Living with HIV/AIDS in Idaho
ISU – Boise professor conducts research to improve services in Idaho
When Duane Quintana graduated from Wendell High School in 1997, he moved to Phoenix, Arizona, with the dream of becoming an architect.
"I wanted to build my parents a nice house on a hill," the 29-year-old recalls.
Two years later, he was back in Wendell, wondering if he'd live another year, let alone start a career in architecture. On May 13, 1999, doctors in Phoenix diagnosed Quintana with HIV, the virus that causes AIDS. He returned to Wendell, where he had the emotional support of his family, but struggled to find HIV services in the agricultural community of 2,400. Quintana had to drive 30 miles to Twin Falls to meet with his case manager, and travel another 100 miles to Boise for appointments with his HIV doctor.
In 2000, he felt he had no choice but to move to Boise where HIV services were more accessible.
Quintana, the founder of the nonprofit support and education group ALPHA – Allies Linked for the Prevention of HIV and AIDS – says his experiences are similar to many HIV/AIDS patients in rural Idaho.
In summer 2007, the Idaho Department of Health and Welfare awarded Idaho State University-Boise professor Galen Louis a $109,164 contract to help communities improve HIV services in Idaho. Funding is from the federal Centers for Disease Control.
"What one community may need for HIV prevention and care may differ from what another community may require," says Teri Carrigan, HIV prevention coordinator for the Idaho Department of Health and Welfare's Family Planning, STD and HIV Program. "We are grateful to be utilizing Galen's expertise in public health for this important project."
In fall 2007, Louis, Ph.D., and his researchers conducted more than a dozen focus groups in Idaho's seven health districts. Their goal was to identify gaps in local HIV services and gauge perceptions of existing services.
"We wanted to find out what users think of the services," says Louis, director of ISU-Boise's Master of Public Health program. "Have they encountered barriers within their own communities? Our goal is to build a profile of what each community looks like."
Though the research is in the initial stages, profiles within each health district are starting to emerge. Researchers have found that although nearly 1,000 people are living with HIV or AIDS in Idaho, the stigma sometimes associated with the disease remains the greatest barrier to seeking out available services.
"Stigma was perceived in all seven health districts," Louis said.
Quintana, who did not participate in the focus groups, said stigma was an issue for him while living in Wendell.
"There was the fear of being identified," Quintana says. "It's a small town. Everybody knows everybody. I was more concerned about my family. I didn't want them to be harassed."
The focus groups had varying perceptions of the level and quality of HIV medical care and services within their communities. For example:
- Coeur d'Alene and Lewiston – which are in Districts 1 and 2 – reported the fewest available services. Focus-group members claimed to have no access or limited access to HIV medical and dental care, forcing many to travel to metro areas, such as Spokane, Wash.
- The more metropolitan areas of Caldwell, Boise and Pocatello – Districts 3, 4 and 6 respectively – perceived access to HIV medical care and social services as good. However, more rural areas reported adequacy of care and services as moderate or even poor.
Also significant, says Louis, is the perception that communities aren't providing enough HIV/AIDS prevention education, particularly in the high schools. That has led some respondents to conclude Idaho is choosing to ignore the issue of HIV/AIDS, says Louis. He expects to compile all findings by September.
It will then be the job of the Idaho Department of Health and Welfare and community stakeholders – relying on Louis and his team's data – to develop strategic plans to improve HIV services within each health district. Local control is the cornerstone of the project's success, says Louis, who will facilitate the planning process.
"Communities own the problems already," Louis says. "Hopefully, they own the solutions, and Idaho State University will help them facilitate those solutions."
Quintana, who will assist in the creation of the Boise district plan, supports the approach. "I think it makes sense," he says. "These things have to be tailored to meet the needs of specific communities."