Syringe exchange programs meant to slow HIV's alarming spread in West Virginia limited by political resistance

Photo by R. Konkathi, Unsplash

Despite federal recommendations and community efforts to stem HIV infections among opioid or methamphetamine users in central Appalachia, the disease continues to spread. Harm-reduction advocates and medical providers cite resistance to syringe exchange programs as the primary obstacle, reports Taylor Sisk of KFF Health News. "The situation likely hasn’t improved, in part because of politicians who contend that such programs encourage illegal drug use."

In 2021, West Virginia's HIV outbreak was particularly concerning to officials from the Centers for Disease Control and Prevention. Sisk writes, "The CDC’s HIV intervention chief called it 'the most concerning HIV outbreak in the United States and warned that the number of reported diagnoses could be just 'the tip of the iceberg.'" 

Rural areas without substance disorder treatment or disease education present a ripe breeding ground where HIV can spread undetected. Ryan White HIV/AIDS Program Director Christine Teague "is concerned for West Virginia’s rural counties, most of which don’t have a syringe service program," Sisk adds. "Tasha Withrow, a harm reduction advocate in rural Putnam County, said her sense is that HIV numbers aren’t alarmingly high there but said that with little testing and heightened stigma in a rural community, it’s difficult to know."

Robin Pollini, a West Virginia University epidemiologist who conducts community-based research on injection drug use, told Sisk, “You would think that in a state that had the worst HIV outbreak in the country, we would have a statewide testing strategy." Sisk reports, "Teague would like every rural county to have a mobile unit. . . offering harm reduction supplies, medication, behavioral health care, counseling, referrals, and more."

While disease prevention through syringe exchange programs is well documented, the CDC's health warnings and recommendations for improved access to syringe exchanges have been largely ignored. Sisk reports, "In April 2021, the state legislature passed a bill limiting the number of syringes people could exchange and made it mandatory to present a West Virginia ID."

Tuesday afternoon webinar will discuss the challenges of HIV/AIDS prevention and treatment in rural America

The Rural Health Information Hub will host a free webinar at 3 p.m. ET Tuesday, Oct. 6, to discuss "recent increases in new HIV infections in rural areas, address barriers to HIV prevention and treatment services, and present on the committee's site visit and policy recommendations," according to the website. Click here for more information about speakers or to register for the webinar.

Specifically, the webinar will discuss recent a recent policy brief and recommendations the National Advisory Committee on Rural Health and Human Services wrote for the Department of Health and Human Services.

The NACRHHS paper made three major policy recommendations: 

1. HHS should modernize the Ryan White HIV/AIDS Treatment Extension Act of 2009 to better meet rural needs. That includes increasing funding to grow existing rural programs and encourage pilot programs, earmarking some funding opportunities for rural areas, giving preference to rural applicants in areas with a shortage of health-care professionals, and expanding telehealth to increase access to services and reduce stigma in rural areas.
2. HHS should increase rural access to pre-exposure prophylaxis for rural residents through the Health Resources & Services Administration's Community Health Centers Program and the Rural Health Care Services Outreach Program.
3. HHS should support a streamlined grant application process for cash-strapped rural providers, as well as more virtual grant-writing technical assistance for rural communities so they have a better chance of successfully applying for HHS funding.

HIV patients in rural South get less experienced local care

A newly published study found that HIV patients in the rural South are far less likely to have local access to experienced HIV clinicians.

They examined 14 states (including Oklahoma, Arkansas and Maryland in the broader South) and found 5,012 clinicians who routinely treat HIV. Of those, 28 percent were considered "HIV-experienced," and most of them practiced in metropolitan areas. Over all, 81% of counties—the vast majority of them rural—had no HIV-experienced clinicians, the researchers found.

"Significant urban-rural disparities exist in HIV-experienced workforce capacity for Southern U.S. communities," the researchers conclude. "Policies to improve equity in access to HIV-experienced clinical care for both urban and rural communities are urgently needed."

