Running Head: SC HIV/AIDS Council 1

Overview of the SC HIV/AIDS Council

Hannah L. Behr

University of South Carolina

SOWK 305

Professor Emma Myers

October 11, 2017

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I. Target Population

The target population that the South Carolina HIV/AIDS Council (SCHAC) serves are

primarily African-Americans. Although, they serve “anyone regardless of race, gender,

socioeconomic status or sexual orientation,” (South Carolina HIV/AIDS Council). The rates of

HIV/AIDS run consistently high among African-Americans in South Carolina and among the

national level (Interview with Vivian Clark-Armstead, 2017). African-Americans make up 12%

of the United States population, but account for 45% of HIV cases (HIV in the United States: At

A Glance, 2017). In the early days of the epidemic in South Carolina, a law was passed stating

that if someone living with HIV does not inform their sexual partner, they can be sentenced to

prison. This is the only STD that has legislation like this. There are other incurable diseases that

do not have laws like this one (Interview with Vivian Clark-Armstead, 2017). I wondered if it

was racially or sexual orientationally charged like many early legislations were.

II. Agency Description

SCHAC is a nonprofit organization. Their goals are to combat stigma related to HIV/AIDS

and to reduce and eliminate new cases of HIV and other sexually transmitted diseases. In order

to make this possible, SCHAC uses prevention, education and advocacy techniques. The council

employ’s medical doctors, nurses, community health specialists, care coordinators and more to

make their programs successful. They also employee people from the community living with

HIV to work in outreach and education.

III. Programs and Services

The council provides a plethora of programs and services to the people of South Carolina.

They have a free and confidential in-house clinic and mobile clinic to detect and if necessary,
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provide treatment for HIV and other sexually transmitted infections or diseases. They have a

“Healthy Relationships” program to help people living with HIV create and maintain

relationships, a “Many Men-Many Voices” program for gay men and a “Safety Counts” program

as an HIV prevention program for people with drug addictions and mental health problems. They

have “HIV Positive Support Groups” to provide resources in their community and social support

from peers also living with HIV. An “Evening Hour Treatment program” is the opening of the

in-house clinic at night to cater to individuals that work during the day and a “Certified

Affordable Care Act Insurance Navigation” service that is meant to help people enroll in the

Affordable Care Act (ACA) in order to receive health insurance coverage. These are only a few

programs and services SCHAC provides and there are about 17 more programs listed on their

website.

IV. History and Mission

The South Carolina HIV/AIDS Council did not always have this name or nonprofit status. It

started out as a small membership group to discuss the changes in the epidemic, but in 1994

expanded to a nonprofit by the name of the African-American HIV/AIDS Council. They changed

the name to SCHAC in 2004. I asked Vivian Clark-Armstead, the project coordinator at SCHAC,

the reason the name was changed, she replied “stigma.” With this name, she said that the council

was having difficulty with fundraising and gaining corporate sponsorships. “It was also

stigmatizing to the African-American community who already had enough stigmatizing labels,”

stated Vivian (Interview with Vivian Clark-Armstead, 2017). She also explained that they will be

taking the “AIDS” part out of their name because of the realization that preventing new cases of

HIV and ending AIDS can be possible.

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According to SCHAC’s website, their mission is “to develop and implement strategies

that reduce the rate of HIV, STI’s or other health disparities,” (South Carolina HIV/AIDS

Council). In order to make this achievable, the council uses education, prevention and advocacy

tools. They also strive to combat stigma, secrecy and the name that accompanies the rhetoric

about this topic. “Our best weapon against the spread of HIV/AIDS is an informed community,”

as stated on SCHAC’s website (South Carolina HIV/AIDS Council). By informing the

community, they can combat the stigma and educate people about treatment and prevention

routes. The council has created the first alternative testing prevention-counseling site in the state.

They also created the first and only HIV/STI mobile testing unit to reach people in rural areas

who do not have access to healthcare. They can perform HIV/STI testing and get 99.9% accurate

results in 60 seconds and begin treatment procedures as well as reach out to people in high-risk

communities about taking preventative steps from their mobile and in-house clinics (Interview

with Vivian Clark-Armstead, 2017). Through advocacy, the council advocates at all levels

including county, state and federal. They make sure new legislators have accurate information on

HIV/AIDS in hopes to gain funding and hopefully influence legislations to aide in the fight to

prevent new cases of HIV.

V. Impact and Statistics

Before 2015, South Carolina consistently ranked in the top 10 for rates of HIV/AIDS, but in

2015 they were ranked as number 13 (South Carolina HIV/AIDS Council). Although, it is great

that South Carolina no longer ranks in the top 10, we must not mistake a success as a victory.

Columbia, South Carolina ranks 11th in the United States and Puerto Rico. Obviously, there is

still work to be done. Over 18,000 South Carolinians are diagnosed and living with HIV and an

estimated 4,353 South Carolinians are undiagnosed. People ages 20-29 have the highest
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percentage of newly diagnosed HIV cases in South Carolina. Out of all 50 states and the U.S.

territories, South Carolina ranks 10th in the percentage of adults and adolescents diagnosed with

HIV contracted through heterosexual sex. Out of all HIV cases in South Carolina, 70% of them

are African-Americans. Of all males diagnosed, 48% are African-American and of all women

diagnosed 80% are African-Americans. In South Carolina, 51% of people living with HIV are

not seeking medical care. According to the American Public Health Association, for everyone

dollar invested in a community-based, public health organization, $5.60 are saved in future

health care costs (Interview with Vivian Clark-Armstead, 2017).

