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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update

Stars Shine Light on Rural AIDS


USA Today (03.27.02) - Friday, March 29, 2002

A diverse group of international stars - from Paul McCartney to Joan Collins and Janet Reno - gathered Sunday at the annual Elton John AIDS Foundation/InStyle post-Oscar party to illuminate the continuing battle against HIV/AIDS.

One major battle continues in rural USA. According to the CDC, only about 5.4 percent of AIDS patients newly diagnosed between July 2000 and June 2001, or a little over 3,002 people, lived in rural areas. But new cases in communities with fewer than 50,000 people are likely to be seriously under-reported, according to Linda Brandt, founder and executive director of the Rural AIDS Action Network (RAAN), headquartered in Minneapolis. "It's really about 10-12 percent of new cases in Minnesota and surrounding states," says Brandt. "And it could be far more because cases are geographically assigned from where the diagnosis was made, and many diagnosed with AIDS return to the rural communities where they were raised." The CDC also cautions that its surveillance reports are not "accurate" profiles. Seventeen states, for instance, do not conduct HIV surveillance at all and report only AIDS cases. More ominously, despite a nationwide decline in new AIDS cases, nine of the 17 states that do not report new HIV infections had more new AIDS cases in 2000-2001 than in the prior year. Six of them - California, Georgia, Kentucky, Montana, Pennsylvania, and Washington - have extensive rural populations.

Among impediments to HIV/AIDS treatment in the heartland are: *Social stigma and fear - "When someone finds out you're HIV- positive or have AIDS in a rural county, you can lose your wife, your kids, your job, your business partners, and the support of your church," said Dr. William L. Yarber, senior director for the Rural Center for AIDS/STD prevention (RCAP), Bloomington, Ind. "Even going to the county courthouse for welfare and to apply for help in paying for medications is risky." *Dispersal - Rural patients must make "half-day trips or more" for treatment, said Brandt. *Lack of experienced medical help - Rural patients with HIV are less likely to see a healthcare provider familiar with HIV/AIDS and are thus three times less likely to receive AIDS medications than their urban counterparts. *Denial - "Since you may lose your life as you know it when you have AIDS in rural areas, there's a great chance of denial," said Brandt. "You can deny you're at risk, deny you had risky exposures, and deny you have symptoms." Sex education in schools is far less likely in rural communities. Only about 60 percent of rural teens use condoms. With treatment, a comprehensive approach to case management would be a substantial help. "They need knowledgeable advocates and treatment within 60 miles of where they live, available people who can tell them about drug treatment options, insurance money and funding treatment," said Brandt.


Copyright © 2002 -CDC Prevention News Update, Publisher. All rights reserved to Information, Inc., Bethesda, MD. The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.

Information in this article was accurate in March 29, 2002. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.