Rural HIV infection rates are rising in much of rural America, even as rates fall in many large cities. 

Rural HIV infection rates rise as urban rates fall; crisis 'can't be ignored any longer,' journalism professor writes

HIV infection rates are falling in many large U.S. cities, but rates are rising in much of rural America.

"There have of course always been cases of HIV in sparsely populated parts of the country, but in these places far from cities, the conditions that lead to HIV transmission are now intensifying — and rural America is not ready for the coming crisis," Northwestern University journalism professor Steven Thrasher writes for The New York Times. "Unlike large urban areas that have dealt with similar health and substance crises in the past, and that have networks of service providers and consumers in place, small rural health jurisdictions often lack the infrastructure to confront the crisis and have little history of dealing with comparable health issues."

The opioid epidemic is a major factor in the explosion of rural HIV infections, since opioid users are more likely to engage in risky behavior such as having unprotected sex while high or sharing needles. (Prescription opioid abusers often turn to higher-octane intravenous opioids like heroin.) In West Virginia's Cabell County and Huntington, for example, where there is a massive prescription opioid addiction problem, 80 new HIV infections have been diagnosed over the past year. "This avoidable crisis has been exacerbated by unemployment, declining coal mining production and economic pressures on regional press to act as effectively as a watchdog," Thrasher writes.

Most frustratingly, the rise in rural HIV infection rates was predictable, Thrasher writes: "After a hepatitis C and HIV outbreak in Scott County, Ind., in 2014 and 2015 that was fueled by deindustrialization and opioids, the CDC released a list of 220 counties similarly vulnerable to such outbreaks among people who use intravenous drugs. The densest concentration of those counties is along the Appalachian Trail, with 28 of them in West Virginia — more than half of the state’s 55 counties."

However, many rural areas are ill-equipped to prevent or deal with an HIV outbreak because they frequently refuse to effective policies such as needle-exchange programs, more comprehensive sex education, and LGBTQ+ public health efforts, Thrasher writes. Rural HIV patients also may be reluctant to admit they're infected or seek treatment because of the stigma associated with it. That leads to worse health outcomes and more infections. Thrasher says the problem "can't be ignored any longer."

Nov. 7 webinar will look at HIV/AIDS in rural America

The Rural Health Information Hub will host a webinar Nov. 7 to discuss HIV and AIDS in rural America. The free event will begin at 11 a.m. ET and will last about an hour. A recording will be available on the RHI Hub website afterward.

The webinar will review a recent Centers for Disease Control and Prevention report that says the decline in HIV infections has hit a plateau because effective prevention and treatment efforts aren't adequately reaching some populations with the highest need for such services, including rural areas.

Speakers will provide an overview of a federally funded initiative called "Ending the HIV Epidemic: A Plan for America. They will also discuss the rural distribution of medical providers funded by the Health Resources & Services Administration's Ryan White HIV/AIDS Program, and highlight the work of a Ryan White grantee in rural Alabama. Click here to learn more or to register.

Why is medication to prevent HIV so hard to find in rural South? Stigma, poverty, racism, ignorant doctors . . .

Rate of people with HIV per 100,000 in 2017. (Map by AIDSVu)

A prescription medication called Truvada can protect users from HIV infection, but it's difficult to find in the rural South. That's a big part of the reason the South had about 20,000 new HIV diagnoses in 2017, more than the rest of the U.S. combined, Lenny Bernstein reports for The Washington Post. "Stigma, poverty, inadequate access to health care and lingering racial bias" are also reasons the South have a disproportionately large share of HIV infections.

The Trump administration says it wants to reduce HIV transmission by 75 percent within five years and at least 90 percent by 2030, but it's unclear how that will be implemented. President Trump's proposed 2020 budget would fund a program targeting HIV transmission in the rural South, but would also slash funding for Medicaid, which most people in poverty, some of them with HIV, depend on. Beyond that, it's unlikely the budget will pass in Congress as is, Bernstein reports.

