HIV rates are highest in the American South, despite effective treatments – a clash between culture and public health

Nearly all participants described the South as a place deeply shaped by conservative values, especially those rooted in religion and traditional family structures. The Black church emerged as both a protective factor and a challenge. While offering vital community support, it also often reinforced stigma around homosexuality and discouraged open conversations about sexual health. Above: Information about PrEP in the clinic can go only so far without community support.