Many AIDS cases, few HIV specialists in South

ATLANTA�The South has emerged as ground zero in the HIV/AIDS crisis in the USA.

Roughly half of all new AIDS diagnoses are occurring in Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee, according to federal estimates.

Overlying that dismal reality is another: There's a severe shortage of HIV specialists in the South, which exacerbates access to treatment for people living with the disease in the region, according to one of the nation's leading AIDS advocacy organizations.

AIDS United, a Washington-based group that provides grants to community organizations, is starting a push to control AIDS in the South. The group seeks to spread awareness of the problem and highlight ways of providing access to care in a congressional roundtable Tuesday on Capitol Hill.

"This disease is no longer a metropolitan problem," says Sen. Jeff Sessions, R-Ala., a host of the roundtable. "In fact, infection rates in the rural South are among the fastest-growing in the country."

There are much higher concentrations of HIV specialists in traditional "epicenters" of the HIV epidemic � 411 in California; 275 in New York state � compared with 243 in the nine Southeast states, says Bruce Packett, deputy executive director of the American Academy of HIV Medicine. This concentration of expert care "just isn't rationally representative of HIV incidences by state," he says.

Sessions and Sen. Kay Hagan, D-N.C., are co-hosting the Senate session. Rep. Ileana Ros-Lehtinen, R-Fla., and Rep. Hank Johnson, D-Ga., are the House sponsors.

"Make no mistake � HIV/AIDS is devastating communities of color, women and young gay and bisexual men in the U.S., especially in the South," Johnson says.

Roundtable participants will hear from activists, patients and care providers, who will share information on programs that are overcoming hurdles to access.

One such effort: People in poor or rural communities with limited HIV specialists can meet with a doctor through a health program electronically with a video hook-up.

Montgomery AIDS Outreach, a group that has about 1,200 active medical patients in 26 counties of south-central Alabama, recently launched such a program, medical director Laurie Dill says. A doctor at the Montgomery hub consults via video with a patient and nurse at the satellite site in Selma, about 50 miles away.

"You're having a real-time, face-to-face conversation, except that it's electronic," Dill says.

According to the Centers for Disease Control and Prevention, 1.2 million people live with HIV in the USA; one in five are unaware that they have it. There are about 50,000 new infections a year.

Ronald Johnson, an AIDS United vice president, points to several reasons for higher incidence rates in the South, including "higher rates of poverty, racism that helps drive and fuel the problem, cultural conservatism that serves as a barrier, stigma around HIV, stigma toward � drug users and sexism."