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On a warm Florida night in May 2013, Christopher “Super” Green learned he was HIV-positive.
“I got my diagnosis on a date, actually,” he said. “I was dating a guy, and we wanted to be intimate. He was studying public health, so we went to a clinic together.”
The result stunned him. Just months earlier, he had tested negative. “I remember feeling like my world had ended,” Green said. “At this point, I felt like my life was over. No one was going to love me. This is it. Get ready. I have three years to live.”
Those early days were marked by fear and shame. Shame made him feel isolated, unwanted, untouchable. But Green’s best friend, T.J., promised to stand by him. That support, combined with meeting J.J.—a young, Black case manager who spoke his language and understood his experiences—shifted everything. J.J. inspired Green to pursue public health himself.
Ten years later, Green is thriving. He works as a lead prevention navigator at Here’s to Life, a nonprofit in Atlanta’s West End serving men with HIV and substance use disorders. He tells his story openly because silence, he said, only fuels stigma.
“For many people, the stigma is more dangerous than HIV itself,” Green explained. “It keeps people from getting tested, starting treatment, or reaching out for support.”
Green’s story mirrors a larger crisis: HIV continues to disproportionately affect Black communities in the South, where systemic inequities drive persistent disparities.
Structural Inequities
Nationwide, more than 1.13 million people were living with HIV in 2023, according to AIDSVu, a project of Emory University. Those aged 55–64 made up the largest group, 26%. Black individuals accounted for 39% of people living with HIV—despite being just 12% of the U.S. population. The prevalence rate among Black Americans was seven times higher than among white Americans.
The disparities start with prevention. In 2023, Black Americans made up 38% of new HIV diagnoses but just 14% of those eligible for PrEP, a highly effective prevention pill.
“These systemic inequities are the main driver,” said Rashad Burgess, vice president of corporate responsibility at Gilead Sciences. “We’ve known this for a long time, and it’s still true today.”
Atlanta is one of the nation’s HIV hotspots, with Fulton County reporting that Black residents account for more than 60% of new diagnoses, though they make up roughly 40% of the population. AIDSVu maps show the hardest-hit neighborhoods concentrated in southwest Atlanta and along the I-20 corridor, areas shaped by housing instability, limited transportation, and scarce access to culturally competent healthcare.
“Having the ability to get a ride to a doctor’s office is key,” Burgess said. “If you’re unstably housed, it’s hard to stay on medications. And if you’re not virologically suppressed, you’re more likely to transmit the virus and your health outcomes decline.”
Gaps in Prevention
Access to PrEP remains one of the biggest gaps. Even when Black patients are engaged in healthcare, Burgess said, they are less likely to be offered PrEP due to provider bias.
“What we find to be really successful are systems that routinize HIV screening,” he said. “That way, people know their status and, if negative, can be offered PrEP as a natural next step.”
Longtime Atlanta activist Daniel Driffin said too many providers still refer patients to specialty clinics instead of prescribing PrEP themselves. Combined with high uninsured rates and Georgia’s refusal to expand Medicaid, many fall through the cracks.
“We’re waiting for people to learn they’re living with HIV before we intervene,” Driffin said. “That’s a horrible place to be in public health.”
Driffin and other activists launched a community-led prevention model to address the gap. Over 60 days, more than 150 participants helped design a program focused on three pillars: robust HIV testing, a pooled “people’s purse” to fund prevention efforts, and culturally resonant messaging.
“We create a hand-holding situation until that person begins care,” Driffin said. “Community-led solutions alongside public health oversight ensure that people aren’t being forgotten.”
Progress and Threats
Medical advances have made HIV manageable. In 2023, 82.8% of newly diagnosed individuals were linked to care, 76.3% of people living with diagnosed HIV received care, and 67.2% achieved viral suppression.
“You can live a normal life, have a normal lifespan, with your virus being managed by therapy,” Burgess said.
But progress is fragile. More than 80% of CDC prevention funding supports state and local health departments through the federal Ending the HIV Epidemic initiative. Proposed cuts of nearly $1.5 billion to Medicaid and CDC budgets could erode years of gains, leading to more infections nationwide.
The Weight of Stigma
Even with medicine and prevention tools, stigma remains the hardest barrier to break, particularly in the South.
“As a matter of fact, many argue stigma is the number one barrier,” Burgess said. “It impacts whether people access PrEP, whether they seek treatment, and whether they’re diagnosed late or with AIDS.”
To shift perceptions, Gilead invests in campaigns featuring trusted voices—from faith leaders to barbershops to celebrities like Tamar Braxton, who has publicly shared her use of PrEP. Partnerships with Morehouse School of Medicine extend outreach to rural Georgia.
“We have to normalize HIV prevention and care as part of overall wellness,” Burgess said. “That means visual representation, trusted messengers, and community-driven dialogue.”
For Green, that mission is personal. Each time he shares his story, he chips away at the silence that once left him isolated.
“I learned what care looks like from another Black man because he knew how to relate to me, how to pour into me what I needed as opposed to giving me just clinical information,” Green said.
“We often talk about the social determinants of health within public health spaces, such as housing, employment, and access to a phone. But we can’t leave out the most important thing, and that is the person and meeting them where they are.”
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Dyana Bagby
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