The care of HIV-infected adults in rural areas of the United States.
OBJECTIVE
This study describes the population of HIV-infected adults receiving care in rural areas of the United States and compares HIV care received in rural and urban areas.


METHODS
Interviews were conducted with a nationally representative sample of 367 HIV-infected adults receiving health care in rural areas and 2806 HIV-infected adults receiving health care in urban areas of the contiguous United States.


RESULTS
We estimate that 4800 HIV-infected persons received medical care in rural areas during the first half of 1996. Patients in rural HIV care were more likely than patients in urban HIV care to receive care from providers seeing few (<10) HIV-infected patients (38% vs. 3%; p <.001). Rural care patients were less likely than urban care patients to have taken highly active antiretroviral agents (57% vs. 73%; p <.001) or Pneumocystis carinii pneumonia prophylactic medication when indicated (60% vs. 75%; p =.006).


CONCLUSIONS
Few American adults received HIV care in rural areas of the United States. Our findings suggest ongoing disparities between urban and rural areas in access to high-quality HIV care.
Cohn
S E
SE
University of Rochester, Rochester, New York, USA. susan_cohn@urmc.rochester.edu
Berk
M L
ML
Berry
S H
SH
Duan
N
N
Frankel
M R
MR
Klein
J D
JD
McKinney
M M
MM
Rastegar
A
A
Smith
S
S
Shapiro
M F
MF
Bozzette
S A
SA
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011010:Pneumocystis; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control; D012423:Rural Health; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D019380:Anti-HIV Agents