In the farmlands of Ohio and Michigan, where tractors plow through quiet cornfields and the warm smells of home cooking linger on the evening air, urban troubles like rampant crime and blight seem far away.
Rural residents often view HIV/AIDS as another problem afflicting city dwellers, but the disease affects dozens of people in the region s small towns.
Most people living with the illness in rural areas keep it a secret, fearing they would be abandoned by their families, friends, and churches if their status leaked out, David s House Compassion, Inc., case managers said.
“In these towns, everybody knows everybody. If one person figures it out, there goes your reputation,” case manager Amy Graber said. “I know one man, a business owner, who feared he would lose his business if people found out he was HIV positive. I believe he was right.”
David s House, a Toledo-based group that provides services for people with HIV/AIDS, met this year with about 70 clients in Wood, Ottawa, Sandusky, Fulton, Defiance, Henry, and Williams counties. Almost 150 people are diagnosed with HIV/AIDS in these areas, according to the Ohio Department of Health.
Case workers hold office hours monthly in Bryan, Fremont, and Findlay, but many HIV/AIDS patients are so afraid that people will discover their disease that they prefer case managers to come to their homes.
“Rural areas have made a lot of progress, but there is still some stigma that keeps people from seeking services,” case manager Ondreya Witmer said.
A study published earlier this month by the American Civil Liberties Union said people in rural areas throughout the country hide their illness.
“In many rural areas, there is still widespread fear of casual contact and people still think of HIV as a gay disease, ” the study said. “People in rural areas are so closeted about their HIV status that complaints of discrimination are rare.”
But people with HIV/AIDS are not always able to conceal the disease.
Louie, a Defiance resident diagnosed with AIDS in 1994, had to take extended sick leave from his factory job, so his employers discovered his illness. Louie asked that his last name not be used.
“There was quite a panic because people worried about working with me,” he said. “People were just really worried that they were going to catch [HIV/AIDS] working side by side with me.”
Louie said some of his co-workers were very supportive, but others refused to learn how HIV/AIDS is transmitted. People can get the disease from sexual contact, sharing needles, or through unscreened blood transfusions.
Ms. Graber said some people she speaks with in rural areas worry that they can get the disease from sharing dinner plates with someone with HIV/AIDS. She grew up in Stryker, Ohio, so she understands that her audiences are often reluctant to talk about the details of sexually transmitted diseases.
“When I was in high school, we got a sex education class from our home economics teacher because nobody else would do it, and it was an abstinence-only class,” she said. “The fears that people have, I can squelch in about five minutes.”
David s House workers try to educate the public about HIV/AIDS by speaking at churches and schools. Ms. Graber said the need for education is great in small towns, and residents are usually more accepting of people with HIV/AIDS after they learn the facts.
“They just need to understand that it affects people in their community,” she said. “People s compassion kicks in. A big part of country living is having compassion for your own.”
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