Stigma and lack of sex ed and health insurance could make it difficult to slow the spread of HIV in rural areas - Entrepreneur Generations

President Trump said in his recent 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. But, although health officials in those rural states (Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma and South Carolina) welcome the funding, they say ending or slowing HIV transmission in rural areas will be a challenge.

In rural areas, Dr. Michelle Salvaggio says there is still a stigma attached to being gay and/or having HIV or AIDS. Salvaggio is the medical director of the Infectious Diseases Institute at the University of Oklahoma Health Sciences Center in Oklahoma City, one of two federally funded HIV clinics in the state. The clinic once employed a case manager to serve a nearby rural area, but had to eliminate the position because none of the patients went to see her. "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," Salvaggio told Fortier.

That lack of anonymity means it will be more difficult to prevent or treat HIV in rural areas. 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.

One HIV-positive Oklahoman and Cherokee Native, Ky Humble, said 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 help, Fortier reports.

Another difficulty: Oklahoma, and many other rural states, don't require comprehensive sex education that could help teens learn about cheap, effective methods of preventing HIV such as condom use. 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.

from The Rural Blog https://ift.tt/2SOI0Nv Stigma and lack of sex ed and health insurance could make it difficult to slow the spread of HIV in rural areas - Entrepreneur Generations

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