HIV rates are highest in the American South, despite effective treatments – a clash between culture and public health

Information about PrEP in the clinic can go only so far without community support. Jahi Chikwendiu/The Washington Post via Getty Images

The American South has the highest HIV rates in the country, accounting for more than half of new HIV diagnoses nationwide in 2023. This is despite growing availability of a highly effective HIV prevention medication that has made it possible to live a long, healthy life with this once fatal disease.

This medication – called preexposure prophylaxis, or PrEP – reduces the risk of HIV transmission by over 99% when taken as prescribed. Yet, in Southern cities such as Jackson, Mississippi, and Memphis, Tennessee, one of the most vulnerable populations – Black men who have sex with men – are rarely using it, with fewer than 1 in 5 who are eligible taking the drug.