A friend asked me that a while ago and I struggled to articulate a succinct answer. I talked about HIV's direction correlation with poverty and about discrimination against people of color and LGBTQ individuals who experience HIV/AIDS at a vastly disproportionate rate. I talked about the government's campaign of fear, neglect and prejudice at the onset of the crisis and the stigmatizing that persists 30+ years later.
I work at four sites for formerly homeless adults with HIV/AIDS so it was important for me to better explain the reason why people with HIV/AIDS deserve a strong safety net and government assistance.
Fortunately, a friend of a friend is a scientist researching the potential for immunotherapy – using the body's own natural defenses to fight disease, cancer or viruses – to treat or even cure HIV. So I asked her for a response. Here's what she said:
Picture a map of New York City where darker shades of red indicate poverty. The richest neighborhoods – Upper East Side, Cobble Hill, Tribeca, Forest Hills – would be faint pink. The poorest neighborhoods – Mott Haven, East New York, Brownsville – would be bright scarlet. Middle income neighborhoods – much of Western Queens, much of Staten Island, Kensington, Ocean Parkway – would be varying shades of red.
Now picture a map of HIV/AIDS prevalence in New York City where darker shades of red indicate a higher rate of HIV/AIDS. The HIV/AIDS map would look exactly the same as the poverty map, aside from Chelsea, a wealthy neighborhood with a high concentration of older gay men who survived the initial HIV/AIDS outbreak.
You could lay the HIV/AIDS map right on top of the poverty map and they'd be nearly identical.
It's a simple mental infographic for understanding just how closely HIV/AIDS correlates with poverty.
It helps to think of HIV/AIDS not as an STD or intravenous drug-using disease but as a disease of poverty prevented by access to financial opportunities and health care.
Now consider HIV/AIDS rates across the country. In The New York Times Magazine last week, Linda Villarosa described the startling rates of HIV/AIDS among gay and trans people of color in the South, a rate that exceeds even the African nations most ravaged by HIV/AIDS.
I envision my acquaintance's description of the poverty map stretched across the United States. The bright red areas where HIV/AIDS rates surge are concentrated around the South, places like Jackson, MI, Columbia, SC, El Paso, TX and Baton Rouge, LA.
Now lay a map of the poorest regions of the country on top of that HIV/AIDS map. The scarlet splotches that represent increasing rates of HIV/AIDS correspond with the the bright red poverty splotches that mottle the South, the region with the poorest states and cities in the country. With 22 percent of its population living below the poverty line, Mississippi has the highest rate of poverty in the nation.
Let's take the mental map infographic one step further.
Picture a map of healthcare access in the United States. States that have near-universal healthcare coverage like Massachusetts, Vermont and Rhode Island are pale pink. States with the highest percentages of uninsured citizens – Texas at nearly 17%, Georgia at 14% Mississippi at 13% – are bright red. These are the states that did not elect to expand Medicaid under Obamacare. Again that map mimics the patches of red on the HIV/AIDS map.
Poverty, homelessness, lack of access to healthcare and HIV/AIDS are interconnected. Addressing the underlying causes of poverty can also serve as preventive Rx for HIV/AIDS, which will protect us all from illness and save on money on healthcare expanses. And, of course, it's the humane thing to do.