Setting: Southwest Missouri is a region of 29 counties, 24 of which are rural. The population is 95% Caucasian; 622 persons are living with HIV disease in the region. Approximately half live in rural areas. While men comprise 75% of those infected, the number of women with HIV has risen 44% since 1996.
Model: AIDS Project of the Ozarks (APO) serves the entire region, utilizing a model that combines on-site care and care by primary care providers located throughout the region. The main clinic is located in Springfield and staffed by an infectious disease specialist, two nurses, a dietician, an adherence specialist, and 5 case managers. Four other ID specialists see clients in the region. Fee-for-service agreements exist with 50 physicians; 20 are located in rural towns. Clients receive at least twice yearly consults with an ID physician. APO is the only provider of comprehensive HIV care in the region.
Access and Linkage: APO provides HIV primary and specialty care, nutritional counseling, adherence assistance, counseling and testing, and case management. Services funded through APO by referral include dental, psychiatric, mental health and substance abuse counseling, ob-gyn, and specialty services. Case managers are located off-site in three rural locations. APO is closely linked with the regional consortia, community planning groups, and county health departments.
Demographics: APO currently serves 360 clients representing a 25% increase from 1996 to 2000.
Summary: APO utilizes a unique combination of direct care and contractual arrangements to provide effective, comprehensive HIV/AIDS services to a large, predominantly rural region.
Learning Objectives: 1. Describe how HIV clinical services are provided in a large predominantly rural area of Missouri through the AIDS Project of the Ozarks. 2. Describe how rural HIV clinical sites link with specialty and community-based services. 3. Understand how quality improvement is monitored in the AIDS Project of the Ozarks model.
Keywords: HIV/AIDS, Rural Health Care Delivery System
Awards: - WinnerPresenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.