Rural people living with HIV/AIDS and rural people at risk of contracting HIV must have access to quality services. Priorities should be set by regional planning processes, not by Portland bureaucrats. Rural counties must receive adequate funding to deliver services, and rural people must have access to HIV prevention services that are relevant and appropriate.
Oregon is a low incident state and should approach HIV prevention like other states where transmission is low. Oregon reports about 300 new cases each year. By comparison, New York reports 7,500 new cases every year. While prevention models that work in New York City may very well work in Portland, it's absurd to think that they will work in Roseburg, Coos Bay or Grants Pass.
About two-thirds of Oregon's new cases of HIV every year are reported in Portland and Portland should receive the lion's share of the funding; however, since the early years of this century, Portland's share has grown disproportionally and needs to be adjusted.
In Portland, homosexual transmission is ten times greater than transmission among heterosexuals. In Oregon's other urban centers, Salem. Eugene and Medford, the ratio is closer to 4:1. In rural Southwest Oregon the ration is closer to 2:1. There cannot be one intervention model that will work throughout the state.
Each year the situation worsens. Our legislature and our governor do not address this problem. They rely on an elite set of Portland based committees to address public health issues, and it's just not working. The process is too politicized. It's time to ask the judiciary to decide our fate. If you qualify as a plaintiff, join us in addressing the disparity.
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