brunt of the South’s AIDS crisis. Of the 1.2 million Americans with AIDS, 545,000 are black, according to the Kaiser Family Foundation.
Experts also believe the war on drugs has slowed the decline in global AIDS rates by pushing addicts underground into conditions where they are more likely to contract the disease via the use of hypodermic needles.
Prichard: “I come from Florida where we party, and we’re not as prude as up here…”
The Canadian Broadcasting Corporation summarized a key finding of a recent study on the issue:
“Pointing to examples such as the U.S., Russia and Thailand, the [Global Commission on Drug Policy] says countries that ‘ignored’ scientific evidence have had ‘devastating consequences,’ while those countries that treat addiction as a health issue like Australia, Portugal and Switzerland have proven effective in lowering HIV rates.”
What’s being done?
Perhaps the U.S. could learn from projects in other countries. In Thailand, for example, the World Health Organization credits the government’s free condom campaign with bringing down AIDS rates. Now, big American cities like Washington D.C., New York and Los Angeles are rolling out similar programs.
In Zimbabwe, where 13 percent of people and 20 percent of teens suffer from AIDS, lawmakers are trying a new approach to HIV prevention: 60 legislators have agreed to undergo circumcision, a procedure that scientists believe can reduce the spread of the disease.
In America, the CDC has announced a $1.2 million program in which drug stores in 24 different cities and rural areas will offer fast and free HIV testing. If you know you have the disease, you’re much less likely to give it to someone else.
But ultimately HIV prevention seems to come down to better, more comprehensive education and more widely available condoms. Abstinence might be the most effective way to prevent AIDS, but some teenagers are going to have sex no matter what anyone says. It might be better if they know the risks of unprotected sex and how to minimize them.
Audio recorded by Kyle Gassiott, a producer at the Southern Public Media Group.