Rural HIV/AIDS in Southeast Ohio :: Case Management

Rural HIV/AIDS in Southeast Ohio History Of all the known cases of HIV / AIDS in the United States "†¦5.5 percent were reported from nonmetropolitan statistical areas (non-MSAs). The Office of Management and Budget defines a metropolitan statistical area (MSA) as a county or group of counties that includes a city of 50,000 residents or an urbanized area with at least 50,000. Nonmetropolitan counties are all remaining counties (Gwinn & Wortley, 1996). "†¦6 percent of the female AIDS cases reported to the Center for Disease Control (CDC) during 1994 were residing in non-MSAs at the time of AIDS diagnosis (CDC, 1996). This is the case in Southeast Ohio where the nearest metropolitan area is Columbus an hour and a half away from Athens. Rural HIV/AIDS patients tend to be diagnosed in later stages of the disease because their physicians do not consider them to be at risk for HIV (Calonge, Petersen, Miller, & Marshall, 1993; Miller, et al., 1995). Many of the clients that apply for services at the Athens AIDS Task Force do so only after a referral from a medical professional after they have been hospitalized with a serious illness. Most already have Center for Disease Control (CDC) diagnosis for AIDS (T-Cell count below 200, normal count is 800 – 1500). Even as the spread of AIDS into small towns escalates, HIV-infected patients who live outside urban areas continue to confront significant obstacles to effective care. Nearly all doctors who specialize in the treatment of HIV are located in cities. Quality of life for HIV-infected rural residents is potentially worse, often for reasons that involve a lack of person-to-person contact both at the medical level and at the personal support level. Researchers have noted that rural HIV/AIDS patients often travel two or more hours to obtain medical care because they lack confidence in their local physicians, are unable to find a local physician who will see them, and are concerned about confidentiality. (Mainous & Matheny, 1996; Rounds, 1988; Rumley, et al., 1991). This is certainly the case in Rural Ohio, many clients travel to Columbus, Akron, Pittsburgh, Pennsylvania and Parkersburg, West Virginia for medical treatment. Many fear that they will run into acquaintances or relatives if they should visit physicians closer to home. People living in rural areas are still generally afraid of casual contact with anyone with the AIDS virus. We also see less intervention and prevention efforts directed toward rural areas, in part because they tend to be more conservative and not as open to sexuality education and safer sex education.