Rural acquired immunodeficiency syndrome in low and high prevalence areas

Background, Too little is understood about the spread of the acquired immun odeficiency syndrome (AIDS) in rural America. This study focuses on changes over 5 years in two low prevalence and two high prevalence human immunodef iciency virus (HIV) rural service areas. Methods. An initial study conducted in 1993 provided a base line for the st udy Each site was revisited in the summer of 1998. Data were analyzed by de gree of rurality of the site, prevalence levels, and risk categories. Results. Changes in the number of AIDS cases ranged from slow steady growth to increases of an epidemic magnitude. Some settings were characterized pr imarily by white homosexual men, and others had a more diverse population l iving in poverty. Conclusions. Populations receiving priority for national AIDS funding shoul d be expanded to include rural America as a target group, and funding shoul d provide the latitude for communities to match their local needs.