"A Hotbed for HIV and AIDS." The Duo of Funders Meeting LGBT Needs in the South

Did you know that a third of LGBT Americans live in the South? Or that this region is home to 44 percent of the nation’s HIV population? These statistics are especially notable considering that LGBT funders have historically directed their grant dollars to other parts of the U.S., shortchanging the South.

The good news is that there are signs that this trend is changing—with LGBT funding to the South climbing 52 percent between 2014 and 2015, according to a recent report by Funders for LGBT Issues. Among other things, community foundations in the South and Southeast have been stepping things up in terms of LGBT grantmaking.


Two national funders keeping a keen eye on the South these days are the Elton John AIDS Foundation (EJAF) and the Elizabeth Taylor AIDS Foundation (ETAF), which have been working collaboratively to support HIV/AIDS and LGBT organizations in the region. Most recently, the two foundations announced nearly a half-million dollars in grants to nine organizations in Georgia, Tennessee, Alabama, South Carolina and Florida to support their efforts to advance LGBT rights and thwart the spread of HIV/AIDS.

New grantees of the EJAF/ETAF partnership are the Jacksonville Area Sexual Minority Youth Network (JASMYN), the Red Door Foundation, the South Carolina HIV/AIDS Council, Birmingham AIDS Outreach, the Equality Foundation of Georgia, the Memphis Gay and Lesbian Community Center, the Racial Justice Action Center, the Coastal Bend Wellness Foundation, and SPARK Reproductive Justice NOW!

To learn more about how these new grants are developing spaces for LGBT people to find safety, receive HIV-related services and counseling, and get LGBT youth involved as advocates for their communities, I connected with EJAF Executive Director Scott Campbell and ETAF Managing Director Joel Goldman to ask a few questions. With federal government support for health and HIV/AIDs now at risk, it’s more important than ever for private funders to take action on these issues and in this region.  

To start off, I asked EJAF’s Scott Campbell and ETAF’s Joel Goldman why the American South is such an important region for LGBT funders to focus on right now. Campbell explained the various factors and urgency of the situation:

LGBTQ funders, and really any funders concerned about healthcare and human rights in general, should focus on the American South for a variety of reasons. The South has the lowest rates of private health insurance coverage, the lowest Medicaid eligibility levels, and the lowest rates of successful HIV treatment and viral suppression, driven by delayed entry into healthcare and poor sustained care of people after they start HIV treatment. Rates of HIV among young people, especially LGBTQ youth, are consistently higher in the South than anywhere else in the U.S.
Furthermore, bad laws and policies in the Southern states push people away from healthcare when access to care is the main pathway to ending the HIV epidemic. For example, we know that syringe access programs help prevent injection-related HIV infections, and yet these programs are limited to only a handful of Southern cities, when it should exist in at least 30 urban areas. Additionally, the Southern U.S. has the largest number of HIV-positive people in prisons and jails, but also the most minimal and restrictive health programs for inmates and ex-offenders. The region also has the highest rates of HIV-related illnesses due to improper treatment and healthcare in correctional systems. 
The South continues to have systemic problems with social and economic inclusion. Demographics research shows that the 6 million black Americans living in poor rural Southern counties have the lowest rates of high school completion, less access to college education and jobs, the highest rates of unemployment and poverty, and worse health statistics for conditions like asthma, diabetes and high blood pressure. All these factors participate in the spread of the disease and black Americans, especially in poor urban neighborhoods and in the rural South, face higher rates of HIV infection than any other racial, ethnic, or national group in the U.S.
So it should come as no surprise that young black gay men in the South are the hardest hit by the disease, which is driven in part by lack of appropriate healthcare and high rates of unemployment and incarceration. According to the Centers for Disease Control and Prevention, approximately 350,000 gay and bisexual men and trans people have gotten a positive HIV test but aren't in regular medical care. That cuts across all age groups and racial/ethnic groups but is particularly severe among young black men in the South and among trans people everywhere.

Goldman added the following explanation to further the discussion:

The U.S. South is a hotbed for HIV and AIDS. The major contributing factors to this include the denial by many Southern governors to expand Medicaid—the single largest source of health coverage for people living with HIV in our country. You’ve also got the states in the Bible Belt providing abstinence-only based "sexual health education." Mix these factors with cultural stigma for these communities and the region becomes an incubator for the spread of this disease. Because of this perfect storm of societal ills, private funding becomes critical to curbing the epidemic.

Overall, both of these foundations share a commitment to addressing the AIDS epidemic where resources are most needed. It certainly didn’t hurt that their founders were great friends, so working together felt natural. They both agreed that the South has been one of the hardest-hit regions in the country, and started conversations to develop a joint grantmaking initiative focused on HIV/AIDS programs in the Southern U.S.

Of note, five of the nine new grantees are returning grantees that received EJAF/ETAF’s support last year, too. Thus far, these funders have focused on larger cities in the South over the more rural areas. There’s been a push lately to help LGBT youth, black and Latino men, and HIV patients in Southern cities.

Another question that I asked the two directors was if HIV/AIDS is a more urgent or unmet need in Southern LGBT communities when compared to other LGBT issues like youth development, senior care, mental health, or legal advocacy.

“At EJAF, we firmly believe that you have to look at the HIV/AIDS epidemic within the context of the larger social, political, and economic issues that create barriers to healthcare and continue to drive further spread of HIV,” Campbell replied. “So it isn’t a matter of HIV/AIDS being more urgent—all of these issues are urgent, because failing to address them contributes to the continuing spread of the virus.”

Goldman agreed about the interconnectedness between HIV/AIDS and the other social issues that burden the LGBTQ community. This is because HIV/AIDS is a uniquely stigmatized disease that disproportionately affects LGBT individuals, African Americans, the poor, drug users and sex workers. All of the layers at work here make HIV not just a health issues, but also a social justice issue.

On that note, Goldman added:

It can be difficult to chip away and get to the root of why this epidemic has been so hard to beat. People living with HIV often face mental health issues because of this "double stigma" that comes with a positive diagnosis. People living with HIV also come into contact with the criminal justice system, not because of crimes they commit, but solely because of their status due to laws that exist that criminalize HIV. One is not more urgent than the other; it’s about getting to the root of all of these issues. This is what we hope to support by funding the organizations we did.

To wrap up our conversation, I asked Campbell and Goldman what advice they would offer to other foundations that are interested in getting educated on local LGBT needs and getting involved with local LGBT nonprofits.

Campbell stressed that the best way is to meet directly with local LGBT groups, activists and community leaders to talk about their concerns and issues. “Perhaps the biggest problem is lack of transportation to obtain healthcare services,” he suggested. “Perhaps they need help educating local political and civic leaders or law enforcement. Perhaps local healthcare workers need to be better educated about working with LGBTQ patients and families. The only way to find out is to ask!”

Goldman reiterated that every community is different and has its own challenges and strengths, so there’s no one "right" way to get involved. “The best thing you can do is get out and talk to people in your community, attend events, and speak to local advocates and activists,” he said. “There may not be many, depending on how rural the area, but I guarantee they’re there.”

Related: Fighting Without Funders: How LGBT Money Skips the South