Although testing and treatment are readily available, some individuals at risk in rural areas face challenges accessing healthcare.
North Carolina, over 2024, has had its major set of problems to contend with. Some are easy to see, like the need for relief efforts after Hurricane Helene’s trek through Western Carolina. Beneath the surface, however, there has been an invisible menace on the rise over the last few years, one of which multiple agencies have made their aim to rub out. Diagnosis? HIV.
Human immunodeficiency virus, or HIV, is a virus that weakens a person’s immune system by attacking cells that fight off infection, specifically a person’s CD4 cells, the white blood cells that play a crucial role in the immune system by activating other immune cells to fight infections. HIV spreads through bodily fluids and allowed to advance untreated, it can lead to Acquired Immunodeficiency Syndrome, otherwise known as AIDS.
According to the 2024 HIV statistics rates analyzed by WorldPopulationReview.com, while not part of the top ten states in America with the highest rates of HIV infection, North Carolina sits at number 11, with 12 diagnoses per 100,000 individuals in the state so far this year, totaling in 1,079 found. Per the same chart, 33,562 people are already known to be infected in the state.
The U.S. Center for Disease Control and Prevention (CDC), through their data, argues that the number is much higher. By their most current report, titled “HIV Prevention to End the HIV Epidemic in the United States: North Carolina,” 37,200 individuals live with HIV in the state, with 12 percent of North Carolinians unaware of their status, and 1,200 new HIV infections confirmed following 40,778 tests that were provided to the state through CDC funding.
The LGBTQ+ community is not immune from the rise of the disease in North Carolina. In the most recent report published by the NC Department of Health and Human Services (NCDHHS), from 2022, the estimated HIV rates for gay and bisexual men was tallied at 15.3 per 100,000. Of the demographics attributed to the findings, Black men were affected the most at 2,044 reports, while Hispanic and Latinx individuals followed at 1,270 counts. Those that most reported their ages fell within the 13 to 30 years old range.
Two years later, newer reports chronicle the rise in the rate of Latino men becoming infected. In an article dated June 24, 2024, WUNC North Carolina Public Radio reported that the most recent data, which claims that Latinos, who make up 19 percent of the United States population, are about 33 percent of new HIV infections.
In the same article, WUNC reported information from KFF Health News-Associated Press, which spoke with public health officials in Mecklenburg County, North Carolina, KFF was told there were no specific plans to address HIV in this population, or that plans are still in the works. With little to no tracking of the Latin population and HIV, the percentage could be far greater than any of the estimates health organizations have been able to track.
Transgender individuals living with HIV are tracked just as little, if not less, than Black and Latino populations, according to the website Aidsvu.org, which provides information on health planning, programming, and resource allocation for multiple minority organizations and individuals, including the trans community. Of the general data available from 2021 via AidsVU, transgender women account for 89 percent of new HIV diagnoses among transgender and AGI individuals, with Black and Latina transgender women representing 78 percent newly diagnosed, and Black and Latino transgender men accounting for 57 percent of new cases.
One of the greatest factors for the continued rise in HIV, especially among the LGBTQ+ community, is homelessness, according to a report titled “HIV/Aids And Homelessness,” researched and written by Evelyn P. Tomaszewski, MSW, of the NASW HIV/AIDS Spectrum Project. It is the inability to access health care and medication, much less food, shelter and clothing, that keeps part of the population unable to regulate their conditions. A 2007 study by the National Coalition for the Homeless concluded that as much as 20 percent of the homeless populous live with the disease.
With many of these statistics in mind, an important question has to be asked: What can be done to stop the spread of HIV through communities, including our own? An answer, according to a story published with NC Health News on June 1, may in part lie with regional agencies.
Bridging the gaps where health care is often hard to come by, staff from the Western North Carolina AIDS Project (WNCAP), an Asheville-based organization, travels to rural locations in order to bring clients to doctors. Connection via automobile is but one way that WNCAP operates. The organization distributes numerous supplies, be it tests or clean syringes, throughout the communities in North Carolina in need.
WNCAP also keeps up with advancements in medicine by providing public education, supplying funding and policy advocacy.
While that promise of progress is there, as stated in the NC News Health article, not everyone survives, and the emotional losses are also taken on by grass-roots organizations like WNCAP, along with everything else.
As quoted from John Chaffin, WNCAP’s community navigation coordinator, “It’s not because HIV is deadly anymore. It is if it’s not treated. It’s not treated because we face a population of individuals who are underserved.”
The Charlotte area has its own major organizational advocates for HIV prevention including RAIN. Established in 1992, the practice has pushed to provide comprehensive services to individuals and families affected by HIV in the Queen City. The advocacy center serves a range of ages, from 13 to adults, by providing advantageous means like medical case management and solutions through health insurance assistance, youth peer counseling, PrEP/PEP programs, early intervention services, HIV/STI testing and much more.
One crucial initiative put together by RAIN comes in the form of combating homelessness, through a program called The Havens, a subsidiary of RAIN which provides access to safe and affordable housing for those experiencing homelessness that also live with HIV or other disabilities.
Also in the Queen City is the Powerhouse Project, run by Quality Comprehensive Health & Wellness Together, that provides a safe, non-judgmental space for young men of color to access essential support services as well as HIV prevention and education. Quality also operates a clinic and offers many other services on the west side of Charlotte not far from Johnson C. Smith University.
Rosedale Health & Wellness, located in Huntersville, also works with individuals who have contracted HIV, in partnership with Dudley’s Place, offering client-centered services including treatment plans for HIV/AIDS, education sessions, mental health counseling, and many other services.
Finally, just south of Charlotte in Rock Hill, the Affinity Health Center serve’s York, Chester and Lancaster counties. It was founded in 1994. In present day, the center has gone on to become a full-service family practice, continuously adding on to their robust high-quality yet affordable healthcare services like Hepatitis C Treatment and STD testing.
Although the election season is now over, another very important way to combat HIV in the LGBTQ+ community is to fight the anti-LGBTQ+ legislation hurting public health care. According to a report published on Oct. 29 by UNC Gillings School of Global Public Health, more than 500 anti-LGBTQ+ bills have been introduced in the United States this year alone. Of those policies, many have the potential to interfere with HIV prevention by increasing the stigma around it and through decreasing health care access.
“LGBTQ+ youth living in states with more discriminatory, anti-LGBTQ+ policies had lower levels of PrEP use,” explained first author Nicole Kelly (PhD ‘24, epidemiology), a recent graduate of the Gillings School. “PrEP is essential to ending the HIV epidemic, and these discriminatory laws may be limiting PrEP use on a national level.”
“Ultimately, I’d like to see anti-LGBTQ+ legislation repealed and replaced with protective policies for youth. In addition to protecting human rights, this step could potentially boost PrEP use and, as a result, reduce population-level HIV transmission.”
One of the core issues regarding HIV is that, given the right amount of care and attention, it is preventable and – if infected – very manageable.
Through organizational outreach, connection with healthcare professionals and platforming bills that open up better health care policies in combating HIV there can be a better tomorrow for many infected individuals in North Carolina.