More than half of new HIV infections occur in South, mainly due to scarcity of preventative drugs
During the past few decades, medicine has made great advancements in treating and preventing HIV infections. That’s the good news. The bad news, as the Washington Post reports, is that HIV infection is becoming an increasingly regional affair, with more than half of all new infections occurring in the deep South. Efforts to curb the virus there with the efficacy it has been curbed in much of the rest of the nation have been stymied by the low availability of the prophylactic medication Truvada, a drug that can vastly reduce infection rates upon exposure to HIV, but which must be taken in advance of that exposure.
The reasons, reports the Post, are the usual ones. Poverty, racism, and social hostility toward LGBT relationships in the rural South combine to make the drug difficult to find, difficult to ask about, and difficult to pay for.
“If you’re in a small town, it may be that at that primary-care provider, one of your cousins or one of your aunties may be working in that practice,” said Patrick Sullivan, a professor of epidemiology at Emory University in Atlanta and one of the authors of the PrEP-to-need study, which appeared in the journal Annals of Epidemiology.
Poorer, rural communities also have significantly less access to health care. Mississippi regularly ranks among the poorest states in the nation, and the poor have the most difficulty sticking with health-care providers’ instructions and taking medications regularly.
It will not be an easy problem to solve. Easily-accessed preventative medication could dramatically reduce HIV infection rates; the prohibitively high expense of as much as $1,600 a month will soon be offset by new federal rules requiring insurance companies to fully cover the drug for high-risk patients. That will not fix the racial disparities in access and the desire—or need—of high-risk patients to hide their sexual activities from their small-town neighbors.
But as it stands, it is possible, if not likely, that HIV will continue to ravage poor areas of the South, even as it declines in other states and regions. And that is as much a cultural problem as a medical one.