Quantcast

Subscribe to:
POZ magazine
E-newsletters
Join POZ: Facebook MySpace Twitter Pinterest
Tumblr Google+ Flickr MySpace
POZ Personals
Sign In / Join
Username:
Password:
Welcome, Guest. Please login or register.
July 25, 2014, 09:56:20 AM

Login with username, password and session length


Members
Stats
  • Total Posts: 631841
  • Total Topics: 47836
  • Online Today: 293
  • Online Ever: 585
  • (January 07, 2014, 02:31:47 PM)
Users Online

Welcome


Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: Death rates up to twice as high in southern U.S. states as northern states  (Read 6579 times)

0 Members and 1 Guest are viewing this topic.

Offline buginme2

  • Member
  • Posts: 2,834
http://www.aidsmeds.com/articles/hiv_states_disparity_1667_21332.shtml

Some highlights..9 of the 10 states with the highest HIV related mortality are in the south.

Mortality in southern states is twice as high compared with other states, even when age and race and population are accounted for.

Louisiana, Florida, Mississippi, and the Carolinas rates are double those in the northeast, midwest, and pacific states.

Interesting article.  WHY is this the case???

Offline d-boy86

  • Member
  • Posts: 119
Lack of testing facilities and outreach programs perhaps? That's the only thing I can honestly think of.

Offline denb45

  • Member
  • Posts: 5,051
  • "1987 Classic Old School POZ+"
http://www.aidsmeds.com/articles/hiv_states_disparity_1667_21332.shtml

Some highlights..9 of the 10 states with the highest HIV related mortality are in the south.

Mortality in southern states is twice as high compared with other states, even when age and race and population are accounted for.

Louisiana, Florida, Mississippi, and the Carolinas rates are double those in the northeast, midwest, and pacific states.

Interesting article.  WHY is this the case???

It's the way of the Bible Belt  :-X
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline leatherman

  • Member
  • Posts: 6,053
  • Google and HIV meds are Your Friends
denial, stigma, and poverty

1) denial - many people just don't want to believe that "they" might be at risk, believing it to be a "big-city, white, gay, drug-user, whore, etc" disease. They think that "good Christians" or "good ol' redneck boys" don't get HIV. These people wait until too late to get tested (the rate of late diagnosis is very high in the South) and are frequently unable to recover.

2) stigma - In the Bible Belt, churches are often to blame for people denying they might be at risk. Since most of the churches berate gays (and pozzies), stigma is a large problem to overcome to even get people to come in for testing. (At my ASO, after diagnosis, nearly 1/3 of our clients refuse to use the front door because of the high rate of stigma in our area.) Also as African-Americans make up a large part of our communities, one must consider the stigma from that demographic which often refuses to believe it's a problem in their community, or believes it to be a conspiracy against them. This leads to the denial discussed above or out-and-out denialism.

3) poverty - the rate of poverty is much higher throughout the South, and the poor don't have much access to insurance, meds, or doctors; there are few ID doctors, clinics or ASOs available; transportation - as much of the South is very rural, services may be hard to obtain when one has no transportation or has to travel hundreds of miles.


for example in SC, Catawba Care (my ASO) is the only HIV clinic/ASO service in a 4 county area (york - where our office is, chester, and lancaster counties in SC and Mecklenburg cty/Charlotte in NC because their ASO closed up nearly 2 yrs ago because of criminal acitivities), servicing clients up to 100 miles away. We host remote clinics once a month in the outlying counties because many of our clients there have no transportation (because of poverty). I have had to use SC medicaid transportation services myself to travel over 100 miles away to a hospital in the state capital of Columbia to get adequate services that are not available any closer to where I live just by the NC/SC state line.

Even though the current highest rate of infection is in the African-American community (67% of all new cases are straight African-Americans) we have a hard time reaching out to that demographic. Because of the nature of Southern African-American society, we often reach out through churches; however many of those churches are very homophobic, and occasionally many are out-right denialists believing they can "pray the AIDS away" or they think that HIV and/or the meds are a method the "white man" is using to subjugate or eradicate the "black man".
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline skeebo1969

  • Member
  • Posts: 5,699


  I don't know about the rest of the northeast, but the people of Massachusetts are too ornery to die..  Just give me another year and this Floridian will have another 10 years added to his life...

 Sike
I despise the song Love is in the Air, you should too.

Offline denb45

  • Member
  • Posts: 5,051
  • "1987 Classic Old School POZ+"
Nicely put & well said Mikie, I didn't want to dis anyone that lives in the Bible Belt or offend them in any way so I just used this icon instead  :-X
"it's so nice to be insane, cause no-one ask you to explain" Helen Reddy cc 1974

Offline Cliff

  • Member
  • Posts: 2,645
Even though the current highest rate of infection is in the African-American community (67% of all new cases are straight African-Americans) we have a hard time reaching out to that demographic. Because of the nature of Southern African-American society, we often reach out through churches; however many of those churches are very homophobic, and occasionally many are out-right denialists believing they can "pray the AIDS away" or they think that HIV and/or the meds are a method the "white man" is using to subjugate or eradicate the "black man".
You have no fucking idea. Just spouting off trite non sense you've read, passing on as an expert.

