Battling HIV in the Epidemic's Epicenter: the South

On today's National Black HIV/AIDS Awareness Day, I find myself reflecting on my more than 33 years of living with HIV and my day-to-day role in the testing outreach program for Mecklenburg County in North Carolina.

I regularly work with individuals who are newly diagnosed with HIV, coaching them through the difficult early days of being positive, accompanying them to doctors' offices, and serving as a sort of support during this time of serious change in their lives. As I work with young black men in the South, I'm especially reminded of the challenges that we're up against.

We can't ignore the reality that the South is still the modern-day epicenter of the HIV/AIDS crisis in the United States -- and that Black and African-American Southerners are at the greatest risk. According to the Centers for Disease Control, more than half of all new HIV diagnoses in the United States occur in the South, and just under half of Americans living with HIV live in Southern states. This fall, new data published by the Campaign for Southern Equality and Western NC Community Health Services found that 22 percent of all Black or African-American respondents to the 2019 Southern LGBTQ Health Survey are living with HIV.

The fight for better understanding and treatment for people living with HIV in North Carolina is personal for me. I know what it feels like to be treated differently because of my status. Many years ago, visiting my mother for her birthday, I suddenly became sick, requiring a trip to an emergency room. Over the course of the appointment the physician learned that I am gay and HIV-positive. Visibly uncomfortable, he left the room. When he returned, he stood at the back of the room and talked to me from there. His tone and approach changed the minute he learned of my status and put both physical and figurative distance between us.

Yes, that was a long time ago, but subtle experiences like that have shaped my approach to seeking standard health care, making me fear that if I go somewhere new, the provider could be judgmental or outright discriminatory because of my sexual orientation and HIV status.

A big reason for this vulnerability is that my home state of North Carolina lacks statewide nondiscrimination protections for LGBTQ people in employment, housing, and public spaces -- including in doctors' offices or hospitals. We are not alone, 29 other states lack the same protections.

The combination of a lack of understanding around HIV paired witha lack of local nondiscrimination laws make it more challenging for me to live my life freely and get the care I deserve.

Heightening both of those challenges is the experience of being Black, which comes with its own layers of oppression, discrimination, and marginalization. Nonetheless there is hope on the horizon for people living with HIV and for the campaign to secure LGBTQ-inclusive nondiscrimination protections nationwide. There is so much that we can do to make a difference -- on this National Black HIV/AIDS Awareness Day and beyond.

We can all take concrete steps toward a better future for the LGBTQ community at large and for people living with HIV, which is both a preventable and treatable disease. We can meet LGBTQ young people with acceptance and kindness and ensure that they have access to accurate information related to sexual health. We can rid our home states and cities of the stigma associated with HIV, which will take widespread familiarization with powerful tools, such as rapid HIV tests, the preventative medication PrEP, and antiretroviral medication that allows people with HIV to live long lives.

And on top of these crucial steps, we must keep up the momentum and encourage our lawmakers at every level to pass comprehensive LGBTQ nondiscrimination protections.

Together, we can -- and must -- build a nation where no one faces discrimination because of who they are or whom they love.

Jeffery Edwards-Knight lives in Charlotte, N.C.