HIV continues to disproportionately affect Black men in the American South, despite the availability of highly effective prevention tools. In 2023, the South accounted for more than half of all new HIV diagnoses nationwide. Among the most impacted are Black men who have sex with men—yet fewer than one in five eligible individuals in cities like Jackson and Memphis are taking PrEP, a medication that reduces HIV transmission risk by over 99%.
This disparity is not due to lack of access. Interviews with patients and providers revealed that stigma, mistrust, and cultural silence around sexuality are the real barriers. “If you’re gay, you’re either ignored or silently judged,” said one participant from Jackson, describing the tension between religious teachings and identity. Many grew up without any education about gay sex or HIV, leaving them vulnerable to misinformation and fear.
The health care system itself is often viewed with suspicion. Black men described rushed appointments, judgmental attitudes, and fears of being outed through insurance. “It’s hard to find affirming care for people in the queer community,” said a Memphis-based provider.
Despite these challenges, peer networks are stepping in where institutions fall short. Friends and community members are often the most trusted sources of information. “I trust my friends more than those ads,” one man said.
To close the racial gap in HIV prevention, public health must go beyond access and address the cultural and systemic forces that continue to leave Black men behind.
See: “HIV rates are highest in the American South, despite effective treatments – a clash between culture and public health” (October 16, 2025)
