The United States has always been divided into geographical fractions based on race and socioeconomic status. Today, the fragmented character of American history has led to a new life-threatening problem — the growing prevalence of HIV/AIDS infection in the Deep South.

“There is a synergy of plagues that put people at risk for HIV,” said Dr. Laurie Dill, director of Medical AIDS Outreach of Alabama, in an interview for Al Jazeera America. “One of them is racism. One is poverty. One is poor education. One is domestic violence. One is rural access. One is stigma.”

A recent study at Duke University, University of North Carolina at Chapel Hill and the Centers for Disease Control disclosed that the increasing numbers in statistics on HIV diagnoses, prevalence, and case fatality rates in the Deep South — including North Carolina — are related to poor health care access and insufficiencies in the national health insurance system.

“People living with HIV in the South may experience greater difficulty accessing health care, as previous research has identified that a lower proportion of individuals living with HIV are covered by Medicaid in the South,” said Dr. Susan Reif, a lead author of the study and principal investigator at Duke University Global Health Institute. “Medicaid tends to cover fewer services for individuals in the South, and the South has received less Ryan White Care Act funding per capita than other regions, although that gap has narrowed over time.  In addition, none of the Deep South states have chosen to expand Medicaid, so gaps in health care access and access to other critical services such as HIV case management, mental health care, and transportation between the Deep South and other regions may continue to widen.”

Moreover, there are other solid factors that influence the causalities of HIV epidemics in the Deep South. In 2010, the Centers for Disease Control reported that blacks experience the most severe burden of HIV, which has remained unchanged for the past four years according to the national statistics.

“There obviously isn’t just one cause or explanation for these disproportionate numbers, but I’d say that HIV-related stigma is a big factor,” said sophomore Nellie Vinograd, majoring in sociology and anthropology.  “Not only were the number of HIV diagnoses higher in the South than in other regions, but the number of deaths related to HIV were higher as well. (This) makes me think that people are possibly not seeking proper treatment because they feel shame or fear concerning their disease.”

In fact, the research suggests that social stigma, fear, stereotypes, poverty, low levels of education and disparities in the health care system have become the most contributing elements of HIV epidemics in the South.

“The Deep South has struggled to keep up with the rest of America in the fight against HIV/AIDS because of a lack of education among young minorities,” said senior Kahlil Perine. “Many youth may feel that being at risk for contracting HIV means having sex with someone they don’t or barely know. With this mindset at work, unprotected sex becomes all the more prevalent in their small towns, as healthy partners are perceived as those whose past relationships are known. In reality, one cannot diagnose STDs in another by simply looking at them and considering their sexual history. “

Now that Reif’s research team has revealed the dire truth about HIV in America, we should be working on strategies that can better solve HIV/AIDS issue in the South.

“I think, at this point, we need to be looking at this issue with more of a lens on an inside perspective,” said sophomore Jocelyn Foshay. “We should be more open to the feedback and experiences that come with being afflicted by HIV/AIDS from those directly involved.”

A more focused investment in education, fighting stigmas and stereotypes, addressing poverty and improving the health care system is needed to lower the number of HIV cases.

“The cause of the observed outcomes (higher incidence, lower survival rates) lies in higher rates of poverty and unemployment in the Deep South,” said Natalya Shelkova, assitant professor of economics. “Until the states come up with the solution for providing the poor with adequate health insurance, we will not see an improvement in the health outcomes for the HIV/AIDS patients.”