Understanding Atlanta’s Persistently High Rate of HIV

By: Ranier Simons, ADAP Blog Guest Contributor

Since the 1950s, Atlanta is commonly known as “Hot Lanta” popularized by the Allman Brothers Band’s song because of its hot and humid climate.[1] But the weather isn't the only thing "hot" in Atlanta as the metro area surrounding the city has become a burning epicenter of new diagnosis for HIV.

Photo Source: ANIZ

Proper data collection and analysis take time. This is especially true regarding public health surveillance and research. It is better to have robust sourcing of quality data collection than analysis of rushed volumes of collected data.[2] The Centers for Disease Control & Prevention (CDC) recently released a national HIV data analysis of infection rates from 2021. Overall, the national rate of new HIV infections has been decreasing over the past few years. However, this is not entirely true for the South.[3] Reporting indicates problematic infection trends in several southern metropolitan areas, one such area being metro Atlanta. 

Data shows that in 2021, metro Atlanta had the third highest new HIV infection diagnosis rate of metropolitan areas, only bested by Miami, Florida, and Memphis, Tennessee.[3] This data gives added context to preliminary data observed presently in 2024. According to Dwayne Ford, director of HIV prevention services with AIDS Atlanta, there are more reported positive individuals living with HIV in the first quarter of 2024 than in the first quarter of 2023.[4]

Various treatment and prevention tools exist, so healthcare professionals and community groups are trying to identify where more work needs to be done to reverse Atlanta and Georgia’s new infection rates. While metro Atlanta is the third highest ranking in new infections for metropolitan areas, Georgia is fourth overall as a state. One challenging area of concern is funding. Georgia is one of the few states that have not expanded Medicaid. If Georgia fully expanded Medicaid as allowed under the Affordable Care Act, over half a million Georgia residents would become eligible for health insurance.[5] 

Photo Source: Atlanta Journal Constitution

This would enable over half of the Georgian residents who are uninsured and enrolled in the Ryan White program to be moved to Medicaid. They would still be able to get all the care they received under Ryan White in addition to other services not available through Ryan White. That, in turn, would free up approximately $53.7 million of Ryan White funding to help non-Medicaid eligible people living with HIV not presently accessing services.[4] Treatment is prevention since increasing the number of people on ART means increasing viral suppression, lowering the number of those able to transmit HIV. Moreover, expanding Medicaid would mean increasing access to PrEP since Ryan White Funding cannot be used for PrEP medications nor its associated medical visits and laboratory testing.[6] African American and Hispanic males comprised the majority of reported new HIV infections yet have much lower utilization of PrEP in comparison to white residents.[3]

Access is a significant issue for low-income residents and the African American and Hispanic populations, which are disproportionately represented in new infection numbers. However, stigma is also still an issue.[3] In African American and Hispanic communities, HIV stigma remains a barrier to care, testing, and support. Efforts to encourage and expand testing lose impact when those who discover their positive status do not seek treatment. It is vital to bolster efforts to get newly diagnosed individuals into treatment as soon as possible and to help them remain in treatment. Support is needed since fear and privacy concerns hinder vulnerable populations from wanting their medications discovered by friends and family. Additionally, fear of the stigma of being seen at public clinics or other healthcare facilities hinders proper follow-up care and testing.

Support and prevention are the two areas many concerned parties are focusing on. Expanding prevention efforts such as PrEP access, education, and culturally competent messaging are imperative. Improving upon existing measures to help those negatively affected by social determinants of health, such as lack of transportation and insurance, is also necessary. 

Photo Source: endhivatl.org

The Fulton County Department for HIV Elimination recently launched a new website, ENDHIVATL.ORG,  in response to the metropolitan Atlanta area epidemic. Citizens can use the site to find service providers based on the services they provide and their proximity to where they live. The site also provides up-to-date information concerning how and where to access PrEP and other medical and non-medical services. To help address stigma, the site has a prominently displayed section entitled ‘Positive & Proud.’ It contains personal stories of local community members living with HIV regarding their lives in general and their experiences with utilizing the Department for HIV Elimination services. There is even a section of the site dedicated to assisting healthcare providers.

Atlanta’s high rate of HIV infection has persisted for years. While rates have declined slightly, they are still disproportionately higher than the rest of the country. Hopefully, continued efforts to highlight the status quo, maintain awareness, and provide further support and prevention will soon result in improved lives and outcomes.

[1] Kane, Deborah (2024, April 10). What is the nickname of Atlanta Georgia? NCESC. Retrieved from https://www.ncesc.com/geographic-faq/what-is-the-nickname-of-atlanta-georgia/

[2] Chiolero, A., Tancredi, S., & Ioannidis, J. P. A. (2023). Slow data public health. European journal of epidemiology, 38(12), 1219–1225. https://doi.org/10.1007/s10654-023-01049-6

[3] Gaines, J. (2024, April 1). New HIV case rate in metro Atlanta third highest in nation. Retrieved from https://www.ajc.com/news/atlanta-news/new-hiv-case-rate-in-metro-atlanta-third-highest-in-nation/6TDMS6CUTZG7RPVPRLE6O3JZCY/

[4] 11Alive. (2024, April 4).HIV cases on the rise in metro Atlanta - What local clinic says about it. [Video]. YouTube. https://www.youtube.com/watch?v=h2jh2TgxfcQ&list=WL&index=1

[5] Equality Foundation of Georgia. (2022). Implications of Medicaid expansion on Georgia's HIV Budget. Retrieved from https://georgiaequality.org/wp-content/uploads/2022/01/REPORT-Medicaid-Expansion-and-Ryan-White.pdf?emci=61ee3ed9-f179-ec11-94f6-c896650d4442&emdi=ea000000-0000-0000-0000-000000000001&ceid=

[6] Department of Health and Human Services. (2021, November 16). HRSA Letter to Ryan White Program Colleagues. Retrieved from https://ryanwhite.hrsa.gov/sites/default/files/ryanwhite/hiv-care/prep-dcl-november-2021-508.pdf

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.