Offline leatherman

  • Member
  • Posts: 6,053
  • Google and HIV meds are Your Friends
You have no fucking idea. Just spouting off trite non sense you've read, passing on as an expert.
of course, living in the UK, you have no fucking idea of what living in South Carolina is like. Why don't you google up "southern black churches homohphobia" or read some of the reports issued from the SC health dpt before you spout off like an idiot.

http://www.scdhec.gov/health/disease/stdhiv/docs/SC%20Epi%20Fact%20Sheet%20Sept2010.pdf
Quote

 By risk, among the 992 people who report risk in S.C., men who have sex with men (64
percent)
represent the largest proportion of recent infections, followed by men who have
sex with women (MSW) and women who have sex with men (WSM) (29 percent). Sixty-
five people (seven percent of total) were infected through injecting drug use (IDU).  
 
By race/ethnicity, among people diagnosed with HIV/AIDS in S.C., 70 percent are
African-American; 23 percent are white
; five percent are Hispanic. African-Americans
have a case rate about seven times greater than whites in S.C.
 
Among men recently diagnosed in S.C., 67 percent are African-American; 25 percent
are white; six percent are Hispanic. Of the 742 men reporting risk, 81 percent were men
who have sex with men, 14 percent were exposed through heterosexual sex; five
percent were injecting drug users.

http://www.yale.edu/divinity/publications/reflections/spring06/12_17.pdf
Black Church Homophobia:  What to Do About It?

http://www.metroweekly.com/news/?ak=4145
Poison Pews
African-American leaders talk about homophobia in the black church

http://www.npr.org/templates/story/story.php?storyId=5415245
'Say a Little Prayer': Black Churches and Homophobia

http://religion.blogs.cnn.com/2011/06/15/my-take-overcoming-the-black-church-tradition-of-homophobia/
My Take: Overcoming the black church’s tradition of homophobia



edited to add the word "southern" into the google search quotes
« Last Edit: October 20, 2011, 05:50:28 PM by leatherman »
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Dachshund

  • Member
  • Posts: 5,941
Cliff is black and I believe he grew up in Texas.

Offline leatherman

  • Member
  • Posts: 6,053
  • Google and HIV meds are Your Friends
Texas.
lucky Cliff. Texas is not one of the states listed having this problem of high HIV/AIDS death rates; however here in SC it's a rising problem in the last year as we moved from #9 to #8 with the highest rates of HIV in the nation.

from the poz article:
Quote
After adjusting for age, the researchers found that death rates among people with HIV, as a percentage of the general population, were highest in New York, New Jersey, North Carolina, South Carolina, Florida, Louisiana and Mississippi and lowest in northern Midwest states. These results are not surprising, as the states with the highest HIV-associated deaths are among the states with the highest HIV prevalence.

http://www.schivaidscouncil.org/downloads/SC_HIV_AIDS_Statistics_8-20-09.pdf
Quote
South Carolina ranks 8th in the nation in the rate of new AIDS cases annually. 
The CDC considers SC one of its top 10 “Hot Spots” nationally – see chart below.
Ranking based on January-December 2007 rate. 
Our capital, Columbia, ranks 9th in the nationamong larger metropolitan areas in the rate of new AIDS cases annually. Charleston is 22rd and Greenville is 68th.
major metro areas are consistently among the nation’s top 100.  Rankings based on January-December 2007 rate.
 For three years running, the SC HIV Testing Reports show the age group 20-29 with   
the highest percentage of newly diagnosed HIV positive people in South Carolina.             
Our youth are our future.  Based on SC HIV Test Reports 2006-2008.
South Carolina currently ranks 1st
in the nation in the percentage of cumulative cases   
of AIDS from heterosexual contact
. Based on Kaiser Family Foundation State Health Facts “Reported AIDS Cases
among Adults and Adolescents, by Transmission Category, Cumulative through 2007.” 
 Among South Carolinians newly diagnosed with HIV who identify their risk factors,     
the modes of transmission are:
Men who have sex with men = 50%, Heterosexual = 40%, Injecting drug users = 9%.
Based on 2006-2007 newly reported adult and adolescent cases.
The rate of reported new HIV/AIDS cases among African American South Carolinians     
is eight times that of whites.

Based on 2006-2007 newly reported adult and adolescent cases.

NATIONAL RANKINGS BY STATE 
Rank State
1 District of Columbia
2 New York
3 Maryland
4 Florida
5 Louisiana
6 Delaware
7 Georgia
8 South Carolina
9 Connecticut
10 Pennsylvania

Texas isn't even on this list either. ::)
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Dachshund

  • Member
  • Posts: 5,941
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #10 on: October 20, 2011, 07:02:14 PM »
God you're dense.

Offline weasel

  • Member
  • Posts: 1,635
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #11 on: October 20, 2011, 07:13:09 PM »
It's the way of the Bible Belt  :-X

    My caseworker .( Prevention Expert)  has been to  SIX SCHOOLS  IN FOURTEEN YEARS OF DOING HER JOB !  She is not welcome in schools or  Churches !  Makes me wonder what she does ????

    In Missouri  we do not have HIV OR AIDS !   I know because the Churches & schools say so !

    I live in one of the poorest Counties in Missouri and they are BLIND to any HIV or AIDS  information !

    Children do not have sex here !   All those Babies from 14 year olds are House hold made  :o

    If things do not change it will only cause more  cases of HIV !

     One Church in Poplar Bluff  did open up and admit there is a problem !  I was glad it was brought up .

