Service needs and networks of rural women with HIV/AIDS.

Despite the fact that one of every 16 women with AIDS in the United States lives in a rural area, little is known about their demographic and epidemiologic characteristics, service needs, social support networks, or service utilization patterns. This article reports key findings from case studies of services to rural women with HIV/AIDS in southwest Georgia, northwest Mississippi, southeastern South Carolina, south Texas, and south-central Washington. Despite the growing numbers of HIV-positive women in these areas, many primary care physicians lack training in the diagnosis and treatment of HIV infection in women, and multidisciplinary protocols for the "shared care" of HIV-positive pregnant women are still being developed. Concerns about confidentiality and the lack of health insurance and transportation pose major access barriers. The findings suggest a need for new kinds of rural initiatives that embed HIV prevention and care into broader programs of educational and economic development.