Bernstein writes that the most effective way to fight HIV transmission is to increase access to Truvada (to prevent infection), and antiretrovirals to lower the viral load of already infected people so they can't transmit the disease. "Theoretically, you could end the epidemic tomorrow if you did that," Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and one of the architects of Trump's plan, told Bernstein.

But in 2015, a third of primary-care doctors surveyed said they had not heard of Truvada, according to the federal Centers for Disease Control and Prevention. "Persuading many more people to take the drugs will require more federal money for health clinics as well as for education and outreach to certain groups, especially black men who have sex with other men. At current rates, half that group will be diagnosed with HIV infection," Bernstein reports.

Stigma, limited privacy, lack of sex education, shortage of health insurance hamper rural efforts to fight HIV and AIDS

President Trump said in his State of the Union address that he wants to stop the spread of HIV in the U.S. within 10 years. "In addition to sending extra money to 48 mainly urban counties, Washington, D.C., and San Juan, Puerto Rico, Trump's plan targets seven states where rural transmission of HIV is especially high," Jackie Fortier reports for NPR. Health officials in those states (Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma and South Carolina) welcome the funding, but told Fortier that ending or slowing rural HIV transmission is a big challenge.

In rural areas,there is still a stigma attached to being gay and/or having HIV or AIDS, says Dr. Michelle Salvaggio, medical director of the Infectious Diseases Institute at the University of Oklahoma Health Sciences Center in Oklahoma City, a federally funded HIV clinic. It employed a case manager to serve a nearby rural area, but eliminated the position because no patients went to see her, Salvaggio told Fortier: "They didn't want to be seen walking into the HIV case manager's office in that tiny town — that can only mean one thing."

That lack of anonymity is not just a problem in small towns. When Native Americans, an at-risk population in Oklahoma, "go into an Indian Health Service clinic, it is possible that they will see their cousin behind the desk, and their cousin's brother-in-law working in medical records, and their niece's boyfriend working in the pharmacy," Salvaggio said.

An HIV-positive Cherokee, Ky Humble, told Fortier that rural Oklahomans with HIV and AIDS need more than medical funding; they also need more access to related services like food pantries, mental health therapy, and transportation assistance.

Another difficulty: Oklahoma, and many other states with large rural populations, don't require comprehensive sex education that could help teens learn about cheap, effective methods of preventing HIV, such as use of condoms. Lack of health insurance will also likely hamper efforts to get rural residents tested and treated, especially in states that did not expand Medicaid, Fortier reports.

Rural residents less likely to get HIV testing; researchers say rural health-care providers should routinely offer it

Rural residents are less likely to have had an HIV test than their urban counterparts, according to a study of responses to a continuous national poll conducted by the federal Centers for Disease Control and Prevention.

The study of the the Behavioral Risk Factor Surveillance System found that HIV tests for rural people were less likely in the past year and over the course of their lives. That's worrisome because rural America is experiencing an increased incidence of HIV, especially in the South and Midwest.

The research used data from 2015. Out of about 250,000 respondents, 24.5 percent of urban residents said they had received an HIV test within the past year, while 20.2 percent of rural residents did. Overall, 26.9 percent of urban residents reported having ever had an HIV test, compared to 21.5 percent of rural residents.

The researchers also dug into where people tend to get HIV tests. In rural areas, people tended to get tested in hospitals, emergency rooms and clinics, and are less likely to get tested in their doctor's office.

The study's authors conclude that rural medical providers should routinely offer HIV testing to patients, and that "targeted interventions are needed to remove structural barriers in rural communities such as long distances to clinics and low availability of free HIV testing at clinics serving the un- or under-insured."

Some rural areas hit by opioid epidemic don't get priority for federal response grants; CDC cites lack of county drug data

"A federal agency recommended steering the $100 million Congress appropriated for rural counties to battle the opioid epidemic to those dealing with high rates of hepatitis C infection and HIV/AIDS instead," leaving out many rural counties hit by the epidemic, Susannah Luthi reports for Modern Healthcare.

