Despite the rapid growth of leading African American businesses in Atlanta, something else is arising and tearing the city down: its HIV rate. In fact, given the rising rate of new diagnosed HIV cases, particularly among gay and bisexual black men, HIV has become a public health emergency in the capital of the south.
In 2014, Atlanta had the fifth highest rate of new HIV infections among metro areas, with a rate of 25.8 new diagnoses for every 100,000 residents. That is more than twice the national rate of 12.3.
Recent reports from the Centers for Disease Control and Prevention (CDC) state that the HIV/AIDS rates in Atlanta, particularly in the downtown area, are as bad as some third-world African countries. "Downtown Atlanta is as bad as Zimbabwe or Harare or Durban," said Emory University Center for AIDS Research co-director Dr. Carlos del Rio.
Atlanta’s HIV epidemic is concentrated within a specific population: young black men who have sex with men (MSM). An 24 month study by Emory University followed a group of Atlanta-area MSM ages 18 to 39 and found that 12.1 percent of the black MSM under 25 contracted HIV. The rate is only 1.0 percent among their white counterparts.
According to the Georgia Department of Public Health, AIDS is the leading cause of death among black people in Georgia ages 35 to 44. Factors contributing to the increase in HIV new infections in the African-American community include racial disparities in health care, poverty, the lack of HIV education, and the lack of funding for education and prevention programs.
The lack of economic opportunity for the black community in Atlanta plays a large role in the transmission of HIV. Young black MSMs are more likely to be affected by poverty than their white counterparts. If infected, this vulnerable group would have greater difficulty affording the compulsory care and have a higher risk of developing AIDS.
Stigma of HIV and homosexuality also hinders utilization of HIV prevention services for black MSM. The double stigma of being a racial and a sexual minority makes it more challenging for gay black men to discuss their HIV status with care providers and sexual partners. This ultimately increases the likelihood of HIV transmission and limits their access to health care services.
Health care access is one way to change the course of metro Atlanta's HIV epidemic. Men who are HIV negative may now receive a treatment called Pre-exposure Prophylaxis, or PrEP, to reduce their chances of acquiring HIV by 50 percent or more. However, the availability of PrEP has been very limited in metro Atlanta. Young black MSM will need ready access to this medication if we hope to reduce HIV rates in the community in Atlanta.
Education is also the key to stem the significant HIV epidemic in Atlanta’s young black community. Many young people begin having sex before age 18, and they have probably been engaging in risky sexual behaviors for several years by the time they find they become infected with HIV. Georgia has high rates of teenage pregnancy and sexually transmitted infections among all youth. We need to make sure that all young people receive accurate and comprehensive sex education and are empowered to make healthy sexual choices during their teenage years and beyond.
To ultimately control and even eliminate the epidemic among young gay and bisexual black men in metro Atlanta, we need to alleviate the social and economic barriers that these men face. Unless we remove these structural barriers, the epidemic will not end and neither can we sustain the health of our community and future generations. Together, we can fight the HIV epidemic and we will end it.