Black Women Imperiled as South Carolina Abandons HIV Prevention

As part of a documentary team researching the impact of HIV/AIDS on black women in the rural South, I have learned these dire facts:

Eight of the 10 states with the most new cases of HIV infection and AIDS diagnoses are in the South.

African Americans account for 46 percent of all HIV diagnoses, and half of all rural AIDS cases.

Black women are disproportionately impacted at the national level (they make up 64 percent of new AIDS diagnoses) and face greater risk in southern states like South Carolina, which ranks fourth in the country for the number of African Americans living with AIDS.

Federal funding, however, is not following the epidemic and South Carolina is a particularly dire example of what that means.

In South Carolina, lawmakers cut the state’s prevention funds to zero in 2010. Now it is the only state in the country that does not fund prevention, despite the fact that the state has the highest rate of heterosexual transmission in the nation, with black women accounting for a quarter of HIV/AIDS cases.

In the rural South, poverty compounds high-risk behavior, making it difficult for people to afford and access health care.

Gov. Nikki Haley and other detractors call “Obamacare,” which decreases the number of uninsured Americans and expands Medicaid coverage, wasteful.

This kind of cold-shoulder policy-making doesn’t help fight HIV/AIDS. But the disease is also fueled socially by factors such as misconceptions about HIV transmission and a reticence among black women to focus on this problem. Arguably, black women do not see ourselves reflected in HIV awareness campaigns, so some of us do not get tested, do not stand before the mirror for fear of what we might see.

With medical care, HIV is no longer a death sentence. But in pockets of rural South Carolina where jobs are scarce and there is only one doctor per 4,000 patients, the epidemic is devastating.

Wilhemina Dixon knows this devastation well.

A 64 year-old living in the dusty backroads of Barnwell, S.C., she spends her mornings in the field picking peas before the onslaught of the midday sun. Her odd jobs provide for her family of six and she takes pride in making an earnest living.

Afterwards, as she sits in the shade of her porch, far removed from the political machinations, I imagine Dixon thinks of her daughter Toni, who died of AIDS last year, and ponders the future of her granddaughter Dayshal, who was born with the virus.

Gov. Haley rejected matching funds for the AIDS Drug Assistance Program, which provides HIV medication to low-income patients. After the June 2012 Supreme Court decision upholding the Affordable Care Act, Haley vowed to refuse Medicaid expansion, which she says would cost the state $1.1 billion annually for the half million citizens who could be covered.

These cuts to Medicaid and the AIDS Drug Assistance Program lower financial incentives for doctors to treat HIV and bar otherwise qualifying low-income enrollees from government HIV funds. And so the disease breeds in small towns like Barnwell, where people cannot afford medication or to disclose their positive status.

Excerpted from Women’s eNews