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PolitiFact: Is the South the HIV/AIDS epicenter?

 
British singer Sir Elton John says the South is facing a dramatic rise in HIV/AIDS, greater than in any other area of the country.
British singer Sir Elton John says the South is facing a dramatic rise in HIV/AIDS, greater than in any other area of the country.
Published Oct. 26, 2015

In advance of the first Democratic debate, CNN decided to ask some of the rich and famous what question they'd like to put to the candidates.

Sir Elton John said his question would be about his personal passion, the fight against HIV/AIDS.

"In spite of great progress, HIV/AIDS is actually dramatically on the rise in the U.S. South. What would you do as president to help stop this epidemic, particularly among minority communities?" John said.

According to the Centers for Disease Control and Prevention in Atlanta, about 1.2 million Americans are living with HIV, and about 12.8 percent of them don't know they're infected.

HIV/AIDS didn't wind up a discussion point in the first Democratic debate. But PolitiFact decided John had a point worth checking.

We began by contacting the Elton John AIDS Foundation in New York City, and it sent us, among other things, a link to a story that appeared in the Washington Post in September 2014 under the headline "Southern states are now epicenter of HIV/AIDS in the U.S."

The article quoted Rainey Campbell, then-executive director of the nonprofit Southern AIDS Coalition, as saying Southern states have the highest rates of new HIV diagnoses, the largest percentage of people living with the disease and the most people dying from it.

The foundation also sent a link to a report by the Southern HIV/AIDS Strategy Initiative (SASI) from November 2012, examining HIV epidemiology in the South using 2010 data from the CDC and other government agencies.

The report focused on nine states in the South that were identified as "particularly affected by HIV" — Florida, Georgia, Alabama, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Texas.

The targeted states had the highest rates of HIV diagnoses in the United States — 23.8 per 100,000 — according to the CDC data. The South, the report said, makes up a third of the country's population but is home to more than half of the new HIV diagnoses.

Nine of the 10 metropolitan areas with the highest HIV incidence rates, and seven of the 10 with the highest AIDS incidence rates, were in the targeted states, according to the report.

We decided to check in with the CDC to see if we could learn more.

Ranking regions by the rate of new HIV diagnoses, the South is highest with 24,323 new cases, or a ratio of 20.5 per 100,00 population, based on the latest data available from 2013.

Next highest is the Northeast (Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont), with 8,908 new HIV diagnoses, or 15.9 per 100,000 population.

The West (Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington and Wyoming) is next with 8,013 new diagnoses, or 10.8 per 100,000 population.

And last is the Midwest (Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota and Wisconsin) with 6,109 new diagnoses, or nine per 100,000 population, according to the CDC.

So, clearly the South has a big problem.

But we still weren't sure whether any of this proved that HIV/AIDS was rising dramatically in the South. Couldn't it be that other regions are doing a better job with education and treatment? Nic Carlisle, new executive director of the Southern AIDS Coalition, said it's likely "a combination of both."

The most recent CDC surveillance report shows the country was making moderate progress until 2011, when the number of new diagnoses started moving in the wrong direction again — with only the West showing a decrease in 2012-13, Carlisle said.

The increases were 3.4 percent in the Midwest, 3.2 percent in the Northeast and a substantially greater 7.5 percent for the South in 2012-13, he said.

"True, we've have made remarkable progress in addressing the HIV epidemic in the United States. Treatment advances have transformed what was once a fatal diagnosis into a chronic disease for many," Carlisle said.

"Unfortunately, while the rest of the country reaps the benefits of this progress, the South is in danger of being left behind."

Even the Obama administration recognizes the need to stem the widening HIV-related health disparities that plague the South. In its update to the National HIV/AIDS Strategy (NHAS), the administration set a goal of reducing disparities in the rate of new diagnoses by at least 15 percent among people living in the Southern states, Carlisle said.

John's overarching point is that the South has seen an increase in AIDS/HIV, greater than any other region in the nation. The data support that.

You can quibble about whether there is enough of a trend line to term this a dramatic jump in cases. That takes his statement down a notch on the Truth-O-Meter.

We rate John's statement Mostly True.

Edited for print. Read the full version at PolitiFact.com/florida.