By Kate Sarmiento
The statistics on Black women and HIV have been sitting in public health reports long enough that anyone claiming surprise at this point has simply not been paying attention. Black women make up 13% of the U.S. female population and account for nearly half of all new HIV diagnoses among women, with diagnosis rates running approximately 10 times higher than those of white women (Source: KFF, 2025). This is not a recent development. It is the result of a healthcare system that was not built with Black women in mind, and Status: Home, Atlanta’s largest and oldest permanent supportive housing nonprofit for people living with HIV, has been watching that gap grow while the broader conversation keeps finding ways to look past it. Maryum Phillips, President and CEO of Status: Home, is not interested in softening what that means. The people most affected by this crisis have been dealing with the consequences of a system that chose not to prioritize them, and the numbers show it.
The healthcare system has not treated everyone the same, and that shows up in these numbers too. Black patients consistently receive lower quality care, get dismissed more often by providers, and wait longer for treatment than white patients, even at the same income levels (Source: JAMA Network Open, 2022). That gap does not pause when the condition is HIV. Wage gaps and higher rates of housing instability leave Black women more likely to be uninsured or underinsured than their white peers, which puts real walls between them and consistent HIV care. The CDC confirms that concentrated poverty is one of the main drivers behind these diagnosis rates, which means this is not about personal choices (Source: CDC, 2023). The system was structured this way, and the institutions responsible for fixing it have been slow to move.
When the System Has Gaps, People Fall Through Them
Georgia sits near the top of every national HIV list, and Atlanta is one of the most affected cities in the country (Source: AIDSVu, 2024). Status: Home operates in that environment every year, housing close to 400 people living with or affected by HIV. What Phillips and her team have seen firsthand is that stable housing is not an add-on to HIV care. It is what makes HIV care possible in the first place. Someone cannot take their medication on a reliable schedule without a stable home to build that routine around. Doctor’s appointments stop happening when the more immediate problem is finding somewhere safe to sleep. People living with HIV who deal with housing instability are less likely to stick to their medication, less likely to reach viral suppression, and more likely to end up in the emergency room (Source: American Journal of Public Health, 2016). According to Status: Home’s own reporting, about 90% of its residents have reached viral suppression. Stable housing sits at the foundation of that outcome.
For Black women, these risk factors do not show up one at a time. Financial pressure, intimate partner violence, and housing instability build on each other, and together they create situations where HIV transmission risk goes up, including depending on relationships for basic needs and having less power to set the terms of those relationships (Source: CDC, 2023). Reaching this population requires care that is designed around those realities, not a general prevention message built for a different audience. That kind of care takes real, long-term investment, and the system has consistently been unwilling to make it in communities that do not have the political and financial power to force the issue.
Good Intentions Have Been the Plan Long Enough
Plenty of programs describe themselves as built for the community they serve. Fewer actually are. The absence of it has real consequences in treatment outcomes. Black women have been left out of HIV clinical trials, which means the guidelines doctors follow were built without their data (Source: Journal of Infectious Diseases, 2023). Whatever is missing from that data becomes something Black women have to sort out on their own, on top of managing an HIV diagnosis. When a care model is built without you, it simply does not work as well for you, and that has been the situation for a long time.
Black communities’ distrust of medical institutions is not a misunderstanding. It is a reasonable response to real history, including the Tuskegee Syphilis Study, the use of enslaved people in medical experiments, and current evidence that Black patients’ pain gets undertreated and their concerns get dismissed more often than white patients’ (Source: New England Journal of Medicine, 2021). Asking Black women to show up and trust the system without the system doing anything to earn that trust is not a public health strategy. What actually improves outcomes is care built around the specific circumstances of the people being served. Community health workers, peer support programs, and organizations accountable to the communities they work with have produced better results for Black populations in HIV prevention and treatment (Source: Open Forum Infectious Diseases, 2024). Status: Home builds everything around who its residents actually are: the housing, the healthcare connections, the on-site support. That is what makes the model work, and it is also what most standard HIV responses still have not figured out.
The Funding Reality Behind the Work
Status: Home’s funding comes largely from government sources, which reflects both the scale of this work and the sustained public investment it has earned. Phillips chairs the National HIV/AIDS Housing Coalition’s board, which has been pushing for housing to be officially recognized as a health intervention in federal policy rather than a social service. That distinction shapes how funding gets allocated, how reliably it flows, and how seriously the work gets treated when policy decisions get made. The difference between those two classifications is not a technicality. It determines whether organizations doing this work can plan ahead, grow, and serve more people.
Private giving for HIV housing has not kept up with the need, and the money is not going where the crisis is worst. Status: Home raised $26 million to purchase five properties in Atlanta and expand permanent housing for people living with HIV, which is a real achievement and a clear sign that when people understand what this work is doing, they back it. The question is whether that backing becomes consistent rather than something each organization has to fight for on its own.
If the Urgency Still Is Not Clear, Read These Numbers Again
Black women account for nearly half of all HIV diagnoses among U.S. women, at a rate approximately 10 times higher than white women, and the response to that reality has not matched what those numbers call for (Source: Howard University, 2025). What Status: Home has shown in Atlanta is that permanent housing, combined with real healthcare access and community support, produces results that hold up. The roughly 90% viral suppression rate the organization reports among its residents is the kind of outcome that should be the standard, not the exception.
Status: Home shares its housing programs, advocacy work, and HIV funding priorities through its website. For Atlanta’s philanthropic, healthcare, and policy communities, the conversation Maryum Phillips is ready to have is the one this city has needed for a long time. Permanent housing, targeted funding, and care designed around the people most affected are not extras in a serious HIV response. They are the whole point, and Status: Home has been proving that since 1988.
Disclaimer: This article is provided for general informational and public awareness purposes only. It is not intended as medical advice or as a substitute for professional diagnosis, treatment, or guidance. Individuals seeking information about HIV testing, prevention, treatment, or related health concerns should consult a qualified healthcare professional.
