Rural Communities Face Unique HIV/AIDS Challenges

In July 2010, the White House developed the National HIV/AIDS Strategy (NHAS), a comprehensive HIV/AIDS plan with measurable targets to be met nationally by 2015. The aim of the national program is to reduce the number of new HIV infections, increase access to treatment, and optimize health outcomes for people living with HIV/AIDS.

To find out where we are regarding those goals in Oregon, we sat down with Renee Yandel, a longtime staff member and the program director for HIV Alliance, trusted grantee, and partner in the fight against HIV/AIDS. The organization is the only nonprofit, community-based health organization in Lane County, and it serves many rural communities throughout the mid and central Willamette Valley, including Coos, Curry, Douglas, Jackson, Josephine, Klamath, Lake, Lincoln, and Marion Counties.

In Oregon, there are between 250 and 300 new cases of HIV/AIDS diagnosed each year, but deaths of people living with HIV/AIDS has fallen significantly. While this is great news, it means that many Oregonians now need access to long-term health care for a disease that is now chronic. At HIV Alliance, 750 clients receive coordinated care services. Some of these services include dental, medical referrals, housing resources, emergency financial assistance, and health insurance. With prevention funding being cut every year from the federal sources, staff members increasingly rely on the dedication of its strong volunteer community that has contributed close to 8,000 hours.

The work of HIV Alliance, which has been based in Eugene for nearly 20 years, aligns with the goals of NHAS. Without a vaccine or cure, prevention is the only tool to control the spread of HIV. To accomplish the first goal of reducing the number of new HIV infections, many organizations are finding creative ways to educate their communities and prevent the spread of HIV. HIV Alliance does this in multiple ways: high-risk testing and counseling, outreach services to people who use injection drugs, men who have sex with men (MSM) outreach, as well as community and youth education.

While these programs have proven successful, they come with their own unique set of challenges, particularly in rural communities.

“The need there is great for needle exchange services, however, many clients report an unwillingness to test with their medical providers for fear that someone in their small community may find out,” states Yandel.

She adds that, although HIV Alliance’s work has progressed in rural counties, many clients still fear what comes with seeking help. “A number of clients are unwilling to indicate their risk category for fear of the stigma they perceive due to being a gay man or an injection drug user.”

Furthermore, areas outside the Portland Metropolitan Area had higher proportions of HIV in the following populations: women, Hispanics, and intravenous drug users were 15% higher. With that said, HIV Alliance’s has experienced deep funding cuts to its prevention programs from the Centers for Disease Control—as high as 30%. Prevention funding for most rural counties in Oregon was eliminated, despite nine new infections discovered in counties where funding was cut.

While dollars have been cut in rural communities where little to no HIV-related work occurs, our partners like HIV Alliance continue to navigate the challenges. In light of current circumstances, many organizations across our region work tirelessly to reduce the number of new HIV infections, increase access to treatment, and optimize the health outcomes for people living with HIV/AIDS.

For Yandel, her years of service leave her humbled by the clients she serves and inspired by the colleagues who share in the daily work.

“I have always been moved by the people we serve, and by their struggles to remain healthy, safe, accepted, and embraced,” Yandel says. “I have been honored to work with HIV Alliance staff who understand the struggles (of the clients) and who reach out with compassion and commitment. At the end of the day, what propels our work is that we continue to see the hope for each client and the evolving face of HIV and AIDS.”

Jett Johnson is Pride Foundation’s Regional Development Organizer in Oregon. Email Jett.

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