The Health Resources and Services Administration's Ryan White HIV/AIDS Program in rural areas of the United States: Geographic distribution, provider characteristics, and clinical outcomes
People living with HIV (PLWH) residing in rural areas experience substantial barriers to HIV care, which may contribute to poor HIV health outcomes, including retention in HIV care and viral suppression. The Health Resources and Services Administration's Ryan White HIV/AIDS Program (HRSA RWHAP)...
Gespeichert in:
| Veröffentlicht in: | PloS one 2020-03, Vol.15 (3), p.e0230121-e0230121 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0230121 |
|---|---|
| container_issue | 3 |
| container_start_page | e0230121 |
| container_title | PloS one |
| container_volume | 15 |
| creator | Klein, Pamela W Geiger, Tanya Chavis, Nicole S Cohen, Stacy M Ofori, Alexa B Umali, Kathryn T Hauck, Heather |
| description | People living with HIV (PLWH) residing in rural areas experience substantial barriers to HIV care, which may contribute to poor HIV health outcomes, including retention in HIV care and viral suppression. The Health Resources and Services Administration's Ryan White HIV/AIDS Program (HRSA RWHAP) is an important source of HIV medical care and support services in rural areas. The purpose of this analysis was to (1) assess the reach of the RWHAP in rural areas of the United States, (2) compare the characteristics and funded services of RWHAP provider organizations in rural and non-rural areas, and (3) compare the characteristics and clinical outcomes of RWHAP clients accessing medical care and support services in rural and non-rural areas.
Data for this analysis were abstracted from the 2017 RWHAP Services Report (RSR), the primary source of annual, client-level RWHAP data. Organizations funded to deliver RWHAP any service ("RWHAP providers") were categorized as rural or non-rural according to the HRSA FORHP's definition of modified Rural-Urban Commuting Area (RUCA) codes. RWHAP clients were categorized based on their patterns of RWHAP service use as "visited only rural providers," "visited only non-rural providers," or "visited rural and non-rural providers." In 2017, among the 2,113 providers funded by the RWHAP, 6.2% (n = 132) were located in HRSA-designated rural areas. Rural providers were funded to deliver a greater number of service categories per site than non-rural providers (44.7% funded for ≥5 services vs. 34.1% funded for ≥5 services, respectively). Providers in rural areas served fewer clients than providers in non-rural areas; 47.3% of RWHAP providers in rural areas served 1-99 clients, while 29.6% of non-rural providers served 1-99 clients. Retention in care and viral suppression outcomes did not differ on the basis of whether a client accessed services from rural or non-rural providers.
RWHAP providers are a crucial component of HIV care delivery in the rural United States despite evidence of significant barriers to engagement in care for rural PLWH, RWHAP clients who visited rural providers were just as likely to be retained in care and reach viral suppression as their counterparts who visited non-rural providers. The RWHAP, especially in partnership with Rural Health Clinics and federally funded Health Centers, has the infrastructure and expertise necessary to address the HIV epidemic in rural America. |
