Rural HIV...

I'm a sociologist.  My emphasis was in social psychology & social ecology with a background in anthropology, education & humanities.   The reason I mention this is because due to these disciplines I studied the intrinsic differences between the urban & rural environments.  There's much more that differentiates the 2 than just sheer size.    The mentalities, philosophies & ideologies can vary greatly

HIV in rural areas is on the rise.  Most of the spending on HIV/AIDS has been in urban areas.  People living in more urban areas may perceive those living HIV or populations more likely to contract the virus very differently.  The nature of religion & politics  often drastically differ between the 2 populations.

In recent years, rural USA has been hit  with a massive economic upheaval.   This has been hard on those living in those areas & many have turned to self medicating via drug use.  This has  been the force behind the rise of HIV & hepatitis rates in rural counties in Indiana & Kentucky.  Some are noting the same in Virginia.  

Adding to that, rural counties have little in the way of HIV prevention or education.  At best they have a health department somewhere in the county.  Many of these rural health departments can offer little more than testing.  They probably won't have staff trained to deal with HIV or other communicable illnesses.  Rural counties most likely won't have support groups, education centers or even doctors capable of helping with HIV.

It's taken this long for some people to figure out what a significant problem HIV in rural areas really is.  In my area there are no resources for HIV beyond testing.  My specialist is 2 hours away.  I no longer have access to telemedicine.   There's no one capable in my county to handle HIV in regards to medicine, support or pharmaceutical needs.

As long as the economy is in this condition & HIV is a back burner issue for most people, then the rural spread of the virus will continue at an alarming rate.  Right along with rural drug use & mental illness.  Maybe the more urban folks are just trying to outlast us.

Cya..