Black By God at National HIV/AIDS Conference in DC: Urgency Echoed as Testing Heads to Healing Appalachia

Getting your Trinity Audio player ready...

Written by

BBG

Washington, D.C. — Black By God was present at the US Conference on HIV/AIDS (with a focus on Aging and Public Health), where the spotlight turned to Appalachia’s overlapping crises of addiction, HIV, and an aging population. The convening underscored that Appalachia’s public health emergency is not only about opioids and infections, it is also about how these crises collide with the realities of a rapidly aging region.

A. Toni Young, founder and executive director of the Community Education Group (CEG), delivered a blunt warning about Appalachia’s future. Young compared the crisis to a runaway train barreling through rural America, its engine fueled by opioids and dragging cars of hepatitis, workforce decline, and HIV.

“Community Education Group’s job is to be the boulder that stops that train in its tracks,” she said.Her message was unsparing: “There’s a fact some people won’t tell you — not all of us (organizations) are going to make it through this.” She stressed that the survival of organizations is not the mission; prevention, treatment, and care for people at risk must remain the focus. With federal dollars shrinking and funders shifting priorities, she warned, the people doing this work are facing more work with less.

Intermediary Funders & Equitable Systems

At the conference, Young joined the panel “Intermediary Funders as Catalysts for Equitable Funding Systems.” She appeared alongside Julia Patterson of the AIDS Funding Collaborative and Athena Cross of AIDS United. Together, they examined how intermediary funders, who redistribute national dollars to local groups, can make or break equity in public health.

For Appalachia, where small grassroots organizations often carry the weight of prevention, testing, and care, this funding model can mean survival or collapse.

Appalachia’s realities:

Aging Population: Nearly 21% of West Virginians are 65 or older — the third-highest rate in the U.S. HIV care and addiction services must adapt to older adults.
Smoking Epidemic: West Virginia has the highest smoking rate in the nation. For people with HIV, smoking is often deadlier than the virus itself, fueling cardiovascular disease and cancers.
Rural Barriers: Limited syringe services and testing access leave counties vulnerable to outbreaks. The CDC has repeatedly identified West Virginia as high-risk for rapid HIV spread.
Racial Disparities: Black West Virginians make up only 3.7% of the population but nearly 20% of those living with HIV. Yet Black-led and Black-serving organizations often receive the least targeted funding.

“The role of intermediaries isn’t just to move money,” Young said. “It’s to move money in ways that respect place, culture, and the scale of the crisis. If that doesn’t happen, Appalachia will continue to be left behind.”

Healing Appalachia: Testing at the Festival Grounds

That urgency will travel with Young and her team to Healing Appalachia, a music festival that draws more than 20,000 people to Ashland, Kentucky, every September. For the first time, the festival will host on-site HIV and hepatitis C testing, modeled on Houston’s “Hip-Hop for HIV” initiative but grounded in Appalachian culture.

“In Appalachia, we’re doing it through country and folk music,” Young said. “We’re meeting people where they are, through music, through community, and bringing the tests and information to them.”

Syndemic Summit in Huntington

From the festival grounds, attention shifts back to West Virginia, where the Syndemic Summit will convene in Huntington on September 19, 2025. The one-day gathering will bring together health leaders, harm reduction workers, and advocates to address overlapping crises of addiction, poverty, aging, and public health collapse. The refrain from Washington still hangs in the air: some of us won’t make it. With many small organizations unlikely to survive the next round of cuts, Young insists that the priority cannot be preserving institutions; it must be ensuring access to care.

West Virginia’s HIV & Aging Landscape

West Virginia’s HIV landscape underscores the urgency. As of 2022, more than 2,200 people were living with HIV in the state. Cabell, Kanawha, Monongalia, and Mineral counties carry the heaviest burdens. The CDC has repeatedly warned of the risk for rapid spread in parts of the state, particularly where syringe services and testing are limited.

At the same time, West Virginia is one of the oldest states in the country. With nearly one in five residents over 65, and rural counties aging fastest, public health systems must adjust to treat both infectious diseases and chronic conditions among older populations.

Another layer of crisis is tobacco. Smoking rates in West Virginia remain among the nation’s highest. For people with HIV, the consequences are even starker: studies show they may lose more years of life to smoking than to HIV itself. For Appalachia, where tobacco use and HIV converge, prevention must also address smoking as a public health emergency.

For Young, the challenge now is to restore a sense of collective mission that once defined the HIV movement. That work will be tested at Healing Appalachia and in Huntington, where the call is not only for funding or policy shifts, but for individuals to take action. For Black Appalachians in particular, too often left out of the conversation, the message is clear: get tested, know your status, and claim the care that is your right. In a region where stigma, poverty, and silence can cost lives, every test is an act of survival, and every diagnosis caught early is a chance to keep the train from running off the tracks.

Resources

HIV Testing & Care

West Virginia HIV/AIDS & STI Program: oeps.wv.gov/hiv-aids
CDC National HIV Testing Locator: gettested.cdc.gov

Tobacco Cessation (with a focus on Black communities)

The Center for Black Health & Equity – Tobacco Cessation Resources: centerforblackhealth.org
West Virginia Tobacco Quitline (24/7): 1-800-QUIT-NOW

Read More from Black By God on HIV/AIDS