Hall H Irene, Li Jianmin, McKenna Matthew T
HIV Incidence and Case Surveillance Branch, Division of HIV/AIDS Prevention, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
J Rural Health. 2005 Summer;21(3):245-53. doi: 10.1111/j.1748-0361.2005.tb00090.x.
The burden of HIV/AIDS has not been described for certain rural areas of the United States (Appalachia, the Southeast Region, the Mississippi Delta, and the US-Mexico Border), where barriers to receiving HIV services include rural residence, poverty, unemployment, and lack of education.
We used data from Centers for Disease Control and Prevention (CDC) HIV/AIDS Reporting System to determine the rates of HIV (data from 29 states) and AIDS diagnoses (data from 50 states and the District of Columbia) in 2000 for the 4 regions by demographic and residential (rural and economic indicators of county of residence) characteristics.
The rate of HIV diagnoses in 2000 was lower in rural areas (7.3 per 100,000) than in suburban (8.6 per 100,000) or urban areas (22.7 per 100,000). The highest race-adjusted rate was observed for the US-Mexico Border (21.1 per 100,000), followed by the Mississippi Delta (17.3 per 100,000), Southeast Region (14.7 per 100,000), and Appalachia (10.4 per 100,000). Heterosexually acquired HIV was more common in the Southeast Region and the Mississippi Delta than elsewhere. The Mississippi Delta had the highest proportion of HIV diagnoses among young people aged 13-24 years (18.4%). More than three quarters of people diagnosed with HIV in the Mississippi Delta and the Southeast Region were black, and diagnosis rates were higher among blacks and Hispanics than whites in all regions. The distribution of demographic and residential characteristics among people with AIDS was similar to that of all people with a diagnosis of HIV.
Strategies are needed to reach the populations of these areas to reduce transmission of HIV.
美国某些农村地区（阿巴拉契亚地区、东南部地区、密西西比三角洲以及美墨边境）的艾滋病毒/艾滋病负担情况尚未得到描述，在这些地区，获得艾滋病毒服务存在诸多障碍，包括农村居住环境、贫困、失业以及教育程度低等。
我们使用了疾病控制与预防中心（CDC）艾滋病毒/艾滋病报告系统的数据，根据人口统计学和居住（农村以及居住县的经济指标）特征，确定2000年这四个地区的艾滋病毒感染率（来自29个州的数据）和艾滋病诊断率（来自50个州及哥伦比亚特区的数据）。
2000年农村地区的艾滋病毒诊断率（每10万人中7.3例）低于郊区（每10万人中8.6例）或城市地区（每10万人中22.7例）。美墨边境的种族调整后感染率最高（每10万人中21.1例），其次是密西西比三角洲（每10万人中17.3例）、东南部地区（每10万人中14.7例）以及阿巴拉契亚地区（每10万人中10.4例）。通过异性性行为感染艾滋病毒在东南部地区和密西西比三角洲比其他地区更为常见。密西西比三角洲13至24岁年轻人中的艾滋病毒诊断比例最高（18.4%）。在密西西比三角洲和东南部地区，超过四分之三的艾滋病毒确诊者为黑人，并且在所有地区，黑人和西班牙裔的诊断率均高于白人。艾滋病患者的人口统计学和居住特征分布与所有艾滋病毒确诊者的分布相似。
需要采取策略覆盖这些地区的人群，以减少艾滋病毒的传播。