| doi_str_mv | 10.1371/journal.pone.0230121 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2382033875</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A618329595</galeid><doaj_id>oai_doaj_org_article_9d4f739890a6427981c45d8c3038a3a0</doaj_id><sourcerecordid>A618329595</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-27637cea189dd8e05fd11f85631266e51c9d5d513c42e864db0bdf46e3e7603</originalsourceid><addsrcrecordid>eNqNk91u0zAUxyMEYmPwBggsTeJDWjs7ThyHC6RqwFZp0tA6xqXl2ieNqyQutjOxd-PhcNpuWtEuUC4SH__O_3zknCR5TfCY0IIcL23vOtmMV7aDMU4pJil5kuyTkqYjlmL69MH3XvLC-yXGOeWMPU_2aBqNec72kz9XNaAzkE2o0SX4qKnAI9lpNAN3Y4bDRLemMz44GYzt3nt0eSs79LM2IXpOr48n0y8z9N3ZhZMtMh1yvZMNkg6kR7ZCIQb40UU4SgYZwH9CpzDAq9oopAdhM-8H6SO0cvbGaHBI1dJJFcDFa6P80Toj1cQ8VNS2fVC2Bf8yeVbJxsOr7fsgmX37enVyNjq_OJ2eTM5HipVpGKUFo4UCSXipNQecV5qQiueMkpQxyIkqda5zQlWWAmeZnuO5rjIGFAqG6UHydqO6aqwX27Z7kVIem0h5kUdiuiG0lUuxcqaV7lZYacTaYN1CSBfraECUOqsKWvISS5alRcmJynLNFcWUSyqHaJ-30fp5C1pBFxvf7Iju3nSmFgt7IwrMy5wNyXzYCjj7qwcfRGu8gqaRHdh-kzeLYEEjevgP-nh1W2ohYwGmq2yMqwZRMWGE07TMy4EaP0LFR0NrVJzRykT7jsPHHYfIBPgdFrL3Xkxnl__PXlzvsu8esPV6tL1t1hPmd8FsAypnvXdQ3TeZYDGs2F03xLBiYrti0e3Nwx9073S3U_QvqGoixQ</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2382033875</pqid></control><display><type>article</type><title>The Health Resources and Services Administration's Ryan White HIV/AIDS Program in rural areas of the United States: Geographic distribution, provider characteristics, and clinical outcomes</title><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><source>Public Library of Science (PLoS)</source><creator>Klein, Pamela W ; Geiger, Tanya ; Chavis, Nicole S ; Cohen, Stacy M ; Ofori, Alexa B ; Umali, Kathryn T ; Hauck, Heather</creator><creatorcontrib>Klein, Pamela W ; Geiger, Tanya ; Chavis, Nicole S ; Cohen, Stacy M ; Ofori, Alexa B ; Umali, Kathryn T ; Hauck, Heather</creatorcontrib><description>People living with HIV (PLWH) residing in rural areas experience substantial barriers to HIV care, which may contribute to poor HIV health outcomes, including retention in HIV care and viral suppression. The Health Resources and Services Administration's Ryan White HIV/AIDS Program (HRSA RWHAP) is an important source of HIV medical care and support services in rural areas. The purpose of this analysis was to (1) assess the reach of the RWHAP in rural areas of the United States, (2) compare the characteristics and funded services of RWHAP provider organizations in rural and non-rural areas, and (3) compare the characteristics and clinical outcomes of RWHAP clients accessing medical care and support services in rural and non-rural areas.
Data for this analysis were abstracted from the 2017 RWHAP Services Report (RSR), the primary source of annual, client-level RWHAP data. Organizations funded to deliver RWHAP any service ("RWHAP providers") were categorized as rural or non-rural according to the HRSA FORHP's definition of modified Rural-Urban Commuting Area (RUCA) codes. RWHAP clients were categorized based on their patterns of RWHAP service use as "visited only rural providers," "visited only non-rural providers," or "visited rural and non-rural providers." In 2017, among the 2,113 providers funded by the RWHAP, 6.2% (n = 132) were located in HRSA-designated rural areas. Rural providers were funded to deliver a greater number of service categories per site than non-rural providers (44.7% funded for ≥5 services vs. 34.1% funded for ≥5 services, respectively). Providers in rural areas served fewer clients than providers in non-rural areas; 47.3% of RWHAP providers in rural areas served 1-99 clients, while 29.6% of non-rural providers served 1-99 clients. Retention in care and viral suppression outcomes did not differ on the basis of whether a client accessed services from rural or non-rural providers.
