More Than One-Third of Rural Adults With HIV Travel Over 1 Hour for Care

The median drive time to their usual health care provider was almost 4 times longer for people with human immunodeficiency virus (HIV) who lived in rural areas compared with urban areas, according to study results published in AIDS Care.

“In the United States, people living with HIV in rural areas fare worse along the HIV care continuum than their urban counterparts; this may be due in part to limited geographic access to care,” wrote corresponding author April D. Kimmel, PhD, and coauthors from the Virginia Commonwealth University School of Medicine in Richmond.

The study included 49,596 adults with HIV from 14 states who were enrolled in Medicaid. Researchers identified each person’s zip code and the practice address of their usual care health care provider from administrative claims data, then calculated their one-way drive time to access care.

The median drive time for patients in rural areas was 43.6 minutes, according to the study, compared with 11.9 minutes for patients in urban areas. For 38% of rural patients, drive times exceeded 1 hour. Among urban patients, just 12% had drive times over 1 hour.

Further analyses—including adjusting the definition of rural; investigating subsamples by state, services, and clinician specialty; and adjusting for individual and county characteristics—also consistently revealed urban-rural disparities.

“Sustained efforts to circumvent limited geographic access to care are critical for rural areas,” the research team advised.

Reference:
Bono RS, Pan Z, Dahman B, Deng Y, Kimmel AD. Urban-rural disparities in geographic accessibility to care for people living with HIV. AIDS Care. Published online November 12, 2022. doi:10.1080/09540121.2022.2141186