According to the U.S. Census Bureau, African-Americans make up 13 percent of the U.S. population, however, they account for 50 percent of the new HIV infections in 2008 alone.

“One reason would be the poverty level. The income guidelines, especially around here in Buncombe County, are so low. The cost of living is extremely high here. It’s happening to heterosexual women. Not women who are gay, but whose husbands could be on the down low, if you know what I mean, or an IV drug user for all we know, or whose boyfriend could just be coming out of prison and contracted (HIV) while he was in prison and come out and not tell anybody,” Jennifer Poore, a SISTA Project facilitator at the Western North Carolina AIDS Project, said.

According to the U.S. Department of Health and Human Services, 74 percent of African-American women living with HIV/AIDS in 2005 were infected by heterosexual sex.

Through the SISTA program, Poore teaches African-American women ethnic and gender pride, HIV/AIDS education, condom use and coping skills.

“In addition to the stigma, there is historically in this area a lot of denial and a lack of really committed focus on HIV by black churches. The black community has a lot of struggle addressing AIDS within its community and congregation, so we try to assist in putting the message out there,” Chris Winebrenner said, a community resource coordinator at WNCAP.

In 1999, Poore’s daughter was diagnosed with HIV and birthed a child who was born with AIDS. After the baby died from complications of AIDS at the age of three and a half months, Poore visited WNCAP to learn about the disease. She said her personal experience with HIV/AIDS influences her work.

“I live with more compassion because I’ve experienced it now. I’m able to teach my sisters as a mom. Everyone I teach calls me Mom, like they’re mine. I teach them just like I taught my children,” she said.

According to Poore, African-American communities tend to keep secrets within their families.

“Like if there was a molestation in the family, that stayed in the family. Nobody knew about it except the people in that family. If someone was gay in the family, no one else knew they were. If there was domestic abuse in that family, no on else knew about it. You didn’t say anything about it. Even today with HIV and AIDS, it’s still kept in the family,” Poore said.

According to the Asheville native, her goal is to get people, especially black churches, to start talking about HIV and to get educated about the disease in order to understand it.

“A lot of black churches still think it’s a gay disease. It’s just like having diabetes or heart disease. It’s treatable, but there’s no cure, just like there’s no cure for diabetes, heart disease or cancer. (HIV) is treatable, you can live a long full life,” she said.

Poore said she will hold a service at her church to educate members and try to reduce stigma.

“I’m real. I don’t sugar coat nothing. I’d rather you come at me and tell me. Like if my hair is out of place, I’d rather you come and say, ‘Girl, your hair is out of place, you need to fix that.’ Just be real. I tell my girls and I’m real with them,” Poore said.

Four months after Ryan White’s death, The Ryan White CARE Act was signed to provide financial assistance to individuals and areas affected by AIDS, the disease that ended White’s life at 18.

“I think using (him) and his mother’s sorrow after his death they were able to generate a great deal of sympathy and empathy for not only the family, but also others who were infected similarly. That certainly propelled the legislation forward,” Ron Curran, executive director of the Western North Carolina AIDS Project said.

According to Curran, when the act was in the process of being passed in 1990, there was a great concern about HIV and AIDS because people were dying quickly after being diagnosed. White provided a face for the disease’s destructive path.

“Ryan White, of course, being a young man who became pretty famous in the newspapers, became the lynchpin as it were for providing funding so that individuals could hopefully not get infected, or if they were infected there could be ways to treat them and to not have the disease be terminal for many people,” Curran said.

The Ryan White Comprehensive AIDS Resources Emergency Act of 1990 provides funds for localities excessively affected by HIV and AIDS and gives funds to states and non-profit organizations.

Since 1990, the act was most recently reauthorized by President Obama in 2009. Obama signed the Ryan White HIV/AIDS Treatment Extension Act of 2009 to extend the act until 2013 and expects to reach more than 500,000 people.

According to Curran, WNCAP receives around 10 percent of their total funding from the act. Curran said this money goes to client services WNCAP provides for HIV and AIDS positive individuals.

WNCAP provides services for individuals in 19 counties in Western North Carolina, and their current case load is around 480.

“Our services are geared toward people in need. People living with HIV who are in need. Whether it’s need on assistance with a power bill, substance abuse referral, housing or compliance with medication. Our case managers address those needs,” Chris Winebrenner, community resource coordinator at WNCAP, said. 

WNCAP, the largest AIDS service organization in Western North Carolina, receives grants from The Ryan White Act along with United Way and other private donors in order to keep their doors open and their services free of charge, according to Winebrenner.

According to the U.S. Department of Health and Human Services, people living with HIV and AIDS are on average poorer than the general population, and individuals who access funds through the Ryan White Act are poorer.

According to Curran, he is very grateful the act has continued to be reauthorized, but he sees a downside in the lack of increasing funds.

“Although it’s a wonderful addition to our budget, it would be nice if the funding for the Ryan White program in general was increased to match some of the expenses in daily living,” he said.

White, a hemophiliac, contracted HIV by receiving an infected blood transfusion and according to Curran, this partially broke the stereotype of HIV and AIDS patients being gay men.

