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    Posted December 1, 2011 by
    Durham, North Carolina
    This iReport is part of an assignment:
    Have you been affected by AIDS?

    Rural Areas and HIV, Mental Health and Substance Abuse


    Many assert that people who contract HIV should be held accountable for not taking proper precautions against getting the disease. They claim that those with HIV knew that they should be wearing condoms during sex, about the risk of having sex with multiple partners or of sharing needles. After all, HIV does still kill people and treating those who can’t afford it costs society a lot of money. Why wouldn’t someone take precaution? For a large percent of the population, it’s not that simple.


    As compared to other parts of a state, rural areas usually have greater poverty and higher unemployment, and few people have the ability to pay for health care services, insurance and medication. For the poor in the rural Southeast, where the epidemic is growing faster than in any other region of the country, many are without the basic needs in life. This means many do without adequate food, clothing, electricity or hot water. Studies have shown that the rate of childhood trauma is comparable in both rural and urban areas. Trauma includes physical and sexual abuse, violence, isolation and neglect. Because of diminished resources, most people living in rural areas don’t get the mental health services they need. (see reference) What does this have to do with HIV? Childhood trauma has been directly linked to risky sexual behavior and drug use which increases the likelihood for someone to be exposed to HIV. These people don't want to ignore warnings, or risk their or another’s health—instead, logic and reason is altered in light of their childhood experiences.


    Several recent articles report that many in the United States see HIV as a chronic treatable disease and believe the fight is over. That’s not the case in the rural Southeast. When educational, economic, religious and health sectors unify to address the issue of poverty, we will see a real way forward in reducing HIV/AIDS cases. Until then, for a growing number of people it’s vital that HIV prevention and care programs are coupled with mental health and substance abuse care, and are readily accessible to all who need them.


    Reference: You’re the first one I’ve told: new faces of HIV in the South, Whetten-Goldstein, Kathryn and Nguyen, Trang Quyen

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