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AIDS Compounded By Distance, Attitudes In Rural Areas

April 15, 1990

WAYCROSS, Ga. (AP) _ AIDS can still be a dirty word out in the country, and sufferers in rural areas often live miles from medical care and face even greater obstacles just to live out their lives, health officials and activists say.

″There’s a big stigma ... about being gay, or being a drug user or being HIV positive,″ said Dr. Ted Holloway, who heads a 16-county health district in southeast Georgia.

Holloway meets Monday with the National Commission on AIDS, which is traveling to rural Georgia to study the effects AIDS outside the big cities, where AIDS patients and their treatment programs are most concentrated.

″We’ve had people lose their jobs and get kicked out of their apartments,″ Holloway said. ″There’s a lot of self-blame. People become totally dependent on their families, living in fear about how people will react to their disease.″

Some patients, Holloway said, are afraid to tell their insurance companies. Instead, they try to pay for expensive tests and drugs out of their own pockets.

A spokesman for Rainbow Partners, a year-old support group here, said a friend spent $10,000 in four years for treatment in Jacksonville, Fla., until he became so sick he had to tell his employer and file insurance claims.

″His employer turned out to be very supportive,″ said the spokesman, who would identify himself only as Charles.

He said rural residents tend to think of AIDS as a big-city problem. ″They see it on TV and say, ’We don’t have that here,‴ he said. ″Once they meet someone who had AIDS, it becomes personalized and changes their attitudes.″

Support programs also exist in Brunswick, Valdosta and Albany, where Ramona Price, the state’s AIDS program manager for 14 southwest Georgia counties, and two others run a group called HIV Positive.

The Albany group provides counseling, educational programs and housing money. This month, the group will train volunteers for a ″buddy system″ to help people sickened by the disease.

″There’s a lot of red tape when it comes to acquiring state funds,″ she said. ″If they’re sick and bedridden, it’s a drain on the family.″

Some of Georgia’s big cities have AIDS treatment centers, including an advanced clinic at Atlanta’s Grady Hospital. But rural patients generally do not have easy access to such care, especially if they are poor.

Dr. Paul White, district health director in southwestern Georgia, which has had 97 reported AIDS cases in three years, said indigent patients from Albany have to make a monthly, 350-mile round trip to Grady for drugs and treatment.

″We need clinics and we need money for drugs,″ White said.

Holloway said there are an estimated 60,000 people who are HIV positive in Georgia and 60 percent, or 36,000, need the drug AZT. This year, the state has federal funds to treat only 150 patients with AZT, he said.

Of 3,488 AIDS cases reported in Georgia since January 1987, the eight- county, 2,736,600-population Atlanta area had 2,549. Holloway’s district, which includes the city of Savannah, has a population of 275,000, was second with 237 cases. Proportionately, the incidence of AIDS is about the same in the two regions.

″We don’t have large gay communities like the big cities,″ Holloway said. ″It’s been hard to mobilize community activities because we don’t have that leadership from the gay community.″

Acquired immune deficiency syndrome attacks the body’s immune system, leaving sufferers prey to various infections and cancers.

The AIDS virus, also known as human immunodeficiency virus or HIV, is spread most often through sexual contact, needles or syringes shared by drug abusers, infected blood or blood products, and from pregnant women to their offspring.

According to a January 1990 study by the state, the increase in the spread of AIDS in rural Georgia is due mainly to drug use and heterosexual transmission from male drug users to their female partners.

Georgia’s problem could be getting worse. Health officials fear that Georgia’s syphilis epidemic - linked to the practice of trading sex for crack cocaine - portends a surge in AIDS cases in years to come.

In southeastern Georgia, syphilis jumped from 48 cases in 1984 to 500 last year. ″We’ve talked to HIV-positive crack addicts who are having sex with 30 or 40 people a month,″ Holloway said. ″There’s just got to be transmission occurring.″

The AIDS commission will visit Waycross and Albany on Monday to meet with AIDS patients, their families, doctors and health officials. On Tuesday they meet with health officials and AIDS patients at a clinic in Macon.

The 15-member panel, created by Congress in 1988, submitted its first report to the White House in December, calling for urgent action to repair the nation’s health care system to make it more responsive to AIDS.

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