Division of STD Prevention, NCHHSTP, Centers for Disease Control, 1600 Clifton Road, MS US12-3, Atlanta, GA, 30333, USA.
AIDS Behav. 2022 Jan;26(Suppl 1):90-99. doi: 10.1007/s10461-021-03416-4. Epub 2021 Aug 26.
Sexually transmitted infections (STI), including HIV, are among the most reported diseases in the U.S. and represent some of America's most significant health disparities. The growing scarcity of health care services in rural settings limits STI prevention and treatment for rural Americans. Local health departments are the primary source for STI care in rural communities; however, these providers experience two main challenges, also known as a double disparity: (1) inadequate capacity and (2) poor health in rural populations. Moreover, in rural communities the interaction of rural status and key determinants of health increase STI disparities. These key determinants can include structural, behavioral, and interpersonal factors, one of which is stigma. Engaging the expertise and involvement of affected community members in decisions regarding the needs, barriers, and opportunities for better sexual health is an asset and offers a gateway to sustainable, successful, and non-stigmatizing STI prevention programs.
性传播感染（STI），包括艾滋病毒，是美国报告最多的疾病之一，也是美国一些最严重的健康差异的代表。农村地区医疗保健服务的日益匮乏限制了美国农村地区的 STI 预防和治疗。地方卫生部门是农村社区 STI 护理的主要来源；然而，这些提供者面临两个主要挑战，也称为双重差距：（1）能力不足和（2）农村人口健康状况不佳。此外，在农村社区中，农村地位和健康的主要决定因素的相互作用会增加 STI 的差异。这些主要决定因素可以包括结构、行为和人际因素，其中之一是耻辱感。让受影响的社区成员参与有关更好的性健康的需求、障碍和机会的决策，是一种资产，并为可持续、成功和非污名化的 STI 预防计划提供了一个途径。
