ABSTRACT
Patterns of HIV infection indicate that the spread of the AIDS epidemic into rural areas in America is rising (Centers for Disease Control and Prevention [CDC], 1995). Rural is defined as counties outside the boundaries of metropolitan areas with no cities with more than 50,000 residents (Ricketts, Johnson-Webb, and Taylor, 1998). According to figures provided by The National Commission on AIDS (NCOA), the number of AIDS cases swelled in one year (1989) by 37 percent in rural areas while the increase in urban areas remained at 5 percent (NCOA, 1990). Another study of AIDS cases in all U.S. counties reported that most of the top twenty-five counties experiencing rapid increases in AIDS cases were predominantly rural (Lam and Liu, 1994). The Centers for Disease Control and Prevention estimated that 17,170 rural residents were living with AIDS in 1997, and 41,000 to 57,000 rural residents were living with asymptomatic or symptomatic HIV infection (CDC, 1999)