      These people do not want to have testing facilities and outreach programs !

       The whole topic is kept very secret !  The heath Dept. is very secretive about what they do .

        What I have seen is that they most often do NOTHING !

      A  FEW  lucky people get good service the rest of us are swept under the rug  >:(

                                                                                            Weasel

        P.s.  I am from Connecticut , where HIV & AIDS people have support and places to live in

        that are not dumps ! 

        Can't really say Missouri cares what you live in  >:(

       

   
" Live and let Live "

Offline Tim Horn

  • Member
  • Posts: 799
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #12 on: October 20, 2011, 08:03:45 PM »
Mikey...

I think some of the frustration with your comment is that you essentially painted Southern African Americans living with, and at risk for, HIV with an impossibly broad stroke. Yes, church-based homophobia likely does play a role... but your comment suggests it is the underlying cause.

Fact is, there is a litany of factors at play here. In all honesty, I think it has more to do with the fact that A) federal funding for state and regional non-government prevention, testing, entry/retention in care, treatment and support services continues to be doled out inefficiently and B) certain state governments do a lousy job of matching (or, perhaps more precisely, compensating for the lack of) federal funds to support their own departments of health, public clinics and regional ASOs that desperately need more money to address community HIV needs.

Again, I really don't think this is as clear-cut as your comment above seems to suggest. IMHO, the reason why we have a hard time reaching most at-risk "demographic" is because funding hasn't been directed at prevention, testing and treatment programs that have been shown to bring people into care, in the face of whatever powers prevent them from seeking awareness/testing/care in the first place.

As for situation in Texas -- I only included examples in my write up of the CDC paper -- Texas actually ranked tenth in terms of AIDS deaths, as a proportion of the general population, compared with the other 36 states included in the analysis. Texas was also ranked 12th in terms of the rate of deaths, as a proportion of the state population living with HIV, compared with other states. The actual rate of HIV-associated deaths in Texas was 23.5 per 100,000 person-years, whereas it's 14.7 per 100,000 person-years in New York. So, like several other Southern states, Texas has a relatively high HIV-associated mortality, regardless of which analysis you look at.

Tim



 
« Last Edit: October 20, 2011, 08:15:29 PM by Tim Horn »

Offline leatherman

  • Member
  • Posts: 6,053
  • Google and HIV meds are Your Friends
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #13 on: October 20, 2011, 08:24:37 PM »
your comment suggests it is the underlying cause. Fact is, there is a litany of factors at play here.
yes, I listed three things, and religion (underneath the umbrella of generalized anti-HIV and homophobic stigma) was only one part. I  listed poverty (which included access to services via funding and transportation) along with the basic denial of risk factors that plays out all over america - along with the extra stigma based upon the high amount of religious-bias in this area.

I'm not responsible for others who have chosen to ignore the totality of my statements; however I am frustrated that people would try to brush off the powerful negative influence of the religious bias againt HIV. The South isn't called the "bible belt" for nothing. To not give some acknowledgement to the large role of religious stigma is to just ignore why those numbers are higher in the south. In the end, the problem basically boils down to poverty and religion. If you believe I said religion was THE underlying cause then you clearly did NOT read reasons 1 and 3; nor did you pay attention to my explanations of simple transportation issues that affect so many (including myself!). I did think that I made anything out to be "clear cut" (since it isn't), as I even pointed out in my explanations the how some of the issues crossed one another.

and you are incorrect, in just the last few years funding has now been directed at "prevention, testing and treatment programs that have been shown to bring people into care". I have helped put together and attended several Black MSM HIV/AIDS conferences, and participated in many programs with local African-American churches that are finally bringing the needed message slowly but surely into that community - as they represent the majority of new (and rising) infection rates.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline james3000

  • Member
  • Posts: 140
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #14 on: October 20, 2011, 08:52:02 PM »
I agree with Leatherman that transportation is a huge issue ignored by those that live in cities. We do not all live in a city and we do not all have cars or transportation living hours away from ASO and clinic services. We don't get to pick and choose who treats us.
This is a major problem that is ignored by many who presume we can all just hail a Taxi to take us anywhere we want to go.
It is well known in the south that many think you can pray AIDS away (having lived there and had rows with people over this).
You need to read leatherman's post again you just did not understand it.

Offline Joe K

  • Global Moderator
  • Member
  • Posts: 3,493
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #15 on: October 20, 2011, 09:36:20 PM »
I agree with Leatherman that transportation is a huge issue ignored by those that live in cities. We do not all live in a city and we do not all have cars or transportation living hours away from ASO and clinic services. We don't get to pick and choose who treats us.
This is a major problem that is ignored by many who presume we can all just hail a Taxi to take us anywhere we want to go.
It is well known in the south that many think you can pray AIDS away (having lived there and had rows with people over this).
You need to read leatherman's post again you just did not understand it.

Transportation is a problem in every part of the country, as most people do not live in cities.  It's also a problem because of a lack of funding, not because it is an issue ignored by city folks.  The south is also hardly alone in having limits on treatment options or treatment facilities as many parts of the country are severely under-served.  I agree that religion probably has more of an impact in the south, but it is not limited to the south.  Many Baptist churches in Detroit were just as misguided and I'm sure there are thousands of such churches in America.

