The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68112

John F. Yannessa, MS, Michael Reece, PhD, MPH, Dewana Allen, MPH, and Erin Koers. Department of Applied Health Science, Indiana University, HPER Building 116, 1025 East 7th Street, Bloomington, IN 47405-7109, (812) 855-0621, jyanness@indiana.edu

Introduction: As HIV extends its impact on diverse segments of American society, providers are faced with new and complex situations that challenge their ability to develop effective HIV prevention and HIV care programs. While some literature has focused on the extent to which HIV and AIDS have affected individuals living in rural America, relatively little is known about the extent to which public health providers in these areas are able to develop effective responses in the context of the complexities of rural communities. Method: To better understand the problematic challenges facing rural HIV providers, semi-structured, in-depth interviews were conducted with 39 providers at 11 HIV service agencies in rural communities throughout the state of Indiana. Results: Results suggest that issues related to substance abuse are among those that most often challenge the ability of providers to engage, and deliver services to, individuals living with HIV. Specific findings related to this include: the existence of HIV-related stigma within multiple facets of rural communities, high levels of individual and community denial, transportation barriers for service providers and the HIV client, limited rural HIV care infrastructures, and limited substance abuse and HIV-related education and training among individuals and providers.Conclusions: Many challenges exist for the rural HIV care provider. However, these communities also have strengths that, if capitalized upon, will enhance the ability of rural community providers to develop more effective responses to the co-epidemics of HIV and substance abuse in their communities.

Learning Objectives:

• Participants will be able to recognize many of the unique issues associated with providing care to substance using individuals living with HIV in rural communities.
• Participants will be able to describe the associations between HIV-related stigma and the ability to provide effective care.
• Participants will be able to describe the characteristics of rural communities that facilitate their ability to overcome many of the challenges they face in HIV related services.

Keywords: HIV/AIDS,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.