Southern HIV/AIDS Awareness Day was this past Aug. 20 and we as a community should take a moment to celebrate how far we’ve come.
In 1981, at the very beginning of the epidemic, we saw what was wrongfully being called GRID, or Gay Related Immuno Deficiency, ravish the gay community. At the time, the face of AIDS was a gay man in New York or San Francisco, and this stereotype allowed the virus to thrive.
The more we thought it only affected gay men the more the virus proved us wrong by spreading into every community one person at a time. Our LGBTQ+ community rallied to fight this deadly epidemic, while the politicians and public health officials of the time turned a blind eye to our suffering. It would be years later, in 1985, that they would finally start to pay attention.
All it took was for a heterosexual, white teenager named Ryan White to contract the virus through a blood transfusion. Now I’m grateful for Ryan White and the lifesaving program that bears his name, however, I’m not blind to the fact that the decision makers of the ‘80s needed to see someone that looked like their children affected by this virus before they took action.
The action resulted in the creation of the Ryan White system of care which offers treatment and wrap-around services to those of us living with HIV who don’t have insurance or the financial means to afford treatment. Ryan White is a payer of last resort that unfortunately is being used more and more every year, especially in Central Florida.
I was lucky enough to get a job straight out of college working for the Ryan White system of care as the coordinator for the Central Florida HIV Planning Council. It was this job that opened my eyes to the current crisis facing Central Florida. I was diagnosed HIV positive at 23 and for years I berated myself thinking if only I hadn’t done this or that but working with the system and inputting the data of new infections taught me that I never stood a chance against this epidemic. The new face of HIV is no longer a gay man in New York or San Francisco. The new face of HIV is us, the communities of color in the U.S. South.
Last year we ranked in the top three for new HIV infections with 592 cases in the Orlando service area; of those cases 40% were Black and 34% Latinx. This is startling considering Blacks make up only 15% of the population in the Orlando service area and Latinx account for 28%. Across the south, the number of infections continue to rise, and much like Central Florida, it is our communities of color that are disproportionately affected by this epidemic. As bleak as this picture might seem, we had something to celebrate on Aug. 20. That’s because Orlando made progress in the way we are addressing the epidemic. Credit where credit is due a lot of this comes as a result of the funding received during the previous presidential administration and their Ending the HIV Epidemic, or EHE plan. This plan gave the Health Department what HIV activists have been asking for: funding with less barriers. Our area team put the EHE dollars to work creating opportunities for afterhours HIV testing, specialized services to our Black and Latinx communities, and new programming for youth affected by HIV.
This year also saw the introduction of injectable PreP, a shot every two months that protects people against HIV. Perhaps the biggest cause for celebration every year since 2018 for those of us living with HIV is the scientific validation of U=U, which stands for Undetectable Equals Untransmittable. This is the science that tells us that those of us living with HIV who are on medication and undetectable are able to live a normal life without fear of spreading the virus to others.
Yes, all of these advancements — both locally and globally — are reasons to celebrate, but there is still a long road ahead. The U.S. south faces a particularly harsh challenge when it comes to stopping the spread of the epidemic due to the rural nature of the region. This means that for many, HIV services and testing sites are miles away. In our urban areas, we have more providers that do their best to handle the growing caseloads but their work is futile when we don’t invest resources in our rural areas.
Another issue we continue to face is that of stigma. It’s easy to be ignorant and think that stigma is no longer an issue; however, HIV stigma still exists. It shows up in the way our state and many southern state’s Legislatures are often unwilling to put more resources into fighting the HIV epidemic. Where New York and San Francisco have made PreP for all a priority we still struggle to get bills supporting the access to PreP through Tallahassee. HIV stigma keeps us stuck in the past as a community.
The road ahead will require us to focus our resources on the Black and Latinx communities that are most in need, increase access to resources in our rural areas and join together to address HIV stigma. The south is the last stronghold for the HIV epidemic in the U.S., so as we celebrate the victories we have already had, I hope we don’t lose sight of the progress needed on the road ahead.
Andres Acosta is a gay Colombian immigrant, graduate of UCF and a U.S. Navy Veteran. He serves as the CDC Ambassador for Let’s Stop HIV Together, works as the community relations manager for Contigo Fund and is the director of respite operations for Peer Support Space.
