While Washington, D.C., and New York City were once thought to be the epicenters of HIV/AIDS in the U.S.,that has definitely changed. Of the 10 cities with the highest rates of HIV/AIDS, nine are in states south of the Mason-Dixon line, with two of Louisiana's most populous cities making the list.

According to data from the U.S Census Bureau and the Centers for Disease Control and Prevention, Baton Rouge has the second-highest HIV/AIDS rate in the nation, and New Orleans comes in eighth. Looking at the state as a whole, for every 100,000 people, 36.6 are living with HIV, compared with 2.3 people in Vermont.

It's also well known that of these PLWHA, African Americans account for almost half.

The Black Treatment Advocates Network (BTAN) Louisiana was created in 2012 to help address this growing epidemic in the Deep South and to meet the needs of the Black community.

BTAN, a partnership between The Black AIDS Institute and Merck, is a national organizing initiative with chapters in 15 cities, including in Southern cities such as Louisiana's Baton Rouge and New Orleans, as well as Atlanta, Houston and Jackson, Miss. Each chapter is dedicated to linking African Americans living with HIV to care and treatment (and retaining them there), strengthening local and national leadership, connecting influential peers, raising health literacy in Black communities and advocating for policy change.

BTAN Louisiana follows in that same tradition, with Priority Health Care (PHC), located in Jefferson Parish in New Orleans, as that network's sponsor organization. And over the years the network and sponsor have worked hard to fulfill these goals by functioning as a team.

Two important staples of BTAN Louisiana's mission are community education and health and science literacy, which together have translated into health fairs and town hall meetings that emphasize teaching people to advocate for themselves at doctor's appointments, explaining why treatment and testing matters, and explaining safer sex practices and HIV basics.

"We've also worked in Black beauty salons and barbershops to encourage conversations about HIV/AIDS [that are] as normal as talking about other issues while their clients [are] in the chair," says BTAN New Orleans co-chair Tonja Walston, a client specialist at PHC. She adds, "The community has been so excited about these kind of programs. They are finally starting to see that HIV can happen to them, too."

Future programs include a hepatitis C informational session in Baton Rouge to talk about how this liver disease disproportionately affects the Black community, as well as new treatment options. In addition, the co-chairs in New Orleans are borrowing from Real Housewives of Atlanta's Bailey Bowl to plan a similar event.

"We're going to have teams competing against each other, HIV testing, information tables and HIV testimonies," says Karen Bennett, PHC's health-models coordinator and BTAN New Orleans co-chair with Walston. She adds, "It's going to be really fun!"

BTAN Louisiana has also found that utilizing peer advocates has made a huge difference. While the network has adopted a multifaceted approach to linkage to care, peer influence is very powerful, says BTAN Baton Rouge co-chair Sharon DeCuir, the prevention-program coordinator at HIV/AIDS Alliance for Region Two, Inc., in Baton Rouge.

"We do one-on-one counseling and group education meetings, but leaning on positive peer advocates to talk to clients about why taking meds are important is so crucial," DeCuir says, adding, "Clients are going to tell another positive friend that they aren't talking their meds before they will tell me or their doctor. So having someone there to lead them in the right direction makes all the difference."

Peer advocates are also a major help when it comes to combating stigma. "We see so many people who are still having issues with disclosure, or people being afraid that they are going to run into someone they know at the clinic," DeCuir says. "By seeing other positive people in the community, like myself, be out about their status and sharing their personal stories, it can help, too."

But stigma isn't the only obstacle standing in the way of reaching the community. All of the BTAN Louisiana co-chairs acknowledge that the lack of state support and funding, crippling poverty, lack of transportation to get clients to appointments and Gov. Bobby Jindal's refusal to expand Medicaid all pose limitations to the work they can do.

But none of that discourages them from advocating for the community.

"I want Louisiana to know that we are working hard to change these things," Bennett said. "We are not going to let our community fall [by the wayside] when it comes to HIV/AIDS."

Read more about BTAN Louisiana at BlackAIDS.Org.

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