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Southern states at epicenter of HIV
Region has higher percentages of HIV/AIDS than other parts of the U.S., and many are unaware they’re infected

By M.J. Ellington · (334) 262-1104

MONTGOMERY — If you think AIDS is somebody else’s problem, the people who track the disease say it is time for a reality check.

Reality is that Alabama and the South have higher percentages of HIV/AIDS than other parts of the United States. Numbers here are increasing while those in other areas are leveling off.

“We are at the epicenter of the AIDS epidemic,” said Kathie Hiers, chief executive officer of Birmingham-based AIDS Alabama.

The nonprofit organization serves people with HIV/AIDS and provides education and advocacy statewide.

“Reality is that to avoid infection, people need to avoid sex until they are in a mutually monogamous relationship,” said Dr. Charles Woernle, assistant state health officer for Alabama.

Short of that, sexually active people need honest, frank communication with their sexual partners that may include testing for the disease, he said. When effective precautions are not part of a person’s life, “they may transmit the infection without knowing it,” Woernle added.

Jane Cheeks, director of the HIV/AIDS programs at the Alabama Department of Public Health, stressed the best way to fight spread of the disease is through knowledge and that includes testing.

Alabama bought notices on the sides of five 18-wheelers that operate in the state as one way to get the message out, especially in rural areas. Cheeks said initial testing is free at state public health clinics and some regional HIV/AIDS clinics.

“Everyone is at risk,” Cheeks said. “You know what you do, but you do not know what somebody else does.”

AIDS Alabama’s Hiers cites statistics that she said show alarming HIV/AIDS trends in the South.

“Over 46 percent of all new infections in the U.S. occurred in 14 Southern states,” Hiers said. “The South is the only area where the percentage of cases is still rising. And 42 percent of the people living with AIDS are living in the South.”

Infected babies

The South is also the only area with continuing increases in the number of babies born with HIV infection, a fact that she said is almost completely preventable if pregnant women with the infection are diagnosed and treated, give birth by caesarian section and do not breast feed.

While the most recent figures for other parts of the country show a decline in the number of babies born HIV positive, figures in the South are up.

In 2006, Alabama got almost $28 million in federal HIV/AIDS funding for testing, HIV/AIDS patient care and medications. The drugs alone average more than $8,000 per year per patient, more than the $7,950 in annual income for the average state AIDS patient.

Hiers said even with that amount, Alabama is not getting its fair share of federal funds. The reason is the federal formula that sends more funds to larger states, even those well outside the virus epicenter.

The state still lacks funds for patient transportation, medications and related needs, she said. In 2005, there were 1.2 million people diagnosed with HIV/AIDS in the U.S. Of that number, there were about 40,000 new cases and 19,000 deaths per year.

The number of fatalities is close to the newly determined death estimates for antibiotic-resistant staph infections in the news last week.

In Alabama in 2005, more than 3,100 people were living with HIV/AIDS. The highest number ever diagnosed in the state was 8,176.

In 2006, U.S. Centers for Disease Control and Prevention recommended that everyone ages 13 to 64 be tested for HIV/AIDS as a part of routine health screenings. CDC estimates that of the 1.2 million HIV-positive people in the U.S., almost 250,000 do not know they have the infection. They may spread the infection unknowingly to others.


Dr. Julie Gerberding, who heads the CDC, said routine screening for everyone in the target age group would remove the stigma of HIV testing and reduce resistance to getting tested. It would also provide a new source of early detection, prolong life and help reduce the spread of the undiagnosed disease.

Although screenings are free at public health clinics and some regional HIV/AIDS clinics, there is a cost at the doctor’s office.

Hiers said some people cannot afford the $8 to $80 cost of routine testing on their own and people with positive first screenings face other charges for re-testing. Some health insurance companies resist paying the extra cost.

HIV/AIDS Resources

Alabama Department of Public Health

HIV/AIDS Division

Hot line (800) 228-0469

Internet: Go to and click “HIV/AIDS Prevention and Control.” The site has Internet links to regional AIDS service and clinic sites and advocacy groups

AIDS Action Coalition

Medical clinic and service for 12 counties including Lawrence, Limestone, Madison and Morgan

Phone: (256) 536-4700 or (800) 728-3603

AAC/Davis Clinic


AIDS Alabama

Statewide organization with testing and clinic services, housing, transportation and advocacy

Phone: (205) 324-9822

Confidential Help Line: (800) 592-2437

M.J. Ellington

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