State of HIV in the US Deep South



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The Southern United States has been disproportionately affected by HIV diagnoses and mortality. To inform efforts to effectively address HIV in the South, this manuscript synthesizes recent data on HIV epidemiology, care financing, and current research literature on factors that predispose this region to experience a greater impact of HIV. The manuscript focuses on a specific Southern region, the Deep South, which has been particularly affected by HIV. Epidemiologic data from the Centers from Disease Control and Prevention indicate that the Deep South had the highest HIV diagnosis rate and the highest number of individuals diagnosed with HIV (18,087) in 2014. The percentage of new HIV diagnoses that were female has decreased over time (2008–2014) while increasing among minority MSM. The Deep South also had the highest death rates with HIV as an underlying cause of any US region in 2014. Despite higher diagnosis and death rates, the Deep South received less federal government and private foundation funding per person living with HIV than the US overall. Factors that have been identified as contributors to the disproportionate effects of HIV in the Deep South include pervasive HIV-related stigma, poverty, higher levels of sexually transmitted infections, racial inequality and bias, and laws that further HIV-related stigma and fear. Interventions that address and abate the contributors to the spread of HIV disease and the poorer HIV-related outcomes in the Deep South are warranted. Funding inequalities by region must also be examined and addressed to reduce the regional disparities in HIV incidence and mortality.





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Reif, S, D Safley, C McAllaster, E Wilson and K Whetten (2017). State of HIV in the US Deep South. Journal of Community Health. 10.1007/s10900-017-0325-8 Retrieved from

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Susan Reif

Research Scholar

Carolyn McAllaster

Colin W. Brown Clinical Distinguished Professor Emeritus

Carolyn McAllaster is the founder of the Health Justice Clinic, formerly the AIDS/HIV and Cancer Legal Project, directs the HIV/AIDS Policy Clinic, and is a Clinical Professor of Law at Duke. She supervises students in the AIDS/HIV Policy Clinic and teaches a course on AIDS and the Law.

McAllaster received her BA in German from the University of North Carolina in Chapel Hill in 1972, and her JD from the UNC Law School in 1976. She began her practice of law in Durham with a litigation firm, and thereafter opened her own practice where she handled a variety of complex litigation in the state and federal courts. While continuing her private practice McAllaster served as an administrative hearing officer for the North Carolina Department of Human Resources from 1981-87. She undertook service as a state court arbitrator in the Fourteenth Judicial District beginning in 1987, and still continues that responsibility. McAllaster joined the Duke Law School faculty in 1988, where she has taught pretrial and trial practice and a child advocacy clinic, as well as the courses she currently teaches. She has also taught trial practice for the National Institute of Trial Advocacy (NITA), and as an adjunct member of the faculty at UNC and other law schools. McAllaster is admitted to practice in the state courts of North Carolina, the United States District Courts for the Eastern, Middle, and Western Districts of North Carolina, and in the United States Fourth Circuit Court of Appeals.

McAllaster was a founder and first president of the North Carolina Association of Women Attorneys and is also a member of the North Carolina Bar Association and the North Carolina Academy of Trial Lawyers. She was appointed by the governor to serve on the North Carolina AIDS Advisory Council in 1996.

McAllaster is the author of two books, North Carolina Litigation Forms and Analysis(3 vols., Lawyers Cooperative Publishing, 1995), and The Law and the Mentally Handicapped in North Carolina, (co-author) (N. C. Institute of Government, 1976 edition), as well as several articles or chapters in books, including "Legal Issues for HIV-Infected Children" in Handbook of Pediatric HIV Care, published by Cambridge University Press in 2006, "Legal Issues for HIV-Infected Children," in Textbook of Pediatric HIV Care, published by Cambridge University Press in 2005 and co-author of "Issues in Family Law for People with HIV" in AIDS and the Law Fourth Edition, published by Aspen Publishers. She is a frequent speaker at Continuing Legal Education programs for attorneys and workshops for non-attorneys in the following areas: AIDS law issues, litigation skills, child advocacy, and women and the law.


Kathryn Whetten

Professor in the Sanford School of Public Policy

Director, Center for Health Policy and Inequalities Research
Research Director, Hart Fellows Program,
Professor, Public Policy and Global Health 
Professor, Nursing and Community & Family Medicine 
Pronouns: they/them

Kathryn Whetten is the Principal Investigator on multiple grants and publishes numerous scientific articles every year. In addition, they mentor many students and give guest lectures and presentations throughout the year.

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