I would think the idea of this discussion would be to help identify "unique" challenges that geographic areas face and ways to address those challenges.  What I don't find helpful is anyone suggesting that just three options have such a sway in infection rates, when they are traits shared by numerous communities across the country.  It would seem there are other factors at play in these states that rank the lowest and identifying and addressing those issues is what is really required to lower infection rates.  Complicated issues rarely have simple answers, otherwise they would not be complicated.

Offline anniebc

  • Member
  • Posts: 5,937
  • AM member since 2003
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #16 on: October 20, 2011, 09:39:33 PM »

You need to read leatherman's post again you just did not understand it.

Are you friggin kidding me, do you seriously think Tim doesn't understand...in case you didn't bother to read up on the staff who keep this site going here's a little snippet for you:

Tim Horn

For more than 20 years, Tim has worked in the vast arena of HIV/AIDS, as a writer, editor, advocate, educator and research associate for organizations like Physicians' Research Network (PRN), the American Foundation for AIDS Research (amfAR), the AIDS Treatment Data Network, Memorial Sloan-Kettering Cancer Center, Mexico's Department of Health, the PWA Health Group and the AIDS Treatment Activist Coalition. He has also served on a number of government and non-government advisory committees.

Tim has been living with HIV for more than 20 years and is a survivor of non-Hodgkin's lymphoma.


Maybe you need to find out who it is you are talking to before you start talking down to them.

Leatheman helps out at his ASO office now and again and dishes out condoms...who would you put your faith in?

Jan.
-----------------------------------------------------------------------
Never knock on deaths door..ring the bell and run..he really hates that.

Offline james3000

  • Member
  • Posts: 140
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #17 on: October 20, 2011, 09:50:01 PM »
This is the same guy who is concerned about people posting on the off topic Forum and threatens to shut it down.
Take your blinkers off Annie we all have lived many years with HIV/Aids he is no more important than anyone else on this site.
I guess he can never be wrong  he has not had all experience all knowledge of all people. Times change and people can become stale in what they do.
I am not talking down to him at all your last statement is offensive and shows why fresh faces are needed asap.

Offline Tim Horn

  • Member
  • Posts: 799
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #18 on: October 20, 2011, 09:58:31 PM »
Hold up. This isn't about who we should have faith in -- there's really no single issue, nor is there a single answer... or even easy answers, as Joe points out.

Aside from a bit of sidetracking and sniping here and there, I think this has largely been an important dialog in which various observations and experiences are worth considering.

Lots can be written about why these numbers are the way they are. Why I think they're important is that they address interstate disparities... and given the ways in which public funds flow in this country... from feds to states and from states to programs, knowing where things clearly aren't working (and where they are) can go a very long way in remedying the problem.  

Offline leatherman

  • Member
  • Posts: 6,053
  • Google and HIV meds are Your Friends
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #19 on: October 20, 2011, 10:00:00 PM »
Leatheman helps out at his ASO office now and again and dishes out condoms...who would you put your faith in?
you, living on the other side of the globe, are sadly mistaken about my activism and advocacy activities here in SC.  ;) I attend and participate in putting together statewide conferences about HIV/AIDS related issues and I am an active member in the statewide HIV/AIDS Task Force. Yes, I spend a great amount of my time pounding the pavement, knocking on doors, and passing out condoms at health fairs because there aren't enough people willing to do the hard work, or for that matter any work, that's needed here in SC.

Rather than mouthing off about what you think I do and don't do, why don't you come help? We sure could use it - at least according to the death rate in that poz article, it sures looks like my state needs more help than others.

I agree that religion probably has more of an impact in the south, but it is not limited to the south.
so you're agreeing with me, that religion probably does have more of an impact here in the South? If you agree then who cares about churches in Detroit? What's that got to do with religion having more of an impact in the South? It either has a greater impact or not. you can't have it both ways.

I would think the idea of this discussion would be to help identify "unique" challenges that geographic areas face and ways to address those challenges.  ... Complicated issues rarely have simple answers, otherwise they would not be complicated.
I did identify some of the unique problems facing this geographic area, and everyone's getting all upset. Poverty and religion are two giant forces at work with the rising rates of HIV and HIV/AIDS deaths in the south - especially here in SC, center of the Bible Belt with Bob Jones university, and the moralistic Tea Party with Jim Demint.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Tim Horn

  • Member
  • Posts: 799
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #20 on: October 20, 2011, 10:01:51 PM »
This is the same guy who is concerned about people posting on the off topic Forum and threatens to shut it down.

And this weakens my argument how?

Offline leatherman

  • Member
  • Posts: 6,053
  • Google and HIV meds are Your Friends
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #21 on: October 20, 2011, 10:04:34 PM »
I think this has largely been an important dialog in which various observations and experiences are worth considering.
no, it has not been a good dialog at all.

I said stigma, denial and poverty are contributing factors in the situation, and a handful of other people - all of whom do NOT even live in the area - seem to be trying to say how those three reasons are not factors.  ::)
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline buginme2

  • Member
  • Posts: 2,834
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #22 on: October 20, 2011, 10:05:18 PM »
There is more to this story than just bad transportation and some nutcase holy rollers.

Florida is listed as a state with high HIV mortality yet its a state of many cities, good transportation, good healthcare (the univ of Miami was like the 3rd hospital in the country to treat HIV), has a lot of ASO's.  