“We have managed our blood supply to the point that it is very unlikely that anyone becomes infected by taking blood. So, we’re back at the position that an individuals lifestyle is at fault or causing new infections. So, there continues to be a stigma related to that,” Curran said.

According to the U.S. Department of Health and Human Services, 66 percent of people who received funds from the act were male, and more than 70 percent of all recipients were people of color.

According to Winebrenner, the demographic with the highest infection rate is black women between the ages of 25 to 34.

“So those obviously aren’t your gay, white men,” he said.

When an individual is diagnosed with HIV/AIDS, not only are they faced with crippling medical bills, but they are also faced with a stigma carried by no other disease.

“One of the biggest barriers we face in the work that we do is stigma, especially down here in the South, the Bible belt. A lot of people still equate HIV or AIDS with some sort of sinful lifestyle or homosexuality. That’s really just not the case. AIDS did start out in the gay community primarily, but it has definitely hit all aspects of society,” said Chris Winebrenner, the community resource coordinator at the Western North Carolina AIDS Project.

According to Winebrenner, HIV/AIDS medication needed to stay alive can cost $2,000 a month. At WNCAP, services are provided to help people with these expenses. 

“When somebody comes in and needs our services we do what we call an in-take. At that point, their needs are assessed. Does this person need help with housing? Does this person need help with a bill?” Winebrenner said. “Their primary presenting problem is identified and there is funding available to assist people with things like their power or gas almost being turned off.”

To assist people with their needs, WNCAP receives federal funding from the Ryan White Care Act, United Way, private funding and hosts fundraisers.

“We do the fundraisers, which are really important. We do two big fundraisers, Dining Out For Life, which is the last Thursday of every April. Last year, we made $119,000, so that’s a big part of our budget. We do an annual silent and live auction, which is a nice, formal event in a ballroom. Generally, we try to make at least $70,000 or $80,000 with that auction,” Winebrenner said.

Without funding, donations and fundraising WNCAP would not survive, Winebrenner said.

“Especially with the way things are politically, we always have this pendulum swinging back and forth. Right now, the pendulum is swinging toward the Republicans and they tend to spend less on domestic social services. So the funding is always a major issue,” he said.

Michael Harney, a prevention educator and street outreach worker at WNCAP, works later than most people work, sometimes until 2 a.m.

“I take condoms, sit at the bar, drink coffee or juice and I try to talk you up. People sometimes say, ‘Oh, you look like you’re going to have a fun time tonight with all those condoms’ and I say, ‘Well you want a few of them? I’m willing to share. I work at the AIDS Project and part of our work is to encourage you to take a few condoms or if you have questions about HIV, STDs or hepatitis to then ask me and I’ll get those answers,’” Harney said.

Harney said he tries to make appearances in Hairspray, Scandals, O’Henry’s, Smokies and Tressa’s at least once a week. He is not limited to gay bars, but particularly tries to visit them.

“Usually people are quite surprised if they’re not from here,” Harney said. “It seems foreign to them.”

According to Harney, his condom distribution among people in the community that know him is an advantage. 

“They come straight up to me and ask for what they want. In that sense, having been consistent all the years I’ve worked here is an attribute for this type of work. If someone considered getting into prevention education and outreach, if you are consistent the people will begin to trust you. If they trust you they open up with all sorts or questions, comments and thoughts.”

Harney has worked as a street outreach worker since 1993. He said he often feels stigmatized. One night while working in a section of town populated with male sex workers known as ‘The Cage,’ near the Grove Arcade, he had an encounter with a police officer.

“I was bent over speaking into a window of a car and a police officer drove by and said, ‘All faggots go home.’ I looked up and that police officer saw me, and I took his car number down. I went and spoke to the chief of police and that officer had to come to the staff of WNCAP and make a formal apology. He said he was just kidding, that he didn’t mean anything and he was there to protect and serve everybody, including people we were working with,” he said.

After hearing her co-workers talk about how stigma is a pressing problem in client’s lives, Laura Kirby, development director at WNCAP, wrote a grant for the ‘I Need U 2 Know’ campaign.

“I keep hearing the case managers talking about what huge an issue HIV stigma is and how it was such a problem for our clients in all areas of their lives. Also, it’s slowed down the prevention efforts because it’s kept people from having open and honest conversations and getting testing,” Kirby said.

The ‘I Need U 2 Know’ campaign consists of a series of four public service announcements centered around ending stigmatization against people living with HIV/AIDS.

“There’s a whole range of different types of examples (of stigma). One that got us started was a client who was HIV positive, homeless and staying at a homeless shelter. When the homeless shelter operators discovered he was HIV positive they no longer allowed him to stay there,” Kirby said.

Kirby said she thinks the stigmatization has changed from the beginning of the AIDS epidemic when people were afraid of casual contact with those infected. Kirby said she hopes to promote acceptance and non-judgmental attitudes toward people living with the disease.

“Topics of sexuality are always hard to talk about, but hopefully if the stigma is no longer a barrier to people talking about it then people will more readily take advantage of testing and finding out what they need to find out about prevention and acting on that information,” she said.