Louisiana’s Two Epidemics

A new report based on data from the Louisiana Department of Health argues that combatting the state’s HIV/AIDS epidemic requires understanding the differences between rural and metropolitan communities. The report, HIV/AIDS in Metropolitan vs. Rural Louisiana: One State, Two Epidemics, was compiled by Heroes (HeroesLA.org), a Northeast Louisiana-based organization focused on HIV in the rural Deep South. It shows that the more than 15 percent of residents living with HIV who reside in Louisiana’s rural regions face much different obstacles than those in cities like New Orleans and Baton Rouge.

Using data from the state’s Department of Health and other sources, researchers examined risk factors for HIV — including stigma, racial disparities, education, poverty, incarceration, and rates of STIs — and compared them in rural versus metropolitan areas of the state.

The report concludes that “in terms of significant at-risk signifiers for HIV/AIDS, the rural region had a lower population of people with at least a bachelor’s degree, a higher proportion of people living in poverty, a higher rate of incarceration, and higher rates of [STI] infection in African-Americans compared with metropolitan regions.”

Additionally, rural areas were found to have fewer HIV resources. For example, the rural northeast corner of the state, a region researchers focused on, has only one Ryan White HIV/AIDS medical care provider. Possibly because of that lack of resources, the study found young people (13-24) were more likely to test positive in the rural region (33 percent) than in New Orleans (25 percent) or Baton Rouge (29 percent). Twenty-seven percent of people diagnosed with HIV in the rural area also received a simultaneous AIDS diagnosis, compared to only 18 percent in New Orleans, and 22 percent in Baton Rouge. People in rural Louisiana were also more likely to develop AIDS within a year of their diagnosis, suggesting that a lack of testing and access to care in these areas is part of the problem. Those living with HIV in the rural northeast were also less likely to achieve viral suppression.

Resolving these issues, researchers argue, lies in understanding the data and finding local solutions.

“Improving understanding of epidemiologic trends in rural Louisiana is crucial to developing customized solutions to address HIV in these areas,” the report notes. “Exploring the contrasts between rural and metropolitan regions for these risk factors will help identify rural-appropriate solutions.”

— DesirÉe Guerrero