I just don't think its a simple as saying "its the bible belt.". That seems rather elementary.

Offline leatherman

  • Member
  • Posts: 6,053
  • Google and HIV meds are Your Friends
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #23 on: October 20, 2011, 10:09:44 PM »
I just don't think its a simple as saying "its the bible belt.". That seems rather elementary.
doesn't poverty count for something?

or how about underfunding by the moralistic/religious Republican leaders in these states? that is why Florida has that huge ADAP waiting list. Because the religious right wing politicans refuse to properly fund services.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline james3000

  • Member
  • Posts: 140
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #24 on: October 20, 2011, 10:10:05 PM »
It weakens your argument because you ignored a fact it is called 'Culture' something that all this funding you talk about will have a hard time overcoming.
Culture where people on a forum felt free to express themselves but now you feel you have to censor for reasons yet unknown.
The word Culture weakens your argument for your lack of understanding it lets face who really does understand every culture ?

Offline james3000

  • Member
  • Posts: 140
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #25 on: October 20, 2011, 10:21:02 PM »
What Annie is telling me is that I should just agree with you because you run this website and in her opinion have more experience than anyone else on here ?
No need for real debate and different points of view. Ok I will Just acquiesce

Offline bocker3

  • Member
  • Posts: 3,358
  • You gotta enjoy life......
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #26 on: October 20, 2011, 10:26:37 PM »
It weakens your argument because you ignored a fact it is called 'Culture' something that all this funding you talk about will have a hard time overcoming.
Culture where people on a forum felt free to express themselves but now you feel you have to censor for reasons yet unknown.
The word Culture weakens your argument for your lack of understanding it lets face who really does understand every culture ?

Clearly you dont understand Culture -- you are showing a distinct lack of any, not to mention you are missing the "culture" of these forums.  Your red herring attack on Tim only shows that you haven't any real facts to stand on.

Now to all the others -- step back, re-read what everyone else has said with an open mind and realize that you all have truth in what you are saying.  It doesn't have to be an all or nothing.  I've not heard anyone say religion doesn't play a part (there may be disagreement on the amount it plays, but that might just be picking nits in the big scheme here) -- no has said poverty doesn't play a part, or transportation, etc.  
I find that these topics, that start out as "good dscussion" turns south when people read other posts as a slam on theirs or that it, somehow, negates your points.  Other than James' lunacy around the dead issue of Off topics, I haven't read anything that I don't agree with here.   Even if you do disagree with someone else's opinions, one doesn't need to be disagreeable.

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline leatherman

  • Member
  • Posts: 6,053
  • Google and HIV meds are Your Friends
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #27 on: October 20, 2011, 10:29:31 PM »
so if several of you do not believe that poverty, stigma and denial play important roles, then please put forth your reasons as to what has caused this disparity. (I never said my list contained the ONLY factors.) Or please provide us all some information specifically showing how poverty (transportation, access to services and meds), stigma (religious bias and influence), and denial do NOT contribute to this situation.

just saying not to listen to me, or trying to attack me personally for my activism, or saying that I sound like a phony doesn't do anything towards moving this conversation forward.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Tim Horn

  • Member
  • Posts: 799
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #28 on: October 20, 2011, 10:36:38 PM »
Mkey...

Listen, I don't think anyone here has said that poverty, stigma or denial don't play roles -- let alone MAJOR roles -- in the disparities. I think where things were misinterpreted, including by me, is that you referenced the burgeoning epidemic among African Americans in the last paragraph of your note above and followed it only with a reference to homophobia and the church. It's now clear that you're talking about a variety of issues, all of which have been clearly shown to play roles... along with other issues presented here.

Tim

Offline Joe K

  • Global Moderator
  • Member
  • Posts: 3,493
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #29 on: October 20, 2011, 10:45:55 PM »
I thought my point was very clear.  I agree that poverty, stigma/denial and religion play important roles in the numbers for S. Carolina, but they are not the only factors.  I said that since poverty and religion also play roles in other communities, there must be other "unique" factors that cause certain states to have such rankings.  I think the difficulty comes from using terms like "poverty" and "religion" which are very broad in scope.

My guess would be that certain states have a "culture" that influences how the state responds to crisis and that probably some crisis are more important than others.  I also think that how the state views the role of government may have a huge impact in how they finance or even offer certain services.  Add to that a lot of heartless politicians and you have the beginning of a real problem.

What strikes me as very interesting is that California is included in the lowest rankings, so that suggests to me that there are a lot of unidentified issues impacting infection rates.  Also I lived in Florida and they don't have any mass transit, so transportation is a real issue, along with limited treatment facilities.

Offline james3000

  • Member
  • Posts: 140
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #30 on: October 20, 2011, 10:48:47 PM »
Bocker gets his little digs in, then ends  with Even if you do disagree with someone Else's opinions you don't have to be disagreeable.
You get to attack ME then end with that sentence wow.
My original comment when I saw Leatherman attacked with no reason whatsover stands.
You sound like a high school teacher berating the naughty student for speaking.

Offline Joe K

  • Global Moderator
  • Member
  • Posts: 3,493
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #31 on: October 20, 2011, 10:56:43 PM »
Bocker gets his little digs in, then ends  with Even if you do disagree with someone Else's opinions you don't have to be disagreeable.
You get to attack ME then end with that sentence wow.
My original comment when I saw Leatherman attacked with no reason whatsover stands.
You sound like a high school teacher berating the naughty student for speaking.

