for one of these agencies to develop a guide or summary document regarding effective interventions in rural areas. In addition, agencies need to learn more about how to serve specific subpopulations—including vision-impaired or hearing-impaired individuals, women who are injection-drug users, and adolescent sex workers—who typically have not been targeted for intervention. “Individuals with special needs often lack sufficient training or educational literature that address those specific needs,” a state HIV/AIDS program official noted. “For example, how do you demonstrate condom use to an individual who is blind or to someone who is mentally challenged?”

Opportunities and Barriers

Many respondents reported that their greatest barrier continues to be a shortage of financial resources to implement prevention programs. “Our state’s planning activities are very strong, but community members become frustrated when they want to implement local plans but don’t have sufficient resources to do so,” noted one state HIV/AIDS program official.

Respondents also noted that there appears to be growing complacency among funders, policymakers, the media, and even many community members about HIV/AIDS prevention, while at the same time there continues to be a growing sentiment among policymakers that HIV/AIDS is treated preferentially, receiving a disproportionate among of funding and attention compared with other health issues. These respondents went on to say that renewed leadership is required, at the national, state, and local levels, to re-engage governmental and nongovernmental support for HIV/AIDS prevention programs.

Among the various opportunities cited, respondents wanted federal and state agencies to expand mass media HIV/AIDS prevention education messages that support local efforts to educate the public on the entire continuum of risk reduction and the level of risk associated with specific behaviors. These messages should be nonjudgmental but communicate that HIV/AIDS is still a dangerous and ultimately fatal disease. Respondents also suggested that in many racial and ethnic minority communities, ethnic media have been greatly underutilized. Such media, especially ethnic radio, offer lower cost ways to reach target populations.

In the educational arena, many respondents called for federal and state agencies to support implementation of classroom instruction on the transmission and prevention of sexually transmitted diseases, including HIV/AIDS. The federal government, they said, should reconsider its prohibition against funding school programs that discuss prevention strategies other than abstinence. “This often forces schools to choose between



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