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AIDS Programs in Rural Minnesota May Lose Funding
By Kathryn Herzog
May 6 1999
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2000 will mark the 20th anniversary of the AIDS epidemic. Since the disease first made headlines, there have been numerous advances in AIDS research and treatment. But AIDS educators say fear and stigma surrounding AIDS continues to be one of the greatest obstacles in AIDS prevention and education. That's especially true in rural Minnesota where state funding for HIV awareness is limited.

MOST OF MINNESOTA'S AIDS CASES are diagnosed and treated in the Twin Cities. Even rural Minnesotans who are HIV positive often chose to travel long distances for medical treatment, rather than risk running into neighbors or family at their local hospital. Because so few people receive treatment in small-town facilities and clinics, rural HIV-prevention programs struggle to secure funding.

Linda Brandt is the Director of the Rural AIDS Action Network, a group of professional volunteers which cares for people with HIV. The network recently lost 70 percent of its federal funding which is allocated through the State Department of Public Health. Brandt says the loss of funding means a loss of local support.
Brandt : Our volunteers that we access are the AIDS-compassionate doctor, the AIDS-compassionate mental-health counselor, the AIDS-compassionate clergy. So that someone can call us and say,"I'm from X County and I don't want anyone to know, but I do want to know who does care and who I could talk to if I get up the nerve?" So that potentially could end.
The Rural AIDS Action Network gives out more than a 1,000 referrals a month to people affected by HIV. Brandt says she recently spoke to a mother who discovered her son is in a Twin Cities hospital with AIDS and she 's afraid to tell the rest of her family. Brandt gave her a list of people outside of her county who would drive to meet her and offer support. Brandt says it's a typical example of the fear and stigma surrounding HIV.
Brandt : In rural towns there is a great fear that if someone is disclosed as a person with AIDS, that negative things will happen. That harassment will happen, that families will have businesses fail, that grandchild will be harmed, that verbal and physical abuse is possible. The fear level is unbelievable.
A 1998 State Department of Health study found a number of barriers when it comes to effectively preventing the spread of HIV in rural areas. Fear of isolation and compromised confidential medical treatment often cause people in rural areas to go untreated for HIV, or head to the Twin Cities.
John: Knowing the AIDS phobia and the reaction to it, I just felt more comfortable there. It was a hiding of sorts.
And this man is still hiding. We'll call him John. Sitting in the kitchen of his Turn-of-the-century farmhouse, John lights a cigarette and takes a sip of coffee. He says it calms his nerves.

John lives outside a small town in west central Minnesota, and discovered he was HIV-positive 15 years ago while trying to donate blood. For years he made the long drive to Minneapolis for medical treatment. Recently he confided with his local doctors about his illness. So far he says he feels ok about it.

John recently retired after more than 30 years in education, where he taught a number of courses, including an HIV-prevention program. John says he drew attention for teaching the course, but he remained silent about his own illness. He's told only a few family members and for now, he plans to keep it that way.
John: There is no guarantee, and if you come out with this kind of thing, you are opening yourself up to some real interesting minds out there that just might have one hell of a day with you. And I have responsibilities where I am here and it's just not really in the ballpark yet. I think, all the signals seem to be fine, but I'm a very cautious person.
AIDS educators who work in rural areas say that's understandable. And although there has been advancement in the way society treats people with AIDS, they say many of the old myths about the disease and methods of transmission, remain.

A bill called Reach 2000 now moving through the Legislature aims to address that misinformation. It's a $10 million funding package for HIV prevention and awareness programs across the state. Approximately $1 million is targeted for rural areas.

Jeremy Hansen of the Minnesota AIDS Project says the bill responds to the second generation of the HIV/AIDS epidemic.
Hansen: Recognizing that HIV has been around for 20 years, we have to look at the impact of having an entire generation of young people who've grown up and lived their entire lives in a world with AIDS. They've never experienced a world free from AIDS and that means very different things in terms of prevention and education for young people.
Hansen says Reach 2000 addresses the spread of sexually-transmitted diseases and drug and alcohol abuse, issues which drive the HIV epidemic.

Hansen says some of the funding would enhance regional training sites for AIDS education and expand AIDS programs in schools. Initially, state funding for HIV prevention in rural Minnesota was targeted at high-risk populations. Reach 2000 would continue that funding, but Hansen says the bill would also address the stigma surrounding HIV and AIDS.
Hansen: What this does differently is it says what we're not funding in outstate Minnesota is general awareness. General awareness and education to deal with the stigma and fear around HIV. And if we don't deal with that greater stigma and fear, we're never going to be really doing effective targeted outreach. We're never really going to get people with HIV connected to services.
Hansen says some money would pay for ads for the statewide AIDS hotline, a resource he says most people don't even know about. Other projects could include a billboard campaign along stretches of rural highway.

At a time when state legislators are focused on cutting programs and funding, people pushing for new money to battle what appears to be an "old" disease have an uphill battle. They insist the Reach 2000 program is critical in building the state's capacity to respond to the HIV/AIDS epidemic.