AIDS in Indiana County

Project Three: Solutions

Issues and Solutions in Indiana County

Interview with Barbara Hoza, HIV/AIDS Nurse serving Southwestern Pennsylvania

Interview with Malinda Cowle, Head of Indiana County HIV Network

Interview Head of HIV/AIDS for Indiana County at Community Care Management

Although there are small numbers of actual AIDS cases in Indiana County and rural Pennsylvania in general, there are still major problems with HIV/AIDS in the area.  Infection rates are not increasing at a high rate, so the problems lie mostly in the treatment of those already infected, and education for those who are not.  One large concern in a rural community is stigma attached to AIDS, and a general lack of knowledge and awareness about it in the community.  All of the women I interviewed responded that HIV/AIDS-related stigma was a major issue.  One explained that, because of fear of stigma, the Ryan White AIDS Clinic in Cambria County doesn’t have a sign advertising its location²⁹.  She explained that the clinic is housed in a family medical center, where someone would more readily assume that people in the waiting room were about to get a flu shot, rather than HIV treatment²⁹.  The poor level of knowledge about HIV/AIDS among rural citizens was also noted as a major problem.  One respondent explained, “People think, ‘we can’t get it here, we’re in rural Indiana County’”²⁸.  In many cases, AIDS is still seen as a disease that only affects the stereotypes – homosexual men, intravenous drug users, and people of color.  And, as I explained in my first paper, there are relatively few people of color in my community, and the IV drug user and homosexual male populations are largely hidden.  Therefore, since rural citizens don’t see people fitting the stereotype for AIDS, they think they aren’t at risk²⁸.  Another person spoke to ignorance on the opposite end of the spectrum; a man who did not know he was HIV+ had recently died from PCP pneumonia, and everyone in the projects where he lived suddenly thought they needed to be tested²⁹.  The problem in this case is that many people still believe HIV can be contracted through casual contact.  Two of the people I interviewed even responded that they receive negative attitudes and comments from people when they explain their job working with AIDS patients, and have been asked, “How can you do that?” as if there were a fear of contracting AIDS just by helping those infected^30,31.  There is, in general, a “lackadaisical attitude” held by rural community members towards HIV, that is very problematic³¹

Regarding support groups, I found they are scarce in rural Southwestern Pennsylvania.  Barbara Hoza, the AIDS nurse, informed me that she had very recently started a support group in Indiana County, an off-shoot of a larger one in Johnstown²⁹.  However, none of the other three women I talked to were aware of it, perhaps because of confidentiality and its newness.  The problem is that support groups are few and far between, and counties like Fayette and Greene, in the south west corner of Pennsylvania, are often lost in the shuffle²⁹_.  Another issue is that support groups have been tried in the past, and have worked for a while, and then just died out.  Malinda Cowles, head of the HIV Network in Indiana County, explained that in her fifteen years at her current post, despite her attempts to run support groups, they have never lasted³⁰. People just don’t take advantage of the service when it’s offered, so support groups must not be working in Indiana County, she concluded³⁰.

Another huge issue in Indiana County is travel distance and transportation to receive adequate care.  HIV/AIDS patients must either travel to Pittsburgh or Johnstown to receive treatment and services.  As Ms. Hoza pointed out, considering two-way travel and waiting room time, such a trip can take an entire day out of a patient’s life²⁹.  Another problem is that public transportation is hard to find in rural areas.  Indiana does have its own bus line, Indigo, but in other nearby counties it’s more of an issue.

I was also able to figure out the MSM problem in Indiana County, thanks to the responses of the women I interviewed.  Ms. Hoza explained that males having sex with males is actually not the biggest risk-group in rural Southwestern Pennsylvania²⁹.  She informed me that most of the MSM cases are cases from gay men who contracted HIV in the eighties and nineties. Malinda Cowles further explained that we see such high numbers of MSM cases, because homosexual men are the ones getting tested the most³⁰. She explained that since homosexuals are an at-risk group, men who have sex with men are most likely encouraged by their physicians to get tested³⁰.

In summary, the major HIV/AIDS-related problems afflicting Indiana County have to do with the quality of life for people living with HIV/AIDS.  Stigma and lack of community knowledge and encouragement are a large strain for HIV-infected individuals.  Largely because of fears of stigma, and also because of lack of resources in a rural community such as ours, they are forced to travel hours out of their way to receive proper care and service in cities like Pittsburgh and Johnstown.  The focus of public health in Indiana County should therefore be on improving the quality of life of HIV-infected individuals, and on providing better HIV/AIDS education to increase awareness among community members and help reduce the stigma of AIDS.

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