Beruflich Dokumente
Kultur Dokumente
Hannah L. Behr
SOWK 305
I. Target Population
The target population that the South Carolina HIV/AIDS Council (SCHAC) serves are
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.
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
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.
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
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,”
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
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
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
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
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
nonprofits, faith-based organizations, families and other communities in order to make a change
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
McAllaster, C., Reif, S. S., & Wilson, E. (2014, November). HIV Infrastructure Study. Retrieved
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
2. Why was the name changed from the African-American HIV/AIDS council?
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
10. What is the benefit of signing someone up for ACA? What would happen if ACA is
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?
16. Are there any new services about to start or are being developed right now?