The report by the Southern AIDS Coalition says federal funding for treatment, education and support services is concentrated in wealthier parts of the country that have fewer new HIV cases and declining death rates.
"Rising infection rates, coupled with inadequate funding, resources and infrastructure have resulted in a catastrophic situation in our public health care systems in the South," the report says.
Kathy Hiers, chief executive officer of AIDS Alabama and co-author of the report, told The Birmingham News that HIV/AIDS is taking hold in isolated parts of the South.
"The ruralness of the epidemic is what's becoming painfully clear," Hiers told the paper.
The report says the number of deaths from AIDS dropped in the rest of the nation between 2001 and 2005 but continued to increase in the South.
Health authorities have known for years that the 16-state Southern region was leading the country in the number of new infections. But, Hiers said, they thought the increase was concentrated in big cities in Florida, not spread across the region.
Experts have now focused in on the Deep South - Alabama, Georgia, Louisiana, Mississippi, North Carolina and South Carolina. They have found HIV infections rising in rural areas populated by blacks with financial, health and social problems.
Gary A. Puckrein is the president and CEO of National Minority Quality Forum in Washington. He said the shift in HIV infections has to be highlighted.
"Certainly one of the big misconceptions is it is big cities on the West Coast and East Coast that are really driving the disease, and it's not so," Puckrein said. "It's moved both in terms of geography and demography. It's really important for people in Southern states to know that because they're not getting their fair share of support."
Formulas for HIV/AIDS funding have traditionally focused on the number of cases of full-blown AIDS, not HIV infections. That means more money goes to large urban areas. For example, in Alabama, 40 percent of HIV cases have matured into AIDS, while in New York, where the epidemic started earlier, 62 percent of cases have matured into AIDS, Hiers said. For that reason, New York receives more per-person funding.
The Southern AIDS Coalition last year convinced authorities to change the funding formula for the Ryan White HIV/AIDS Treatment Act, which includes much of the federal funding for the fight against the disease. That helped, but the South still leads in new HIV cases and is still last out of four regions in overall federal funding.
"We're driving the epidemic, but we're still getting the least money," Hiers said.
The South also gets less private funding to fight HIV, according to another recent report from Funders Concerned About AIDS, a New York-based organization. That report focused on Alabama, saying the state's challenges and funding problems are typical of the South.
That report said fighting HIV/AIDS in Alabama faces many challenges, including, but not limited to, high rates of other sexually transmitted diseases, a rural population, poverty, mental health problems and lack of insurance.
http://accesswdun.com/article/2008/7/211692