One of the goals President Donald Trump announced in his State of the Union address was to stop the spread of HIV in the U.S. within 10 years.

In addition to sending extra money to 48 mainly urban counties, Washington, D.C., and San Juan, Puerto Rico, Trump’s plan targets seven states where rural transmission of HIV is especially high.

Health officials and doctors treating patients with HIV in those states say any extra funding would be welcome. But they say strategies that work in progressive cities like Seattle won’t necessarily work in rural areas of Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma and South Carolina.

Stigma around HIV and AIDS and around being gay runs deep in parts of Oklahoma, said Dr. Michelle Salvaggio, medical director of the Infectious Diseases Institute at the University of Oklahoma Health Sciences Center in Oklahoma City. The institute is one of two federally funded HIV clinics in Oklahoma; the other is in Tulsa, the state’s second-largest city. Support services are sorely lacking—including ood pantries, mental health therapy and transportation assistance — to help them deal with the disease. Populations are uninsured.

Even inexpensive, proven methods for fighting HIV — like distributing condoms — can be a tough sell in a state that doesn’t mandate comprehensive sex education. Read more via KHN