RWHAP providers are a crucial component of HIV care delivery in the rural United States despite evidence of significant barriers to engagement in care for rural PLWH, RWHAP clients who visited rural providers were just as likely to be retained in care and reach viral suppression as their counterparts who visited non-rural providers. The RWHAP, especially in partnership with Rural Health Clinics and federally funded Health Centers, has the infrastructure and expertise necessary to address the HIV epidemic in rural America.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0230121</identifier><identifier>PMID: 32203556</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; AIDS ; Ambulatory care facilities ; Biology and Life Sciences ; Clients ; Clinical outcomes ; Community ; Commuting ; Earth Sciences ; Epidemics ; Geographical distribution ; Grants ; Health care ; Health care facilities ; Health care industry ; Health services ; HIV ; HIV patients ; Human immunodeficiency virus ; Infrastructure (Economics) ; Low income groups ; Medical diagnosis ; Medicine and Health Sciences ; Mental health ; Narcotics ; Organizations ; Patient outcomes ; Public health ; Retention ; Rural areas ; Rural health ; Support services ; White, Ryan</subject><ispartof>PloS one, 2020-03, Vol.15 (3), p.e0230121-e0230121</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-27637cea189dd8e05fd11f85631266e51c9d5d513c42e864db0bdf46e3e7603</citedby><cites>FETCH-LOGICAL-c692t-27637cea189dd8e05fd11f85631266e51c9d5d513c42e864db0bdf46e3e7603</cites><orcidid>0000-0002-0475-1122 ; 0000-0001-8311-5804 ; 0000-0003-4613-3725</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7089565/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7089565/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32203556$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Klein, Pamela W</creatorcontrib><creatorcontrib>Geiger, Tanya</creatorcontrib><creatorcontrib>Chavis, Nicole S</creatorcontrib><creatorcontrib>Cohen, Stacy M</creatorcontrib><creatorcontrib>Ofori, Alexa B</creatorcontrib><creatorcontrib>Umali, Kathryn T</creatorcontrib><creatorcontrib>Hauck, Heather</creatorcontrib><title>The Health Resources and Services Administration's Ryan White HIV/AIDS Program in rural areas of the United States: Geographic distribution, provider characteristics, and clinical outcomes</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>People living with HIV (PLWH) residing in rural areas experience substantial barriers to HIV care, which may contribute to poor HIV health outcomes, including retention in HIV care and viral suppression. The Health Resources and Services Administration's Ryan White HIV/AIDS Program (HRSA RWHAP) is an important source of HIV medical care and support services in rural areas. The purpose of this analysis was to (1) assess the reach of the RWHAP in rural areas of the United States, (2) compare the characteristics and funded services of RWHAP provider organizations in rural and non-rural areas, and (3) compare the characteristics and clinical outcomes of RWHAP clients accessing medical care and support services in rural and non-rural areas.
Data for this analysis were abstracted from the 2017 RWHAP Services Report (RSR), the primary source of annual, client-level RWHAP data. Organizations funded to deliver RWHAP any service ("RWHAP providers") were categorized as rural or non-rural according to the HRSA FORHP's definition of modified Rural-Urban Commuting Area (RUCA) codes. RWHAP clients were categorized based on their patterns of RWHAP service use as "visited only rural providers," "visited only non-rural providers," or "visited rural and non-rural providers." In 2017, among the 2,113 providers funded by the RWHAP, 6.2% (n = 132) were located in HRSA-designated rural areas. Rural providers were funded to deliver a greater number of service categories per site than non-rural providers (44.7% funded for ≥5 services vs. 34.1% funded for ≥5 services, respectively). Providers in rural areas served fewer clients than providers in non-rural areas; 47.3% of RWHAP providers in rural areas served 1-99 clients, while 29.6% of non-rural providers served 1-99 clients. Retention in care and viral suppression outcomes did not differ on the basis of whether a client accessed services from rural or non-rural providers.
RWHAP providers are a crucial component of HIV care delivery in the rural United States despite evidence of significant barriers to engagement in care for rural PLWH, RWHAP clients who visited rural providers were just as likely to be retained in care and reach viral suppression as their counterparts who visited non-rural providers. The RWHAP, especially in partnership with Rural Health Clinics and federally funded Health Centers, has the infrastructure and expertise necessary to address the HIV epidemic in rural America.