In April, the Health Resources and Services Administration said it would award 75 grants to counties to develop plans for opioid-abuse treatment and recovery, selecting counties considered "at risk" by the Centers for Disease Control and Prevention. But the CDC prioritized counties based on confirmed cases of hepatitis C instead of opioid-overdose rates, according to emails obtained by Modern Healthcare. A CDC official wrote in one that the agency's selected counties are not those "most at risk for overdose or with the highest rate of opioid overdose." The emails said the agency chose hepatitis C infection rates as the key indicator because there is no county-level measure of injection drug use.

While there is a great deal of overlap between the counties facing hepatitis C and those with many  overdoses, some counties with high overdose rates and low hepatitis C rates were left out of the CDC's recommendations. "The CDC's metrics excluded some states battling the highest rates of opioid deaths, including New Mexico, New Hampshire and Florida. Other states with equally high rates, such as Nevada and Pennsylvania, have only a few counties flagged even though they are heavily rural," Luthi reports. "Kentucky, Tennessee, West Virginia and Missouri hold the most counties recommended for funding. These states face the same high opioid overdose death rates as excluded states like New Mexico and New Hampshire. But counties in other states with significantly lower death rates, such as Kansas and Georgia, also made CDC's priority list."

Free webinar on rural HIV and AIDS set for Nov. 7

The Rural Health Information Hub and the the Walsh Center for Rural Health Analysis, part of the research organization Norc at the University of Chicago, will host a free webinar, "Rural HIV/AIDS Prevention and Treatment," Thursday, Nov. 7.

The one-hour webinar will begin at 1 p.m. EDT, and will present a toolkit designed to help rural communities plan, implement and sustain HIV/AIDS programs. The toolkit was developed by Norc for the federal Office of Rural Health Policy. The speakers will discuss examples of successful programs and lessons learned. Featured speakers will be:

• Alycia Bayne, senior research scientist at the NORC Walsh Center for Rural Health Analysis;


• Daniel Wakefield, interim director of the Ursuline Sisters HIV/AIDS Ministry in Youngstown, Ohio; and 


• Lisa McKeithan, director of Positive Life and the North Carolina Rurally Engaging and Assisting Clients who are HIV positive and Homeless (NC REACH) project at CommWell Health. 

 A recording will be available on the Rural Hub website afterward. Click here to register or for more information.

HIV outbreak in rural Ind., driven by intravenous drug use, puts other rural areas on notice

Last year's outbreak of HIV in rural Indiana—blamed on a rise in intravenous drug use—has put other rural areas on notice to look for warning signs to prevent a similar epidemic in their necks of the woods. The number of HIV cases in southeastern Indiana, mostly around Austin in Scott County, stands at 188, according to state data. A Centers for Disease Control and Prevention study released in December said that rural areas lack prevention services for opiate addiction and HIV infections.

The Indiana epidemic has put Virginia officials on notice, Becca Pizmoht reports for the Madison County Eagle. While HIV rates remain stable statewide, "concern grows that rural counties are seeing a disproportionate number of new cases. Several factors are cited as possible causes, including lack of available education and testing and increased intravenous drug use in rural populations." Madison County (Family Search map), population of 13,000, has not had any reported HIV diagnoses since 2011, but adjoining Greene County (18,000) has had six and Orange County (34,000) eight.

Ann Rhoades, director of HIV Surveillance in Virginia, told Pizmoht, “After the Indiana outbreak we have been watching rural areas more closely. Urban areas have a lot of available testing and there are needle exchange and education programs in place. We need to have education and testing available to our rural populations because there is a stigma attached to HIV sometimes people in small communities aren’t willing to get tested.” (Read more)

In impoverished rural Alabama, officials hoping to educate teens about HIV through video games

In one of the poorest regions of the country, where African American males have significantly higher rates of contracting HIV and schools do little to nothing to educate about safe sex, one health official is turning to video games in an attempt to teach about the virus, Dan Carsen reports for NPR. The hope is that video games can be used to reach teenage boys who might not be interested in learning through other mediums.

