Navigating “Nowhere”: Building a Medical AIDS Response in the Rural Heartland

Though the AIDS epidemic presented itself on a much smaller scale and with a slightly delayed timeline in the Heartland region than it did in coastal cities, it also faced a vastly different social and political terrain that significantly impacted the way that doctors and public health officials responded to the disease locally. This paper explores the medical challenges faced by doctors in this region which included political and religious conservatism of a greater scale than the coasts, a much more anemic medical infrastructure, increased social stigma for people with AIDS, and a disparate set of patients. The tactics deployed by doctors, researchers, and public health officials in response to these regional idiosyncrasies ranged from a physician using a crop-duster to reach, yet insure discretion for, far-flung patients to fostering deep community and regional investment in medical trails and research initiatives offered the region’s best medical school and research center. This focus on the heartland puts in stark light the importance of each AIDS-focused medical professional in states where the number of AIDs specialists can be counted on a single hand. It also puts on full display how the simple act of being a medical professional or researcher can, in and of itself, both be a form of activism and foster political engagement.