If Southern States Follow Tennessee

A new study by amfAR’s public policy office responds to an urgent question: What are the potential consequences if Southern states follow Tennessee’s lead in rejecting federal guidance and funding for HIV prevention?

In 2023, the Tennessee Department of Health did precisely that, refocusing state-level HIV prevention, testing, and treatment activities away from populations that are disproportionately affected by HIV (cisgender women, men who have sex with men, transgender people, and people who inject drugs) and toward populations that are non-disproportionately affected by HIV (pregnant women, infants, first responders, and human trafficking victims). State officials also decided to forgo $8.8 million in CDC funding for prevention activities.

The study warns that if Southern states adopt a similar approach to public health and redirect HIV prevention and testing efforts away from populations most at risk for acquiring the virus, the effort to end AIDS will be derailed both on a regional and national level.

According to the analysis, the American South—the region that accounts for the highest rates of HIV—will see an estimated additional 32,000 avoidable HIV cases by 2030, which is nearly comparable to current cases for the entire U.S. during an average year. In contrast, directing HIV prevention efforts toward populations most at risk would substantially reduce the trajectory of the HIV epidemic in the South.

The study advises that state-level HIV prevention and testing efforts adhere to evidence-based approaches and focus on populations that are directly affected by HIV in order to meet the goals established by the federal initiative, Ending the HIV Epidemic.