Commentary on "Accessibility and effectiveness of sources of information about HIV/AIDS in a rural population".

The conversion of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) from death sentence to chronic disease stands as a triumph of modern medicine. Although information regarding HIV/AIDS is widely available,many studies have shownnodecrease inHIVincidence with increased education. The continued burden on society of HIV/AIDS, particularly on low-income people, makes it one of the most critical preventive medicine challenges facing our generation. Primary care providers are in a uniqueposition to prevent the spread of this scourge because they have knowledge of the disease and access to the broad population. It is imperative that we develop more effective methods to propagate this knowledge. There are few studies on the prevention of HIV/AIDS in an American rural population. In this issue of the Southern Medical Journal, Hormes and Theall present a study on HIV/ AIDS with questions on media sources, knowledge, and highrisk behaviors in that population. Their poll was completed in a sparsely populated area in rural southeastern Louisiana between October 2008 and October 2010. The population was mostly nonwhite heterosexual women. Specifically, their questionnaire compared the number of media categories and category type (mass media, small media, interpersonal contacts) against high-risk sexual behavior and knowledge of HIV/AIDS. Although this high-risk group does not perfectly mirror the rural population, this cohort most likely has the highest impact on HIV transmission. Results demonstrated that information was widely available. Respondents received information from mass media, interpersonal sources, and small media (eg, brochures). Level of education was correlated with increased exposure to all media sources. The total number of information sources accessed was associated with a perceived risk of contracting HIV, but had no impact on HIV/AIDS knowledge or high-risk behavior. Exposure to specific types of information sources had few significant results. Exposure to small media and interpersonal information was associated with asking steady and casual partners about HIV status. Small media exposure alsowas associated with perceived HIV risk, but inexplicably decreased condom use in all types of sexual activity. One possible explanation for decreased condom use may be a more honest representation of actual use. Because of the saturation of mass media exposure, further analysis of data from this group is not useful. A change is required in our dissemination of information about HIV/AIDS. Fortunately, the message is well dispersed in the study cohort, with nearly all of the participants receiving information from mass media. Unfortunately, this education is not changing high-risk behavior and further studies are required to investigate alternate methods to disseminate instruction that will modify behavior. For example, some studies have shown ways to increase knowledge and decrease risky behavior. Another study analyzed information communicated through Facebook, which improved HIV knowledge but eventually increased HIV stigma. Hormes and Theall’s study should serve as a call to action for health professionals to improve interventions to reduce HIV infection.