Civil Rights Movement Veterans graphic

The 18-counties of Alabama's "Black Belt" region "is predominantly African American, the poorest part of a poor state and home to underfunded, segregated schools, a weak health care system and an alarming number of new HIV cases," Carsen writes. "Here, young black men are at least 10 times likelier than the state average to contract the virus. But with talk of HIV still largely taboo in rural Alabama, one nursing professor has turned to an unlikely technology in hopes of changing things: video games."

Comfort Enah of the University of Alabama at Birmingham came up with the idea. She told Carsen, "Gaming is particularly appropriate for adolescents because of where their brains are. We have a scenario where we have hormones, but they don't have the brain capacity to anticipate long-term consequences. So gaming can tap into that mismatch and kind of force them to see consequences right now."


As part of the game, "players build avatars, customizing their appearance, hobbies and personality," Carsen writes. "Then they respond to age-tailored but potentially risky situations any way they want. In the do-over world of the game, consequences include points, praise, good health and money . . . or embarrassment, unemployment, HIV and even death."

The game is still in its infancy, and teens have responded that it's boring or has out-dated graphics, but those are the kind of responses officials are looking for in an attempt to continue tweaking the game until it is one that teens can be drawn to, because teens—especially males—tend to identify more with games than with reality, Carsen writes. And in this case, that could be a good thing.

Debra Lieberman, director of the University of California Santa Barbara's Center for Digital Games Research, told Carsen, "Avatars that the player identifies with are especially powerful. You'll hear players saying, 'Oh, I did this' or 'Oh, look what happened to me.' They are just totally transported into the game, and that avatar is them. There have been studies that have found that when your avatar engages in health behaviors, then you are more likely to go out into your daily life and adopt those behaviors." (Read more)

Rural southern minorities new face of HIV/AIDS; states that failed to expand Medicaid hit hardest

AIDS was once thought to mainly affect middle-class, often white gay men living in urban areas. However, because states like New York offer free health care to uninsured or underinsured residents who are HIV positive, as opposed to limited and expensive care in the South, "today, the face of AIDS is black or Latino, poor, often rural—and Southern," Teresa Wiltz reports for Stateline. (Associated Press photo: Sterling Williams hammers in markers representing the 3,423 people in Shelby County, Tennessee, who have died from AIDS.)

"Southern states now have the highest rates of new HIV diagnoses, the largest percentage of people living with the disease, and the most people dying from it, according to Rainey Campbell, executive director of the Southern AIDS Coalition, a non-profit group serving the 16 Southern states and Washington, D.C.," Wiltz writes. "Fifty percent of all new HIV cases are in the South. The HIV infection rate among African-American and Latina women in the South now rivals that of sub-Saharan Africa. In some Southern states, black women account for more than 80 percent of new HIV diagnoses among women."

"States in the South have the least expansive Medicaid programs and the strictest eligibility requirements to qualify for assistance, which prevents people living with HIV/AIDS from getting care, according to a Southern AIDS Coalition report," Wiltz writes. "In the South, Campbell said, people living with HIV have to reach disability status before they qualify for aid. This is significant, because nationally the vast majority of HIV/AIDS patients rely on Medicaid for their health insurance, according to research conducted by the Morehouse College of Medicine." 

The nine deep South States with the highest rates of new HIV/AIDS diagnoses—Alabama, Georgia, Florida, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Texas—have all refused to expand Medicaid under federal health reform, Wiltz writes. "Those states also have the highest fatality rates from HIV in the country, according to the Southern AIDS Coalition."

