State of HIV primary care in rural settings

Issues: Access to HIV primary care in rural settings is a critical issue for many providers and PLWHA across the U.S. Description: HealthHIV surveyed healthcare providers in the Inaugural State of HIV Primary Care survey in 2009. Many of the 1,100 survey respondents were from rural primary care settings. Data were gained from multiple sources, evaluation data from a national HIV capacity building assistance (CBA) program providing assistance to clinics in rural settings, as well as data collected from a Mississippi Delta region specific nurse recruitment and retention project. These data will be used to describe the state of HIV primary care in U.S. rural settings. Lessons Learned: Many of the more than 100 organizations receiving CBA through are in rural areas. The combination of quantitative survey data and the qualitative, in-depth interview data from the CBA program evaluation provide a unique perspective on how HIV primary care is being delivered in rural areas. These data also illuminate the challenges to providing HIV primary care in rural areas in contrast to urban areas. The project focusing on nurse recruitment in the Mississippi Delta region highlights one program designed to address at least the recruitment challenge in that region. Recommendations: CBA is essential in building the HIV primary care capacity of health centers in rural areas. The survey data also point to the specific technical assistance and CBA needs of many rural providers. Chief among these needs is development capacity and specific program implementation challenges.