Tearing down fences: HIV/STD prevention in rural America

Background: Despite their stereotypical "safe" image, rural communities are not immune to HIV or other STDs. HIV/STD interventions designed for urban areas may not fit diverse rural needs. Strategies that may work in rural settings need to be identified and shared. Method: The Rural Center for AIDS/STD Prevention (RCAP) convened a Work Group of 19 rural HIV/STD prevention leaders to identify important issues and essential HIV/STD prevention strategies unique to rural communities. An online survey of 264 rural prevention specialists from 39 states identified additional HIV/STD prevention, testing, and care strategies. The RCAP editors, in consultation with guide co-sponsors, combined Work Group perspectives, strategies from the field, and current national recommendations to develop a guide. Results: In 2009, RCAP published, Tearing Down Fences: HIV/STD Prevention in Rural America to help policy-makers and funders understand issues rural communities face and help those living and working in rural communities address challenges, prevent HIV and other STDs, and provide care to those diagnosed with HIV/STD. Fences describes the state of HIV/STD in rural America, rural prevention challenges, approaches to HIV/STD education, and strategies to care for people diagnosed with HIV or AIDS. This guide shares ideas for engaging hard-to-reach populations and describes programs currently being implemented in rural areas that may reduce HIV transmission. Conclusion: The collaborative development of Fences by RCAP, the Work Group, Centers for Disease Control and Prevention, and guide co-sponsors (NASTAD, NAPWA, NCSD, NMAC, and NRHA) produced a document that shares innovative approaches to HIV/STD prevention in rural communities.