Just because we may disagree does not mean we are attacking anyone.  Bockers' suggestion is very sound, keep your eye on the point of the discussion and stop looking for ways to go after others.  Most responses did not attack Leatherman and for those that did, well he is an adult and he can look after himself.  You contribute to this atmosphere of rancor when you end your post with a dig at Bocker.  Can't we all pretend to be adults?

edited for clarity of members
« Last Edit: October 20, 2011, 11:03:07 PM by killfoile »

Offline phildinftlaudy

  • Member
  • Posts: 2,959
  • sweet Ann what you think babe...
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #32 on: October 20, 2011, 10:59:57 PM »
Reading the article and findings, one thing stands out clearly - a "cookie cutter" approach to prevention and treatment does not and will not work.  Every geographic area has its own reasons that contribute to health disparities.  I believe the article speaks of examining not just geographic areas but also individuals.

There are a host of factors that contribute to higher death rates in the southern states compared to northern states -
1) poverty - but not in all areas of the south
2) stigma - but not in all areas of the south
3) religious beliefs - but not in all areas of the south
4) transportation - but not in all areas of the south
5) access to care - but not in all areas of the south
6) access to private, employer sponsored insurance - but not in all areas of the south
7) prevalence of HIV prevention/treatment messages - but not in all areas of the south
8) access to a continuum of care - but not in all areas of the south...
etc, etc, etc.

As a grant writer, one of the primary elements of every proposal I write - and usually the first section of every grant is a "Statement of Need."  Statement of need might focus on age, race, ethnicity, income, range of services, modernization of technology of lack of, education level, transportation, actual geography, employment, household size, attitudes, beliefs, perceptions... blah, blah, blah ---

Depending on the need identified, project design is developed, as is reach, range, and scope, budget, personnel, evaluation, etc.

What may make up disparity factors in Tallahassee, Florida may not be what makes up disparity factors in Miami.  Oh, and what makes up disparity factors in downtown Miami may not be what causes disparity in North Miami...

There is not going to be one correct answer - nor should there be.  It is up to each community (whether community be defined as a region, state, county, city, neighborhood, or family) to determine what factors are at work that are leading to the disparities - it is only then that appropriate prevention and treatment can be delivered.

Oh, and I have always been taught - and I have been taught by the best - to give a lot of weight to someone's background, education, experience, credentials, and actions when deciding whether their opinion or statements have value and are likely to have a high degree of validity and reliability.  

I'm not going to listen as intently to the neighborhood landscaper tell me what may be leading to disparities in HIV-related death rates between southern and northern states - but I will give a strong listening ear to someone who has a proven and long-track record of being educated on HIV prevention, treatment and research; someone who has been involved in HIV action, activity and policy at local, state, national, and (I would bet) international levels; and someone who is not only living with HIV, but decided to put somethings (actually many things) into action to improve the lives of people with HIV and to make sure our voices are heard - not just by each other, but by policy makers and others.

September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline wolfter

  • Member
  • Posts: 4,365
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #33 on: October 21, 2011, 05:48:13 AM »
No wonder our leaders have a difficult time dealing with HIV/AIDS.  We as a community, who have a vested interest, can't discuss the issues without rancor.  It follows that those who have no interest would be less inclined to delve into an issue that doesn't appear to have a general consensus.  

Or could it be that sometimes, personalities trump principles on these forums?

Wolfie
« Last Edit: October 21, 2011, 07:14:10 AM by wolfter »
productivity breeds content

Offline Cliff

  • Member
  • Posts: 2,645
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #34 on: October 21, 2011, 06:50:45 AM »
of course, living in the UK, you have no fucking idea of what living in South Carolina is like. Why don't you google up "southern black churches homohphobia" or read some of the reports issued from the SC health dpt before you spout off like an idiot.
There are a whole host of socioeconomic issues leading to an alarming high HIV incidence in the community, that you just (unfairly, I might add) condensed to it simply being a problem of homophobic churches and blacks blaming the "white man" for HIV. I'm surprised you didn't add "low down" and "how Stella got her groove back" to your analysis for good measure.  That you felt the need to reference where I live (as if that mattered) illustrates your ignorance.

Perhaps it's best you stick to sipping pina coladas on the side of your mom's pool.

Offline leatherman

  • Member
  • Posts: 6,053
  • Google and HIV meds are Your Friends
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #35 on: October 21, 2011, 07:08:56 AM »
Every geographic area has its own reasons that contribute to health disparities.  I believe the article speaks of examining not just geographic areas but also individuals.
exactly.

when the question was first posed by the OP, I simply listed some of the reasons why there are disparities. I never claimed that they were ALL the reasons or that they effected ALL the individuals - only that they were some of the reasons.

In my area (very rural, by the state line), transportation is the #1 issue (because my car is a serious problem), while stigma is just a minor issue problem (because my neighbors all live too far apart and I attend no church), along with access (because of my medicare/medicaid)

Twelve miles down the highway, in Rock Hill where the ASO is, in a city without cabs or buses, transportation is still a problem. Access is a problem because the very poor still have aid, yet some of the working poor have hurdles to gaining access. Not too mention that there is only one ID doctor available only 2 days of the week in this 3 county area. Community stigma and religious bias (from both white and black churches) are a problem however, making many people loathe to even enter the front door.