</description><subject>Acquired immune deficiency syndrome</subject><subject>AIDS</subject><subject>Ambulatory care facilities</subject><subject>Biology and Life Sciences</subject><subject>Clients</subject><subject>Clinical outcomes</subject><subject>Community</subject><subject>Commuting</subject><subject>Earth Sciences</subject><subject>Epidemics</subject><subject>Geographical distribution</subject><subject>Grants</subject><subject>Health care</subject><subject>Health care facilities</subject><subject>Health care industry</subject><subject>Health services</subject><subject>HIV</subject><subject>HIV patients</subject><subject>Human immunodeficiency virus</subject><subject>Infrastructure (Economics)</subject><subject>Low income groups</subject><subject>Medical diagnosis</subject><subject>Medicine and Health Sciences</subject><subject>Mental health</subject><subject>Narcotics</subject><subject>Organizations</subject><subject>Patient outcomes</subject><subject>Public health</subject><subject>Retention</subject><subject>Rural areas</subject><subject>Rural health</subject><subject>Support services</subject><subject>White, Ryan</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk91u0zAUxyMEYmPwBggsTeJDWjs7ThyHC6RqwFZp0tA6xqXl2ieNqyQutjOxd-PhcNpuWtEuUC4SH__O_3zknCR5TfCY0IIcL23vOtmMV7aDMU4pJil5kuyTkqYjlmL69MH3XvLC-yXGOeWMPU_2aBqNec72kz9XNaAzkE2o0SX4qKnAI9lpNAN3Y4bDRLemMz44GYzt3nt0eSs79LM2IXpOr48n0y8z9N3ZhZMtMh1yvZMNkg6kR7ZCIQb40UU4SgYZwH9CpzDAq9oopAdhM-8H6SO0cvbGaHBI1dJJFcDFa6P80Toj1cQ8VNS2fVC2Bf8yeVbJxsOr7fsgmX37enVyNjq_OJ2eTM5HipVpGKUFo4UCSXipNQecV5qQiueMkpQxyIkqda5zQlWWAmeZnuO5rjIGFAqG6UHydqO6aqwX27Z7kVIem0h5kUdiuiG0lUuxcqaV7lZYacTaYN1CSBfraECUOqsKWvISS5alRcmJynLNFcWUSyqHaJ-30fp5C1pBFxvf7Iju3nSmFgt7IwrMy5wNyXzYCjj7qwcfRGu8gqaRHdh-kzeLYEEjevgP-nh1W2ohYwGmq2yMqwZRMWGE07TMy4EaP0LFR0NrVJzRykT7jsPHHYfIBPgdFrL3Xkxnl__PXlzvsu8esPV6tL1t1hPmd8FsAypnvXdQ3TeZYDGs2F03xLBiYrti0e3Nwx9073S3U_QvqGoixQ</recordid><startdate>20200323</startdate><enddate>20200323</enddate><creator>Klein, Pamela W</creator><creator>Geiger, Tanya</creator><creator>Chavis, Nicole S</creator><creator>Cohen, Stacy M</creator><creator>Ofori, Alexa B</creator><creator>Umali, Kathryn T</creator><creator>Hauck, Heather</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-0475-1122</orcidid><orcidid>https://orcid.org/0000-0001-8311-5804</orcidid><orcidid>https://orcid.org/0000-0003-4613-3725</orcidid></search><sort><creationdate>20200323</creationdate><title>The Health Resources and Services Administration's Ryan White HIV/AIDS Program in rural areas of the United States: Geographic distribution, provider characteristics, and clinical outcomes</title><author>Klein, Pamela W ; Geiger, Tanya ; Chavis, Nicole S ; Cohen, Stacy M ; Ofori, Alexa B ; Umali, Kathryn T ; Hauck, Heather</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-27637cea189dd8e05fd11f85631266e51c9d5d513c42e864db0bdf46e3e7603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>AIDS</topic><topic>Ambulatory care facilities</topic><topic>Biology and Life Sciences</topic><topic>Clients</topic><topic>Clinical outcomes</topic><topic>Community</topic><topic>Commuting</topic><topic>Earth Sciences</topic><topic>Epidemics</topic><topic>Geographical distribution</topic><topic>Grants</topic><topic>Health care</topic><topic>Health care facilities</topic><topic>Health care industry</topic><topic>Health services</topic><topic>HIV</topic><topic>HIV patients</topic><topic>Human immunodeficiency virus</topic><topic>Infrastructure (Economics)</topic><topic>Low income groups</topic><topic>Medical diagnosis</topic><topic>Medicine and Health Sciences</topic><topic>Mental health</topic><topic>Narcotics</topic><topic>Organizations</topic><topic>Patient outcomes</topic><topic>Public health</topic><topic>Retention</topic><topic>Rural areas</topic><topic>Rural health</topic><topic>Support services</topic><topic>White, Ryan</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Klein, Pamela W</creatorcontrib><creatorcontrib>Geiger, Tanya</creatorcontrib><creatorcontrib>Chavis, Nicole S</creatorcontrib><creatorcontrib>Cohen, Stacy M</creatorcontrib><creatorcontrib>Ofori, Alexa B</creatorcontrib><creatorcontrib>Umali, Kathryn T</creatorcontrib><creatorcontrib>Hauck, Heather</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Klein, Pamela W</au><au>Geiger, Tanya</au><au>Chavis, Nicole S</au><au>Cohen, Stacy M</au><au>Ofori, Alexa B</au><au>Umali, Kathryn T</au><au>Hauck, Heather</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Health Resources and Services Administration's Ryan White HIV/AIDS Program in rural areas of the United States: Geographic distribution, provider characteristics, and clinical outcomes</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2020-03-23</date><risdate>2020</risdate><volume>15</volume><issue>3</issue><spage>e0230121</spage><epage>e0230121</epage><pages>e0230121-e0230121</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>People living with HIV (PLWH) residing in rural areas experience substantial barriers to HIV care, which may contribute to poor HIV health outcomes, including retention in HIV care and viral suppression. The Health Resources and Services Administration's Ryan White HIV/AIDS Program (HRSA RWHAP) is an important source of HIV medical care and support services in rural areas. The purpose of this analysis was to (1) assess the reach of the RWHAP in rural areas of the United States, (2) compare the characteristics and funded services of RWHAP provider organizations in rural and non-rural areas, and (3) compare the characteristics and clinical outcomes of RWHAP clients accessing medical care and support services in rural and non-rural areas.
