HIV in the South: Not Close to Zero

HIV in the South: Not Close to Zero - HIV and AIDS has become a disease that sometimes we do not realize at first, but all this can be cured and require a special attention from those around them. This week, we hosted a renowned expert in HIV/AIDS care currently practicing at a hospital known for serving the poor and vulnerable in New York.

It was her impression that there has been a dramatic decline in the number of hospitalized patients living with HIV. Presently, in fact, the hospital is considering closing the service that cares exclusively for these individuals because of the small number of admissions.

Those of us involved in the care of individuals with HIV in Atlanta were amazed. At Grady Hospital and the Ponce de Leon Center, which is our outpatient HIV/AIDS clinic, we remain busy seeing newly diagnosed individuals with AIDS, particularly presenting with late-stage disease and afflicted by the classic infections and cancers so common 30 years ago, when HIV was first described.

This month, Secretary of State Hillary Clinton gave a moving address at the National Institute of Health calling for an AIDS-free generation, and the theme of World AIDS Day on December 1 was "Getting to Zero."

A recent study that examined outcomes in patients identified with early HIV infection found that a risk factor for development of AIDS was residence in the South. Furthermore, resources are scarcer for patients in the South. For example, federal support is based on the number of cumulative cases of patients with HIV or AIDS rather than the development of new cases, penalizing states with later epidemics (like the South) and those whose policies did not support early reporting of cases of HIV.

Medicaid income eligibility is based on individual state policy. In the South, the income cutoff for eligibility is lower on average than elsewhere and is a fraction of the federal poverty level, leaving many without the ability to access this medical help. State health departments are often poorly funded or organized and do not have the same strong infrastructure and reporting capabilities that have been highly successful in Washington, New York and San Francisco.

AIDS drug assistance programs in the South are underfunded, limiting access to life-saving medications for patients. In Georgia, which has the second-longest wait list in the country, patients may be less able to access medications for life-threatening AIDS complications than those in the developing world.
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