A White House Council of Economic Advisers study found "that if the nine deep South States expanded Medicaid coverage, more than $65 billion in federal funding would flood those states, and an additional four million people would have insurance coverage," Wiltz writes. Campbell told Wiltz, “Jurisdictions throughout the South fail at nearly every level of HIV prevention and care, ignoring proven strategies that could help to address the uncontrolled epidemic and alarming death rate."

Part of the problem is the Southern attitude towards AIDS, Wiltz writes. "The escalating HIV rates are the result of a perfect storm of social factors including poverty, racism, persistent anti-gay attitudes, increasing homelessness and a lack of transportation in rural areas. In the South, AIDS still has the taint of the plague. Fear of being judged and ostracized keeps some people away from clinics and the care they need. Those who don’t know they’re infected will infect others, creating what the University of Alabama’s (Dr. Michael) Saag calls a 'silent epidemic.'” (Read more)

Webinar will focus on HIV/AIDS in rural America

The Rural Assistance Center and the Health Resources and Services Administration’s Federal Office of Rural Health Policy are hosting a webinar Tuesday, Oct. 1 at 2 p.m. (EDT) on "HIV in Rural America." Featured speakers will focus on the Patient Protection and Affordable Care Act and the Ryan White Program, including  opportunities for people living with HIV/AIDS, research findings on HIV/AIDS in rural America, and HIV/AIDS prevention. A limited number of seats are available. For more information, or to register, click here.

Rural HIV/AIDS patients have fewer resources

Cases of HIV/AIDS are mostly concentrated in urban centers, but as the disease moves out into rural areas, educational and medical resources for preventing and treating it are left behind. In Florida, a State Healthcare Access Research Project report on HIV/AIDS in rural North Florida reveals trends found in rural places across the country.

Between Gainesville and the state border with Georgia, there are more than 1,500 AIDS patients and more than 2,617 HIV patients, according to the report. Men with AIDS outnumber women 4 to 1, and they are disproportionately African-American. "A lot of the challenges here are similar to what you find in other Southern states, with a rural population and pretty pervasive stigma," Amy Rosenberg, associate director of the Center for Health Law and Policy Innovation at Harvard Law School, told Kristine Crane of The Gainesville Sun.

Rosenberg said rural HIV/AIDS patients face challenges their urban counterparts don't necessarily face, including finding transportation to appointments. The Patient Protection and Affordable Care Act does provide a lot of funding to help HIV/AIDS patients, though, she said. It mandates that insurance companies pay for HIV testing for everyone aged 15 to 65. (Read more)

Lack of education apparently leading to rise in HIV and AIDS cases in the Navajo Nation

HIV infections drop or reamain steady in other parts of the country, but are rising sharply in the Navajo Nation, reports Stephen Ceaser of the Los Angeles Times. Poverty, poor education, alcohol abuse and a culture where talking about death causes it all combine to create an environment where the virus can spread, and where many know little about it until they contract it.

Ceaser reports the 35 new cases of HIV infection a year seems small when compared to the 173,600 people living on the reservation. However, that is three times the number of new cases recorded a decade ago. When the increase began in 2001, HIV cases were rare among Navajo, with cases coming from people contracting it in cities and returning home for treatment or to die. Then, Navajo began infecting other Navajo.

Many patients choose to mix modern medical treatment with traditional Navajo healing. Ceaser reports the Indian Health Service encourages this, out of respect for the Navajo and to make patients feel comfortable and optimistic about treatment. (Times photo by Barbara Davidson: Jerry Archuleta, left, and his partner, Emerson Scott)


HIV and AIDS are widely considered a "white man's disease," and those who contract it are often shunned in the Navajo Nation. However, a small number of Navajo are coming together to educate others about the dangers of the diseases. Emerson Scott and his partner Jerry Archuleta, both HIV positive, are two. Scott stands outside his local library handing out condoms and encouraging people to get tested, though no one has accepted his offers yet. Both volunteer with the Navajo AIDS Network and several support groups for HIV and AIDS patients, spending hours with those who consider suicide. (Read more)

South leads in spread of HIV and AIDS, but region has fewer services, more social stigma

HIV and AIDS in the South constitute a growing epidemic. The region "accounted for 46.4 percent of new AIDS cases in 2007 and has the greatest number of people estimated to be living with AIDS," writes Dahleen Glanton in the Los Angeles Times, citing a Kaiser Family Foundation analysis of data from the Centers for Disease Control. Rural Southern communities are particularly affected, but HIV and AIDS patients in the South, the nation's most rural region, often face fewer services and more social stigma than they find in other areas.

