HIV/AIDS in Rural America
"STDs are hidden epidemics of tremendous health and economic consequences in the United States. They are hidden because Americans are reluctant to address sexual health issues in an open way and because of the biologic and social characteristics of these diseases. All Americans have an interest in STD prevention because all communities are impacted by STDs, and all
individuals directly or indirectly pay for the costs of these diseases."
Since the early 1990s, 5% to 8% of the annual new AIDS cases have been diagnosed among those who live in rural areas. Although the proportion of rural people living with AIDS is relatively small, it represented over 56,209 people at the end of 2007.[5, 8]
Evidence shows that rural Americans experience a broad range of health disparities, especially in comparison to persons living in suburban areas. For example, findings from a study conducted in the late 1990s show that rates of HIV/AIDS and STD morbidity and mortality are particularly evident in the rural South. Two-thirds of newly diagnosed rural HIV cases were located in the rural South in 2007 and the greatest number of deaths from AIDS now occurs in the South. Yet the South receives the least funding for HIV testing and treatment compared to other regions of the country.
Much like rural America itself, the road to effective HIV/STD prevention and control may be unpaved and winding, yet the moral obligation to develop and smooth this road is clearly evident. The challenges are inherently difficult and the available research and financial support are modest at best. Innovative, collaborative responses and solutions are required to contain and reduce HIV and other STDs in rural locations.
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After acknowleging the epidemiology of HIV/STD in rural America, PIA has developed "prevention messaging strategies" for rural settings that may assist in reducing HIV/STD infection rates.
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Even though the vast majority of the rural population remains white, African Americans, Latinos, and Native Americans have a substantial presence today, especially in the rural Southeast, Southwest, and northern Great Plains. Providing care for those living with HIV/AIDS is challenging in all settings, but it is uniquely challenging in rural areas. Several interventions show that the lack of rural HIV care specialists, transportation challenges, and poverty can be overcome to effectively link rural residents to HIV care. Other interventions describe programs to motivate and train rural medical care providers to include HIV/STD prevention messages in their routine care to help protect the health of those living with HIV/AIDS and their partners. PIA's "prevention messaging strategies" can play a pivital role in meeting the chellenge of disease risks reduction.
Meeting mental health needs in rural area can be improved by partnering with primary care, using telephone technology, and bringing those affected by HIV together to develop support networks. Helping people living with HIV/AIDS maintain stable housing and become more integrated with the community can be accomplished through individual level counseling, programs sponsored by faith-based organizations, and community task forces. Hopefully, these programs can work for other rural communities or at least provide suggestions for ways to bring innovative ideas and resources together at multiple levels to confront rural obstacles to HIV care and prevention.
Most information provided by Rural Center for AIDS/STD Prevention (RCAP) http://www.indiana.edu/~aids/index.html