Spotlight on the South: “I am not the enemy, I am the answer” – an interview with Bonetta Graves and Juanita Williams

By Sonia Rastogi and Naina Khanna The epidemic in the Southern United States is “skyrocketing. Every week we get two to three newly diagnosed people, while HIV clinics are closing their doors from lack of funding” states Bonetta Graves, speaker and educator for Common Threads, a project of the National Association of People with AIDS (NAPWA), a POSITIVE Voices member, a project of the South Carolina HIV/AIDS Council, and an HIV-positive woman based in Manning, South Carolina. Geographically, the South is disproportionately hard-hit by the HIV epidemic. In 2001, the South was 36% of the U.S. population and 39% of AIDS cases (not including HIV cases) . Extreme poverty, stigma, unstable health care, and piecemeal funding create a context where the Southern U.S. has the highest total number of new HIV/AIDS cases, the most people without health insurance, and the highest overall death rate linked to HIV.  Seven of the ten states with the highest AIDS case rate among women are in the Southern U.S. including Louisiana, South Carolina, Mississippi, and Tennessee. Juanita Williams states that the top three needs of HIV-positive women in the South are transportation, housing and supportive services. Based in Orangeburg, South Carolina and a previous resident of Atlanta, Georgia, Juanita is a facilitator for Common Threads, founding member of PWN, founding member of SisterSong, and an HIV-positive woman. She remarks, “peer support is hard to find. You have to go underground. You have to talk to one of your friends to see if they know someone who is HIV-positive and who is willing to sit down and meet with you.” Accessing a public space such as a hospital or a clinic is not an option.     Known widely as the Bible Belt, the South is also the stroke belt. When discussing health disparities, the South experiences lack of access to information, technology, services, and quality health care. “There are very few churches that will associate themselves with people living with HIV […] [people living with HIV are] treated as cast aways,” states Bonetta. For Juanita, stigma starts with health care providers who have significant influence in the community: “if the health care field would stop the fear, they could dispel [stigma]. Even with criminalization, you have people criminalized for spitting on people. Health care field support us and say [that HIV cannot be transmitted from spit].” The U.S. National HIV/AIDS Strategy (NHAS) is a monumental document in the government’s approach to the domestic HIV epidemic. However, the NHAS does not prioritize women. The 12 Cities Project is the first initiative to implement the goals of the NHAS by choosing and funding 12 cities to create HIV Prevention Planning Programs. This initiative does not include states where women are predominately affected including Louisiana, South Carolina, Mississippi, North Carolina, and Tennessee. Funding continues to be inadequate and restricted for the Southern U.S. Investment in building leadership of HIV-positive women, especially women of color, and their allies, proportional and long-term resources to combat stigma and criminalization, and a scaled up health delivery model for non-urban geographies is needed. Juanita concludes that the voices of HIV-positive women are critical: “I am not the enemy, I am the answer.”