Health officials face difficulties fighting HIV in the South

Health officials say they are having a particularly hard time fighting the spread of HIV and sexually transmitted diseases in the South, where new HIV infection rates outpace every other region of the country. The number of new HIV cases rose 27% in six Southern states--Alabama, Georgia, Louisiana, Mississippi, North Carolina, and South Carolina--between 2000 and 2002, more than 2.5 times faster than in the Midwest. In North Carolina the number of AIDS cases climbed by 36% between 2001 and 2003. Southern states also have the highest prevalence rates of gonorrhea and chlamydia in the country. Health officials say high rates of poverty, poor health care services, and high numbers of uninsured and underinsured people contribute to the spread of HIV and STDs in the region. They also say stigma and a reluctance to talk about sexuality and safer sex keep people from communicating with their sexual partners about disease prevention and from using condoms to protect themselves against STDs. Stigma and silence on AIDS issues is a particular problem in Latino and African-American communities, AIDS experts say. HIV prevention efforts need to target specific at-risk groups, especially prevention programs that are culturally relevant to Latinos, African-Americans, women, and gay men, health experts say. And broader health-care issues that make accessing prevention and care services difficult must be addressed. "Things don't seem to be getting any better, even though we keep talking and working," said Kate Whetten, a Duke University health policy expert. "What we've done hasn't worked."