Photo caption: Guests attends World AIDS Day 2022: Reading of the Names of those lost to HIV/AIDS at NYC AIDS Memorial on Dec. 1, 2022 in New York City. (Chance Yeh | Getty Images for Housing Works)

By: A. TONI YOUNG – DECEMBER 1, 2023 5:59 AM

For the past 35 years, Dec. 1 has been recognized as World AIDS Day and serves as a reminder of our collective action to end the stigma around HIV and honors the lives we’ve lost over decades of struggle. As World AIDS Day is recognized across the globe, I urge communities across Appalachia to recognize that they too have a place in this conversation.

HIV transmission is on the rise across much of the Appalachian region, and it’s because of its intersection with substance use and viral hepatitis. At Community Education Group (CEG), where I serve as its executive director, we call this intersection the “syndemic.”

Over the last 10 years, CEG has coordinated with community groups across the region to address the growing syndemic, and we’ve been really heartened by the progress we’ve seen. We’ve built relationships with resource providers and local anchor institutions to help increase testing and treatment for individuals living with HIV, and we’ve been able to educate community members on what their options are. More than that, we’ve been able to train community health workers (CHWs) specifically around the syndemic so they can create lasting continuums of care within their own communities–work that, by itself and in the bigger picture creates sustainable economic impact in addition to positively affecting health outcomes.

Even though this work transforms communities, the syndemic is bigger than what our team and community partners, and even our county and state-level institutions, can do. To win the fight against the syndemic, and to build off of all the work that’s been done to mitigate the AIDS epidemic the last 35 years, we need policy changes on the federal level and collaborations between local, state, and national agencies.

Earlier this fall, local public health and community leaders welcomed the delegation from the 78th Presidential Advisory Council on HIV/AIDS (PACHA) to Charleston to discuss HIV in Appalachia and shine a light on interagency perspectives and community initiatives to address HIV.

I can’t underscore enough how important it was that PACHA was in our region, discussing the syndemic and hearing perspectives from state and county governments, researchers from West Virginia University, free and charitable clinics, and community health groups. This type of interagency and agency-community-practitioner collaborations have the potential to transform the way we address the syndemic. Our hope, too, is that this type of collaboration opens the door for federal level policy change that will allow the Appalachian region to use resources in multi-state initiatives, as opposed to the silos they currently exist in.

While the visit was a success, we were reminded that there are still significant political obstacles to tackling HIV in our region. Opioid settlement dollars provide great promise and potential for new funding streams to combat infectious disease, but we have no guarantee the newly appointed foundation board will prioritize these kinds of efforts. And I’m not going to get off my soapbox about the need for MAT providers to engage in HIV treatment, PrEP, and hepatitis C screening. But regardless of the challenges, I’ve never been more committed or inspired to keep up on efforts to tackle HIV, and end this epidemic once and for all.

When it comes to fighting the syndemic in Appalachia, we need to think bigger and have bigger conversations. CEG is just one part of the picture, and we are looking forward to PACHA’s continued recognition of HIV in Appalachia, and the partnership of agencies like the Appalachian Regional Commission, and our local partners on the ground across West Virginia.

But don’t forget that this work succeeds when dedicated people like you get involved too. So, on this World AIDS Day, I urge you all to get tested, resist HIV-related stigma, and connect with the organizations in your community that advocate for big policy changes that can mitigate–and possibly, end–HIV in Appalachia.

Together, we are Appalachia, and there’s no challenge we can’t tackle.

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