With these statistics, we can clearly tell that there is still work to be done in preventing

and treating HIV/AIDS, but this is not to say that SCHAC has not had an impact. With

utilization of their in-house clinic and mobile unit, SCHAC has tested over 12,000 South

Carolinians in the Midlands area for HIV and STI’s (South Carolina HIV/AIDS Council). With

their Project P.A.C.T. (Personal Action Changes Things), they have partnered with the

Lexington/Richland Alcohol and Drug Abuse Council (LRADAC) to educate addicts, people in

recovery and people with mental illnesses reduce and eliminate the risk of contracting HIV or

any STD/STI. SCHAC’s mobile testing unit can be labeled as having the biggest impact on the

HIV/AIDS epidemic in South Carolina (South Carolina HIV/AIDS Council). Some barriers

attributed to the high levels of HIV are the lack of transportation and access to insurance and

quality healthcare (Interview with Vivian Clark-Armstead, 2017). With the mobile unit, SCHAC

can go directly to people who do not have transportation, health insurance and towns lacking in

access to medical care.

Their in-house medical clinic that is equipped with rapid-testing, a medical doctor and nurse,

are open during evenings and weekends. This provides a great impact to South Carolinians that
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work odd hours or during the day. With their ACA insurance navigation, people who did not

have health insurance before can receive help in enrolling in the program and then being able to

access healthcare. Through their Ryan White AIDS Drug Assistance Program (ADAP), people

requiring expensive HIV medications can have their costs assisted with. There has been a huge

increase in the utilization of this program because of SCHAC’s increased HIV testing around the

state (South Carolina HIV/AIDS Council). In 2006 SCHAC had a wait list with over 600 people

wanting HIV medication and some people died while waiting for the life-saving treatment. This

occurred because South Carolina only gave $500,000 to their ADAP program. This issue led to

the creation of the South Carolina HIV/AIDS Taskforce. With the help of late representative

Joseph H. Neal, the taskforce worked with insurance providers and stakeholders to increase the

funding to $4,000,000 (Interview with Vivian Clark-Armstead). All of these programs, services,

initiatives and advocacy work has lead SCHAC to have a huge impact on the HIV/AIDS

epidemic in South Carolina.

VI. Challenges and Opportunities

When a nonprofits’ focus is sensitive, stigmatized and politically charged, they will

probably be faced with many challenges and barriers. One barrier is that people are afraid to talk

about HIV or even go into the building. Vivian said that people will avoid coming into the

building because of the council’s name and in fear of contracting the disease just by proximity

(Interview with Vivian Clark-Armstead). In an HIV infrastructure study, one participant stated,

“I don’t want to get tested because I don’t want to know. I don’t want to know the answer,”

(McAllaster, Reif & Wilson, 2014). This fear of being stigmatized by the diagnosis challenges

SCHAC immensely. If people refuse to get tested because of stigma, SCHAC has to work much
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harder to educate people and combat the stigma so that people will get tested and stop the spread

of HIV.

Another major, inhibiting barrier is the lack of funding that SCHAC receives. After 35

years of the epidemic, SCHAC does not receive reoccurring funding at the state, city or county

level for HIV prevention, even though South Carolina consistently ranks high in HIV,

Chlamydia, Gonorrhea and Syphilis. She explained to me that South Carolina did not opt. into

Medicaid expansion where people in need could have accessed coverage. “It would have brought

in $11 million and around 40 plus jobs would have been created with the expansion of Medicaid

which would have been free for the first three years,” stated Vivian (Interview with Vivian

Clark-Armstead, 2017). When I asked about ACA being repealed, Vivian said, “if we have a

replace and repeal of the Affordable Care Act then we’re in big trouble because it will change

the whole playing field.” Even with these barriers, SCHAC perseveres through whatever current

political climate.

The biggest opportunity SCHAC has had was the help of the late representative and

reverend Joseph H. Neal. With his help SCHAC raised awareness in faith-based organizations

where this topic is almost never talked about. As I explained before, he also helped SCHAC

increase their ADAP funding from $500,000 to $4,000,000. They also have had the opportunity

to reach more people by having the only mobile testing unit in the state. Although SCHAC has

had some opportunities, they have had way more challenges and barriers to overcome. These are

topics that need to be discussed by everyone. They need to be discussed by legislators,

nonprofits, faith-based organizations, families and other communities in order to make a change

and combat these negative barriers.

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References

HIV in the United States: At A Glance. (2017, September 08). Retrieved October 11, 2017, from

https://www.cdc.gov/hiv/statistics/overview/ataglance.html

Interview with Vivian Clark-Armstead [Personal interview]. (2017, September 27).

McAllaster, C., Reif, S. S., & Wilson, E. (2014, November). HIV Infrastructure Study. Retrieved

October 11, 2017, from https://southernaids.files.wordpress.com/2011/10/columbia-

report-final.pdf

South Carolina HIV/AIDS Council. (n.d.). Retrieved October 11, 2017, from

http://www.schivaidscouncil.org/
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Appendix
Interview Questions

1. History of the SC HIV/AIDS council?

2. Why was the name changed from the African-American HIV/AIDS council?

3. Why do you think SC has ranked so high in the rate of HIV/AIDS?

4. What is the mission of the council?

5. What are your desired outcomes?

6. What are some projects that were successful and some that failed? What contributed to

that?

7. How does someone advocate for this organization? How important is advocacy?

8. Being the first to create alternative testing prevention-counseling site, what challenges

did the council face to make that happen?

9. Why is it important to target people of color (POC)?

10. What is the benefit of signing someone up for ACA? What would happen if ACA is

repealed? Other economic or social policies affecting this?

11. How do you make these programs and services fit the needs of your target population in

South Carolina?

12. What are the services you provide and how do they work?

13. What has been the impact in SC so far regarding this subject with your organization?

14. What challenges does this organization face?

15. In what ways are people with HIV/AIDS considered a minority?

16. Are there any new services about to start or are being developed right now?