Urbs in rure: human immunodeficiency virus infection in rural Tennessee

Although the AIDS Commentaries published over the past 18 months have focused on clinical questions relevant to all practicing infectious diseases physicians, they have emphasized clinical information gathered from the large epicenters of the epidemic. We need to remember that clinicians dealing with HIV-infected patients outside metropolitan areas may face problems that are unique. For example, fighting the stigma of AIDS in a low-prevalence population may be as important an issue as treating pneumocystic pneumonia. In this AIDS Commentary, Drs. Abraham Verghese, Steven L. Berk, and Felix Sarubbi of the Veterans Administration Medical Center, East Tennessee State University and describe their experiences in such an environment, discuss some of the problems they've faced, and offer suggestions about what physicians and health officers need to do to prepare for the inevitable spread of AIDS to rural communities.