Fifty miles down the highway in Chester, a small close-knit community, transportation, stigma, and religious bias are huge issues along with the lack of any targeted prevention/education message

Yet more than a hundred miles down the highway in Columbia, transportation is no longer a problem; but access for the working poor, stigma, and religious bias are still major problems


Oh, and I have always been taught - and I have been taught by the best - to give a lot of weight to someone's background, education, experience, credentials, and actions when deciding whether their opinion or statements have value and are likely to have a high degree of validity and reliability. 

I'm not going to listen as intently to the neighborhood landscaper tell me what may be leading to disparities in HIV-related death rates between southern and northern states - but I will give a strong listening ear to someone who has a proven and long-track record of being educated on HIV prevention, treatment and research; someone who has been involved in HIV action, activity and policy at local, state, national, and (I would bet) international levels; and someone who is not only living with HIV, but decided to put somethings (actually many things) into action to improve the lives of people with HIV and to make sure our voices are heard - not just by each other, but by policy makers and others.
unlike others here who often disparge the statements of others out of personal animosity, I believe everyone can lend appropriate input into these forums. I don't believe it takes a list of credentials for someone to be able to contribute to what should be an open discussion, because everyone should have the opportunity to discuss their valid experiences. As has been pointed out, situations vary from individual to indivual. Too often we see someone make comments about what applies in their situation to only have others try to refute those comments as if that person's experiences were on no consequence.

the reasons I listed of poverty, denial, and stigma are completely valid reasons to answer was the OP posted, as several of you have gone on to give agreement to those issues. Some here had no right to dispute those reasons that are very valid from my point of view, my experiences, and for my geographic area.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline leatherman

  • Member
  • Posts: 6,053
  • Google and HIV meds are Your Friends
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #36 on: October 21, 2011, 07:22:05 AM »
There are a whole host of socioeconomic issues leading to an alarming high HIV incidence in the community, that you just (unfairly, I might add) condensed to it simply being a problem of homophobic churches and blacks blaming the "white man" for HIV.
like Tim did at first, you obviously choose to ignore the larger preceding paragraph describing the transportation problems, or all the words preceding that discussing the 3 reasons I laid out. Obviously racially motivated, you stuck to the one, might I add REAL problem in my geographic area, and decried in a rather hateful manner that I was incorrect to mention that real problem.

That you felt the need to reference where I live (as if that mattered) illustrates your ignorance.
of course geographic area matters. we are talking about the South. An area where I live and which I experience everyday - an area that you no longer live in and therefore have less current experience with. Your experiences are obviously not the same as mine; but my experiences are just as equally valid as yours. I don't know why your would want to disparge my experiences - all that does is ignore the very real problems in my area of the South. I'm sure that there are other problems where you used to live in the South and I would never berate you for discussing those problems. I would want to discuss ways to solve those problems too.

Perhaps it's best you stick to sipping pina coladas on the side of your mom's pool.
your personal animosity about my lifestyle obviously influences some strange bias you have against me, and I can't help you with that.  I would point out that whatever lifestyle I'm living (poverty and the dead of my partners has forced me to move in with my mother into a very rural area where, as a person on disability because of the AIDS, my big "fun" is a cheap above ground swimming pool. I drink very little alcohol but I am too poor to afford it.), my lifestyle does not invalidate my very real experiences and opinions about what is happening in my area.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Tim Horn

  • Member
  • Posts: 799
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #37 on: October 21, 2011, 07:40:21 AM »
like Tim did at first, you obviously choose to ignore the larger preceding paragraph describing the transportation problems, or all the words preceding that discussing the 3 reasons I laid out.

And there we go. Mikey, you just as easily could have accepted some responsibility here -- perhaps the suggestion that you could have worded things a bit more carefully so that it didn't sound as if there was a singular issue associated with the burgeoning epidemic among African Americans in the rural south. But here, its about readers "obviously choos[ing] to ignore" your overall thought process. This rather disingenuous dig doesn't really help matters.

Edited to add: If you had prefaced your overall argument with the stat you cited, rather than ended your note with it (and the example of homophobia in Southern churches), this may have played out differently.  
« Last Edit: October 21, 2011, 07:46:21 AM by Tim Horn »

Offline leatherman

  • Member
  • Posts: 6,053
  • Google and HIV meds are Your Friends
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #38 on: October 21, 2011, 07:50:43 AM »
Edited to add: If you had prefaced your overall argument with the stat you cited, rather than ended your note with it (and the example of homophobia in Southern churches), this may have played out differently.  
so because of the order in which I presented 3 (ie THREE, not one!) real problems, it's my fault?!? what a hoot! ::)

I accept the responsiblity of discussing 3 real issues that impact the disparity of health care for people in the South with HIV: stigma ie sexual/racial/religious bias, poverty (transportation and access), and denial of risk factors.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline james3000

  • Member
  • Posts: 140
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #39 on: October 21, 2011, 08:04:18 AM »
In my opinion Leatherman is right
He puts into words what I would like to say.

Admin should make it clear that anyone without a degree is not welcome to post.
I listen to peoples stories hey you just need two ears for that.
The reason for my posts are that I am against this rampant belief that only the few have the answers and should not be questioned . Everyone has things to say that are valid or not I have read these forums for years so was ready for the old boys club mentality have seen it many times on here.