Sheila Holt said when she moved from New Jersey to Henderson, N.C., she lost access to many of the services available in her former state: housing, transportation and medicine, to name a few. But she also lost access to the emotional support that comes from being able to talk freely about life with the disease. "People are scared in the South. They don't really understand that this is a disease," said Holt, of her experience. "They are either too religious to open up or they don't want the stigma." To combat the problem in her community, she has become a vocal advocate for HIV prevention.

Part of the problem is that the federal money allocated to AIDS prevention and awareness is unevenly distributed. The South and Midwest get less funds than any other region, says a study by the Trust for America's Health. Rural areas face even larger funding gaps. "There needs to be a better level of parity between the states. The money should follow the epidemic, but the way it stands now, the cities get way more per person than the rural areas," say Kathie Hiers, former co-chairwoman of the Southern AIDS Coalition. (Read more)

Rural areas in Southeast see spike in HIV cases

Rural ares in the Southeast have become one of the fasting growing areas of cases of HIV in the U.S. "As groups gathered recently across the country to recognize National HIV/AIDS Day, new cases were popping up with little fanfare in Georgia and South Carolina," writes Ray Chandler of the Independent Mail in Anderson, S.C. "Cases in these mostly-rural areas are growing faster than anywhere else in the country, experts say."

These experts blame the increase on the lack of resources for prevention and treatment. State health and human resource departments are developing plans to slow the spread of the virus. “In the rural areas, in particular, we have tried to initiate more opportunities for rapid HIV testing so that people can know their status,” adds Raphael Holloway, HIV director for the Georgia Department of Human Resources. “But also what we’re trying to do is ensure that people receive the prevention counseling that comes along with the rapid testing. The biggest way to have an impact with people is going to be to promote behavior change." (Read more)

AIDS Day forum in N. Dakota spotlights need to increase knowledge of the disease in rural areas

As part of World AIDS Day yesterday, an organization supporting HIV/AIDS survivors in Minnesota and North Dakota addressed the importance of spreading awareness of the disease in rural communities.

While more dispersed populations may make it seem that AIDS isn't a pressing issue in such areas, “If there’s one person in our community living with this disease, then we’re all living with it,” Clinton Lende, the executive director of Minnkota Health Project, said at the organization's World AIDS Day Community Forum.

Kim Winnegge writes for The [Fargo] Forum: "Geneva, who gave only her first name, said the stigma attached with HIV/AIDS can make it difficult to fully identify herself – even though she’s been HIV-positive for 18 years." Geneva, who lives in rural Minnesota, said that stereotypes of people living with HIV/AIDS ignore the reality: "This is a human disease ... People think it’s a gay man’s disease, or a drug user’s disease. I’m neither, and I got it." (Read more)

Study faults rural medical referral system in Ind.

A new study at the University of Indiana points to significant problems with the state's rural medical referral system. "The findings of this study demonstrate inefficiencies in our public health care system and our inability to link people easily to a range of health care providers in rural areas," said Michael Reece, lead investigator in the study and director of The Center for Sexual Health Promotion in the School of Health, Physical Education and Recreation.

"This also has an important economic impact given that our investments in the public health system may not be achieving the outcomes we need, such as improvements in health status," Reece says. The study is also significant because, he adds, "As the incidence of new HIV infections continues to increase in more diverse areas of the country, researchers can make incredible contributions to public health by focusing some of their attention to what is happening in the backyards of their own universities."(Read more)