HIV/AIDS in nonurban Alabama: risk activities and access to services among HIV-infected persons.
BACKGROUND
Because AIDS is increasing in rural areas and small cities of the United States, we sought to further describe the epidemiology of HIV/AIDS in nonurban Alabama.


METHODS
Extensive interviews of HIV-infected residents of Alabama living outside of urban Birmingham were conducted at clinics throughout the state.


RESULTS
Of the 417 HIV-infected persons interviewed from January 1995 through January 1997, 310 (74%) were male, 229 (55%) were white, and 179 (43%) were black. Over time, increasing proportions of HIV infections have likely been acquired in nonurban areas. Of the 417 subjects, 43 (10%) had visited an STD clinic in the past year, and 31 (7%) had smoked crack-cocaine during the past month. Of the 166 persons who had been sexually active in the past month, 59 (36%) had used alcohol before sex and 56 (34%) used condoms inconsistently. Of the 417 subjects, 161 (39%) currently had no health insurance, and 68 (16%) had lost medical insurance since becoming HIV-infected.


CONCLUSIONS
HIV-infected persons in nonurban Alabama are likely to have practiced high-risk behavior, to have acquired HIV in nonurban settings, and to have inadequate health insurance.
Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
J F
JF
Beltrami
S H
SH
Vermund
H J
HJ
Fawal
T D
TD
Moon
J C
JC
Von Bargen
S D
SD
Holmberg
D000293:Adolescent; D000328:Adult; D000368:Aged; D000407:Alabama / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology / Q000635:transmission*; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008875:Middle Aged; D020380:Needs Assessment; D012307:Risk Factors; D012309:Risk-Taking; D012423:Rural Health; D012725:Sexual Behavior / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires