Challenges and New Directions in the Rural Setting

ABSTRACT Although frequently not perceived as a rural problem, the prevalence of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) has been increasing in rural settings. Since the emergence of the AIDS epidemic in the United States, researchers and clinicians have been concerned about behaviors placing adolescent populations at risk for acquiring HIV and have sought to develop effective intervention programs. To date, most of these programs have targeted urban or suburban settings. Assessing the applicability of current adolescent risk reduction interventions in new settings is essential to the successful deployment of intervention programs on a wide scale basis. Previous rural research has identified factors suggesting that programs originally developed for urban areas may need to be altered to be applicable to rural settings. As part of our effort to adopt an urban adolescent HIV prevention program entitled “Focus on Kids” to a low-income rural setting, we explored the interplay of rural factors within adolescent risk and protective behaviors and prevention programs according to the perception of community residents. Qualitative research methods were used, including ethnographic approaches previously employed in the urban setting to design the original “Focus on Kids Program.” The findings from the present study identified several factors that might influence the adaptation of urban adolescent risk reduction interventions in low-income rural areas. The present findings suggest that a poor, rural setting provides contextual differences that may influence adolescents' involvement in unprotected sexual behaviors and other risk behaviors.