HIV testing and HIV/AIDS treatment services in rural counties in 10 southern states: service provider perspectives.
BACKGROUND
Forty percent of AIDS cases are reported in the southern United States, the region with the largest proportion of HIV/AIDS cases from rural areas. Data are limited regarding provider perspectives of the accessibility and availability of HIV testing and treatment services in southern rural counties.


OBJECTIVE
We surveyed providers in the rural south to better understand: (1) the accessibility and availability, and (2) the facilitators and barriers of HIV testing and treatment services.


METHODS
All county health departments (N = 326) serving populations of <50,000 persons, within 10 southern states, were mailed surveys. Responding health departments identified up to 3 HIV testing sites and up to 3 HIV treatment sites to which they refer clients.


RESULTS
Overall, 243 of 326 (75%) health departments, 133 of 250 (53%) HIV testing sites, and 73 of 152 (48%) HIV treatment sites responded to the surveys. The number of testing sites per county ranged from 0 to 20; the number of treatment sites ranged from 0 to 4. An average distance of 50 miles for clients to travel for HIV treatment was reported by health department respondents as a barrier. Facilitators of HIV testing were (1) integrating HIV testing into other health services; (2) using rapid HIV testing; and (3) establishing easily accessible HIV testing locations and free testing services.


CONCLUSIONS
Providers perceive that distance from local health departments to HIV treatment sites presents a barrier to HIV care for their clients. Future studies should ascertain clients' perspectives to ensure appropriate service provisions.
Sutton
Madeline
M
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. msutton@cdc.gov
Anthony
Monique-Nicole
MN
Vila
Christie
C
McLellan-Lemal
Eleanor
E
Weidle
Paul J
PJ
D003430:Cross-Sectional Studies; D005843:Geography; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000191:economics; D015497:HIV-1 / Q000302:isolation & purification; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006801:Humans; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States