Why are HIV rates among women in the South higher than in other regions—and what can be done to address this health disparity? The National Institutes of Health (NIH) awarded researchers at the University of Alabama at Birmingham (UAB) a combined $19.5 million in federal grants to investigate these very questions, according to a UAB press release.

Although 38% of the U.S. population lives in the South, the region accounts for 53% of new HIV cases and 47% of all deaths among people with HIV, according to the Centers for Disease Control and Prevention. Specifically, it’s estimated that 18,500 of the 34,800 new HIV diagnoses in 2019 were in the South. What’s more, about 55% of women diagnosed with HIV in the United States live in the South, according to AIDSVu. (For more statistics about the region, see the POZ write-up on Southern HIV/AIDS Awareness Day, which is marked each August 20.)

The NIH grants will fund two studies focusing on the ways behavioral, geographic and demographic factors relate to HIV rates among women in the South, according to a UAB news release.

The bulk of the funding—$15 million—will go to the AWARE project, which is led by researchers at UAB, the Columbia School of Nursing in New York City and Lurie Children’s Hospital in Chicago.

The AWARE Project will enroll a national digital cohort of 1,800 women who are HIV negative to study how various factors impact the risk of acquiring HIV as well as other sexually transmitted infections (STIs).

“Looking at factors beyond individual-level factors, which have failed to understand women’s vulnerabilities to HIV acquisition, will have the potential to build a knowledge base that will help us in the development of effective prevention programs for women in the future,” said Mirjam-Colette Kempf, PhD, professor in the UAB School of Nursing and co–principal investigator on the AWARE project, in the release.

The second study, the Camellia Project, will receive $4.5 million and be co-led by Latesha Elopre, MD, associate professor in the UAB Division of Infectious Diseases in the Marnix E. Heersink School of Medicine, and Lynn Matthews, MD, associate professor in the UAB Division of Infectious Diseases.

In addition to HIV and STIs, the Camellia Project will also focus on access and use of pre-exposure prophylaxis (PrEP) among vulnerable cis- and transgender women in Alabama. PrEP refers to the daily pills or long-acting injectables that prevent a person from contracting HIV.

“The rate of HIV infection is 10 times higher for Black women compared to white women; however, PrEP utilization remains low,” Elopre said. 

The study will identify the barriers that prevent people of color, specifically women in the Deep South, from accessing PrEP.

“We’ve long known that HIV cases among women are higher in the South than in other parts of the country,” Elopre told UAB. “These grants will be a major step in understanding why and finding ways to reduce the impact of HIV on this vulnerable population.” 

Click #South for more stories about the region, including “AIDS Memorial Quilt Heads to the South to ‘Change the Pattern’” and “Increasing PrEP Uptake in the South.” Click #Women for articles such as “Women Like Us—Aging Positively,” “Women Are Missing From HIV Trials” and “Why Does the Mifepristone Decision Matter to the HIV Community?”

Correction: An earlier version of this article misidentified the Aware Project.