Geography partly responsible for HIV infection among unaware women.

Masonia Traylor curled up in the corner of her patient room, repeatedly crying out, "No." At 23, she received an unexpected HIV diagnosis. Now 38 and from Decatur, Georgia, Traylor had always been proactive about her health, regularly visiting her OBGYN and getting tested for HIV to set a good example for her loved ones.

Her perspective shifted after hearing a Black woman share her near-death experience from HIV at a school assembly years ago. The story emphasized that HIV is not limited to gay or bisexual men. Traylor recalls thinking, "You cant tell that girl got it. She looks so healthy and vibrant."

Despite advancements in HIV treatment and preventionallowing people to live long, healthy lives with undetectable viral loadstens of thousands of new cases are diagnosed in the U.S. each year, with certain regions and populations disproportionately affected. One group frequently overlooked in discussions about HIV is Black women, especially those living in the Southern United States.

"You feel isolated, alone, like nobody else will understand," Traylor says about living with HIV. AIDSVu, an interactive mapping tool from Emory Universitys Rollins School of Public Health and Gilead Sciences, notes that gender-based power dynamics, economic vulnerability, and limited access to prevention resources create a high-risk environment for HIV in this population. Gilead produces PrEP medications such as Truvada and Descovy, which can cost tens of thousands out-of-pocket. In 2025, the FDA approved the companys twice-yearly injectable HIV prevention drug, lenacapavir (Yeztugo).

In 2023, the U.S. reported over 39,000 new HIV cases among people aged 13 and older; 81% were men, 38% were Black, and 51% lived in the South. Black women represented half of HIV diagnoses among women, though they comprise only 13% of the female population. While these numbers are lower than the epidemics peak in the mid-1980s, the overall case count remains significant. Funding cuts to HIV prevention programs exacerbate the challenge.

"Were at an interesting inflection point," says Athena Cross, vice president at AIDS United. "Progress against the HIV epidemic is at risk due to current public health infrastructure challenges."

New Prevention Developments

Men who have sex with men remain the primary group associated with HIV historically and in the present, often leading in PrEP use. PrEP usage increased 17% from 2023 to 2024, but Black individuals represented only 12% of users, the South 39%, and women just 9%.

"Im a walking red flag when it comes to HIV risk," says Tori Cooper, a Black woman living in the South and director of community engagement at the Human Rights Campaign. She notes that HIV stigma persists among both patients and providers, highlighting the importance of supportive, judgment-free networks.

Traylor went public with her status after struggling to find groups that could provide understanding and support. She recalls a former classmates death from HIV as a motivating factor. "Sharing my status sooner might have helped him," she says, underscoring the isolation many feel.

Regional Disparities

The Southern U.S. bears a disproportionate burden of HIV. In 2023, the region accounted for over half of new HIV diagnoses and 56% of deaths, despite making up roughly one-third of the population. Limited education, stigma, fewer healthcare providers, and anti-LGBTQ+ attitudes contribute to ongoing challenges.

"HIV impacts some of the most vulnerable communities disproportionately," says Rashad Burgess, vice president at Gilead Sciences. Social and sexual networks, along with gaps in reliable information about HIV and sexual health, make the virus more prevalent among Black communities in the South.

Fighting Stigma and Supporting Women

Efforts to reduce stigma include programs like AIDS United's Melanated Movement, which empowers young women on HBCU campuses to lead educational initiatives. SisterLove, a longstanding southeastern U.S. nonprofit, provides support for women living with HIV, sexual health, and reproductive justice issues.

Traylor, now CEO of Lady BurgAndy Inc., helps women and young people affected by HIV/AIDS, emphasizing that living with HIV can coincide with thriving, healthy lives. "The key is open discussion and making clear that an HIV diagnosis is not a death sentence with proper care," she says.

This story highlights ongoing challenges and the need for awareness, prevention, and support for Black women living with HIV in the South.

Author's Opinion: Addressing the Unseen HIV Crisis Among Black Women in the South

The recent report on Masonia Traylor’s experience with HIV underscores a critical, yet often overlooked, public health issue in the United States. While medical advancements in HIV treatment and prevention continue to evolve, the disparities in diagnosis and care, particularly for Black women in the South, remain deeply concerning. This narrative highlights the struggles faced by a vulnerable population that is too frequently ignored in larger HIV discussions.

The data presented shows that despite a decline in new diagnoses overall, Black women still represent half of HIV diagnoses among women, a staggering statistic considering they make up only 13% of the female population. In particular, the Southern U.S. is disproportionately affected, contributing over half of the nation’s new cases. These regional disparities are compounded by factors such as stigma, lack of access to prevention resources, and limited healthcare infrastructure. For many, these challenges are more than just statistics; they are a daily reality that affects their health, relationships, and social standing.

What stands out in Traylor’s story is the intersection of personal awareness, systemic gaps, and social stigma. Despite her proactive health habits, her diagnosis reflects a larger issue: limited education, economic vulnerability, and lack of access to necessary healthcare resources are exacerbating the HIV crisis in marginalized communities. This is not just an issue of health; it is also one of social equity and justice.

Moreover, the story of Traylor and others like her should serve as a reminder that HIV is not confined to a particular demographic or geographic area. The narrative needs to shift toward a more inclusive and comprehensive understanding of HIV prevention, especially for Black women in the South, who continue to be disproportionately affected by the disease. We must advocate for expanded access to prevention programs like PrEP, encourage open discussions about sexual health, and eliminate the stigma surrounding HIV diagnosis.

In conclusion, while progress is being made in HIV treatment and prevention, there is still much work to be done to ensure that Black women and other high-risk populations are not left behind. This issue demands continued focus, funding, and action from both the public health community and society as a whole. The fight against HIV is far from over, and it is crucial that we approach it with the urgency and empathy it deserves.

Sources:

• An unsuspecting group of women are getting HIV. Geography is in part to blame.