Offline Dachshund

  • Member
  • Posts: 5,941
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #40 on: October 21, 2011, 08:10:11 AM »
In my opinion Leatherman is right
He puts into words what I would like to say.

Admin should make it clear that anyone without a degree is not welcome to post.
I listen to peoples stories hey you just need two ears for that.
The reason for my posts are that I am against this rampant belief that only the few have the answers and should not be questioned . Everyone has things to say that are valid or not I have read these forums for years so was ready for the old boys club mentality have seen it many times on here.


Leather couldn't have said it better if he had written it himself.

Offline james3000

  • Member
  • Posts: 140
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #41 on: October 21, 2011, 08:17:15 AM »
God you're dense.

Offline Dachshund

  • Member
  • Posts: 5,941
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #42 on: October 21, 2011, 08:26:36 AM »
God you're dense.

Ain't it the truth. Let me lay it out for you James. If anyone ever disagrees with leather he plays the victim card (or in this case, you do). If you have been around as long as you say you have you would understand why people raise an eyebrow whenever leather discusses race. 

Offline james3000

  • Member
  • Posts: 140
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #43 on: October 21, 2011, 08:52:07 AM »
I do not have a 25 year degree on the comments of Leatherman thus cannot comment on that however I did agree with some of his points not all but most.
To often we become statistics and numbers lines on a chart going up and down. Some of those making them have never met any  PLHA perhaps if they heard some of the human stories it would help to find a solution to these complex problems.

Offline Theyer

  • Member
  • Posts: 2,471
  • Current ambition. Walk the Dog .
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #44 on: October 21, 2011, 02:13:12 PM »
I think Tim,s point about looking at what works, is important. All too often the focus immediately goes to what is failing,is there anything in the best 10 states that is absent or rare in the worst 10 states ?

The amount off difference is huge, I would like to hear what the people in positions off power say about there states position.
t


ed //  Well I have just read that Mr. Barbour Gov.off Mississippi does not intend to apply for Federal money for his State,reason being not wanting to establish a system that would support people with HIV as much as Massachusetts.This is from a blog called   " The Bilerico Project "
Deliberate non-funding.Could there be a case for Manslaughter? I really do not get it .
« Last Edit: October 21, 2011, 02:50:54 PM by Theyer »
"If we can find the money to kill people, we can find the money to help people ."  Tony Benn

Offline Growler

  • Member
  • Posts: 559
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #45 on: October 21, 2011, 06:10:57 PM »
Since this thread began 29 hours ago, 5,958 people world wide have died from AIDS.

Growler (who thinks everyone should pull out their dicks and whoever has biggest one will be deemed the winner)
“If loving someone is putting them in a straitjacket and kicking them down a flight of stairs, then yes, I have loved a few people.”

Offline tednlou2

  • Member
  • Posts: 4,760
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #46 on: October 22, 2011, 12:42:42 AM »
Why do things have to always get so tedious here?  If folks disagreed with what Mikey said, they could have said, "I disagree and here's why."  Or, "You make some good points, but things are more complex than that, and here's why."  But, there was an immediate jab at Mikey accusing him of Googling some facts and trying to be an expert and being dense.  Was that really necessary?  One could easily post their beliefs and data without making it personal.   

So, many threads end up turning into personality fights and the main points end up lost.  Oh, and then they get shut down.  What was this thread about again? 

Offline Joe K

  • Global Moderator
  • Member
  • Posts: 3,493
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #47 on: October 22, 2011, 12:53:43 AM »
Why do things have to always get so tedious here?  If folks disagreed with what Mikey said, they could have said, "I disagree and here's why."  Or, "You make some good points, but things are more complex than that, and here's why."  But, there was an immediate jab at Mikey accusing him of Googling some facts and trying to be an expert and being dense.  Was that really necessary?  One could easily post their beliefs and data without making it personal.    

So, many threads end up turning into personality fights and the main points end up lost.  Oh, and then they get shut down.  What was this thread about again?  

I don't agree that many threads turn into personality fights, but what are you attempting to do, by restarting something that already stopped?  Maybe, if folks just offered their thoughts on the thread and ignored the bad behavior, there may be less of it.  But when the only thing you can do is complain about the tone of a thread, then you become part of the problem.

Offline james3000

  • Member
  • Posts: 140
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #48 on: October 22, 2011, 09:34:42 AM »
It is clever what you are doing Killfoile throwing out personal snarky comments about people and telling them off when they respond . lol

Offline skeebo1969

  • Member
  • Posts: 5,699
Re: Death rates up to twice as high in southern U.S. states as northern states
« Reply #49 on: October 22, 2011, 10:04:32 AM »
It is clever what you are doing Killfoile throwing out personal snarky comments about people and telling them off when they respond . lol

Pot calls kettle black?  And, I fully disagree, Joe's been one of the more even voices in this thread, along with Tim's.

Anyways, Mikey had two people disagree with his take.  It was he who decided to throw words around like "several"...  He was the one who felt "everyone" was disagreeing with him, when in actuality this simply was not the case.  Even when others showed agreement to his spin on it he couldn't see it because he was so into making this about himself.

It became a pissing match of sorts for him....  and I commend the ones who participated and never unzipped.
I despise the song Love is in the Air, you should too.

 


Terms of Membership for these forums
 

© 2014 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.