266836 Healthcare resource disparities among persons living with HIV and AIDS (PLWHA)

Monday, October 29, 2012

Deshia Leonhirth, MBA , South Carolina Rural Health Research Center, University of South Carolina, Columbia, SC
Medha V. Vyavaharkar, PhD, MPH, MD , South Carolina Rural Health Research Center, Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina., Columbia, SC
Saundra Glover, MBA, PhD , Institute for Partnerships to Eliminate Health Disparities, University of South Carolina - Arnold School of Public Health, Columbia, SC
Janice C. Probst, PhD , University of South Carolina, South Carolina Rural Health Research Center, Columbia, SC
Background: Many persons living with HIV and AIDS (PLWHA) face challenges in accessing healthcare. Lack of providers who accept and treat PLWHA contributes partly to inconsistent utilization of healthcare services among PLWHA. Ryan White (RW) medical providers offer primary care and referral services to PLWHA irrespective of insurance status or ability to pay. This study examined rural-urban differences in availability of RW medical providers. Methods: Data on prevalence of HIV/AIDS and RW providers were extracted from publically available state surveillance reports and an on-line search tool available on the Health Resources and Service Administration's website respectively. The states that provided county-level information on HIV/AIDS prevalence (28 states; 2,172 counties) were included in this 2008 cross-sectional analysis. The dependent variable was presence of at least one RW provider in a county. The independent variables included prevalence of HIV/AIDS, rurality, and percent of population: below poverty, minority, African American and uninsured. Results: More than 14% of PLWHA live in counties without a RW medical provider. Higher proportion of rural PLWHA (74.8%) lived in counties lacking a RW medical provider compared to urban PLWHA (11.0%). Adjusting for prevalence of HIV/AIDS, percent population: below poverty, minority, African American and uninsured, urban counties had almost 5 times the odds of having a RW medical provider than rural (p<.0001). Conclusion: Findings highlight rural-urban resource disparities for PLWHA. There is urgent need to consider and implement policies that would help improve safety net access for PLWHA living in rural counties.

Learning Areas:
Public health or related public policy
Public health or related research

Learning Objectives:
Describe availability of RW medical providers by rurality.

Keywords: HIV/AIDS, Rural Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a 2nd year Doctoral student at an accredited school of public health at the University of South Carolina. In the past year and a half I have worked on a grant funded by the Office of Rural Health Policy to complete the submitted research on HIV/AIDS.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.