By CRAIG SCHNEIDER
The Atlanta Journal-Constitution
HIV/AIDS has assumed a new face in Georgia. It is younger and more rural, more likely to be black or female.
And it is harder to reach with prevention messages, testing and services.
Old messages geared to urban, white, gay men simply don’t resonate with many African-American and rural people, advocates say.
That worries the advocates.
The inability to reach those groups “is really a threat to everyone’s well-being,” said Clarence Reynolds, spokesman for AID Atlanta, the largest AIDS service organization in the Southeast. He said people who do not receive services and safe-sex counseling are more likely to spread the virus.
The number of Georgians living with HIV/AIDS jumped almost 27 percent from 2004 to 2007, to 32,740, reports the state Division of Public Health. The number of deaths has leveled off, as stronger drugs have allowed infected people to live longer.
Stigma for gays in rural and black communities, has often kept the issue out of churches and schools, advocates say.
An “unholy trinity” of silence, shame and stigma prevents many African-Americans from getting tested for the virus, said the Rev. Raphael Warnock, senior pastor at Ebenezer Baptist Church in Atlanta.
Hartsel Shirley has felt that stigma firsthand. The 39-year-old southwest Atlantan was diagnosed with HIV years ago but a fear of being exposed kept him from seeking care, he said.
“If you’re black and a gay man, you’re not even looked at as a man,” Shirley said. “If you have HIV, you’re almost not human.”
By 2006, 71 percent of those living with HIV/AIDS in Georgia were black, although African-Americans are about 30 percent of the state’s population, according to state figures. Seventy-nine percent of Georgians diagnosed with HIV that year were African-American.
Rural and other areas outside metro Atlanta often have HIV/AIDS prejudice.
Frank Tant, who grew up in Rome, said his parents asked him to move out when, at 19, he told them he was gay. He has since moved back to Rome and sees better treatment of gay people.
He’s gotten overwhelming support since sharing his story in the local newspaper. “People in Rome think of me as Mr. HIV,” the 48-year-old said.
Lola Thomas, executive director of the AIDS Alliance of Northwest Georgia, said reaching gay men in rural areas, where they have few public gathering places, has proved so difficult that she all but gave up trying.
“We’ve stayed away from gay and bisexual men. They’re much more difficult to target,” Thomas said.
Instead, the Cartersville nonprofit has focused on emergency assistance, financial help, transportation and counseling for clients.
Frustrations abound, as mirrored in several recent national reports.
The Centers for Disease Control and Prevention issued a revised estimate this month that 56,000 people nationally were newly infected with HIV in 2006, 40 percent more than previously estimated.
A report by the Southern AIDS Coalition said inadequate health care for HIV/AIDS patients in the rural South is a regional catastrophe. The Black AIDS Institute said if black America were a country, it would rank 16th in the world in the number of people with the virus.
Health officials are particularly concerned about the number of young people being infected. Many came of age after the AIDS ravages of the 1980s and early 1990s. As more effective drugs helped reduce the death rate, many young people saw it as a manageable illness rather than a death sentence, activists said.
“They see the drugs as a cure,” said Cathalene Teahan, president of the Georgia AIDS Coalition.
In Georgia, one-third of newly diagnosed HIV cases in 2006 were among 20-29 year olds, according to the state public health division.
Teahan said reaching young people in schools has been difficult since so much sex education in Georgia is abstinence centered.
“No one can use the word condom now,” she said.
But Bruce Cook, whose Atlanta company Choosing the Best provides abstinence-centered education materials to Georgia schools, said such instruction can be effective in leading young people to make the right decisions.
“The only way you eliminate risk is abstinence,” Cook said. “Condoms do break and they do slip off.”
The majority of HIV/AIDS cases still occur in metro Atlanta, where advocates say they see more women, particularly African-American women, with the virus.
Dazon Dixon Diallo, executive director of SisterLove, said her group has seen success by addressing the broader economic and relationship issues in many of these women’s lives.
“Ignoring women, young people of color, people in rural areas — we have done them a disservice,” said Diallo, whose Atlanta nonprofit works with African-American women.
Freda Jones got HIV from sex with a man she didn’t know had the virus. When she was diagnosed, the hairstylist did not tell her customers for years, afraid they would abandon her.
She said she pushed her boyfriend to get tested and he was positive, but he went into denial and refused care. It broke up their relationship.
She is now a peer counselor for people with HIV.
“It made me grow up,” she said. “I thought it couldn’t happen to me.”
Meanwhile, some advocates say the response of state and local governments has been inadequate. The state has done little to provide leadership and coordinate prevention efforts, advocates say.
“It is a disorganized mess,” said Kathie Hiers, community co-charwoman of the Southern AIDS Coalition.
Among rural county and municipal governments, HIV/AIDS “is not even on the radar,” said Thomas, with the AIDS Alliance. “Most government people here see it as a city problem.”
The state appointed a new HIV unit director a few months ago, and Raphael Holloway acknowledged that the agency needs to do better at reaching out to community advocates. At the same time, he said increasing services would be difficult at a time of budget cuts.
Still, state officials say they are making progress, increasing testing and working with community leaders to craft a comprehensive plan for the prevention of HIV in urban and rural areas.
But advocates say there’s a long way to go. Thomas said many of the men who come to her Cartersville office to get tested worry they’ll be seen and identified.
“Some are shaking in their boots,” she said, “and practically wearing disguises.”
Staff researcher Sharon Gaus contributed to this article.
Strategies to break through
STAND Students Together Against Negative Decisions is an HIV prevention program developed in rural Middle Georgia. The course trains teen leaders to be role models and peer educators, focusing on both abstinence and education about sexually transmitted diseases and pregnancy prevention.
SisterLove The Atlanta-based HIV prevention program targets African-American women in low-income neighborhoods. It holds Healthy Love parties that celebrate a woman’s sexuality while stressing their right to demand safe sex.
Ebenezer Baptist Church in Atlanta In March, Julian Bond, U.S. Rep. John Lewis and the Rev. Raphael Warnock were tested for HIV publicly at the church, highlighting the need for more testing among African-Americans.
State of Georgia The state Division of Public Health recently launched the “HERstory” marketing campaign targeting HIV prevention for African-American women.