Data for this analysis were abstracted from the 2017 RWHAP Services Report (RSR), the primary source of annual, client-level RWHAP data. Organizations funded to deliver RWHAP any service ("RWHAP providers") were categorized as rural or non-rural according to the HRSA FORHP's definition of modified Rural-Urban Commuting Area (RUCA) codes. RWHAP clients were categorized based on their patterns of RWHAP service use as "visited only rural providers," "visited only non-rural providers," or "visited rural and non-rural providers." In 2017, among the 2,113 providers funded by the RWHAP, 6.2% (n = 132) were located in HRSA-designated rural areas. Rural providers were funded to deliver a greater number of service categories per site than non-rural providers (44.7% funded for ≥5 services vs. 34.1% funded for ≥5 services, respectively). Providers in rural areas served fewer clients than providers in non-rural areas; 47.3% of RWHAP providers in rural areas served 1-99 clients, while 29.6% of non-rural providers served 1-99 clients. Retention in care and viral suppression outcomes did not differ on the basis of whether a client accessed services from rural or non-rural providers.
RWHAP providers are a crucial component of HIV care delivery in the rural United States despite evidence of significant barriers to engagement in care for rural PLWH, RWHAP clients who visited rural providers were just as likely to be retained in care and reach viral suppression as their counterparts who visited non-rural providers. The RWHAP, especially in partnership with Rural Health Clinics and federally funded Health Centers, has the infrastructure and expertise necessary to address the HIV epidemic in rural America.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32203556</pmid><doi>10.1371/journal.pone.0230121</doi><tpages>e0230121</tpages><orcidid>https://orcid.org/0000-0002-0475-1122</orcidid><orcidid>https://orcid.org/0000-0001-8311-5804</orcidid><orcidid>https://orcid.org/0000-0003-4613-3725</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2020-03, Vol.15 (3), p.e0230121-e0230121 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2382033875 |
| source | DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Acquired immune deficiency syndrome AIDS Ambulatory care facilities Biology and Life Sciences Clients Clinical outcomes Community Commuting Earth Sciences Epidemics Geographical distribution Grants Health care Health care facilities Health care industry Health services HIV HIV patients Human immunodeficiency virus Infrastructure (Economics) Low income groups Medical diagnosis Medicine and Health Sciences Mental health Narcotics Organizations Patient outcomes Public health Retention Rural areas Rural health Support services White, Ryan |
| title | The Health Resources and Services Administration's Ryan White HIV/AIDS Program in rural areas of the United States: Geographic distribution, provider characteristics, and clinical outcomes |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T11%3A17%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Health%20Resources%20and%20Services%20Administration's%20Ryan%20White%20HIV/AIDS%20Program%20in%20rural%20areas%20of%20the%20United%20States:%20Geographic%20distribution,%20provider%20characteristics,%20and%20clinical%20outcomes&rft.jtitle=PloS%20one&rft.au=Klein,%20Pamela%20W&rft.date=2020-03-23&rft.volume=15&rft.issue=3&rft.spage=e0230121&rft.epage=e0230121&rft.pages=e0230121-e0230121&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0230121&rft_dat=%3Cgale_plos_%3EA618329595%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2382033875&rft_id=info:pmid/32203556&rft_galeid=A618329595&rft_doaj_id=oai_doaj_org_article_9d4f739890a6427981c45d8c3038a3a0&rfr_iscdi=true |