Recorded presentation

Edward Mamary, DrPH, MS, Department of Health Science, San Jose State University, One Washington Square, San Jose, CA 95192-0052, (510) 452-4657, mama100w@yahoo.com, Lin Downs Becker, MPH, Private Consultant, 7321 Marbella Echo Drive, Delray Beach, FL 33446, and Karla Burnworth, BA, Plumas County Dept. of Health Services, P.O. Box 3140, Quincy, CA 95971.

The number of individuals living with HIV in rural areas has increased significantly in recent years. Rural communities face many unique challenges to providing quality care to their HIV-positive clients. The clinical and psychosocial needs of individuals living with HIV and residing in three rural mountain counties of California were assessed in order to plan a system of health care tailored to their specific needs. The assessment tool was developed with input by an advisory group of providers and consumers for content validity. Individuals receiving HIV care were recruited by their case managers. Case managers gave each participant a pre-paid phone card and obtained a signed informed consent for participation in the study. Participants were instructed to call an interviewer who was unknown to them and who lived and worked in the San Francisco Bay area, more than 200 miles from the mountain counties region. Each client called his/her interviewer at the appointed time, using the phone card to cover long distance expenses. By not allowing interviewers to call participants at their home, clients felt assured their anonymity was protected. The survey completion rate was 98% and is attributed to this innovative method of survey administration. Interviews were conducted during May and June 2002. Of the 42 eligible clients residing in three mountain counties of California, 27 (23 men and 4 women) were interviewed. Most respondents (52%) self-identified as being gay/bisexual. The majority (70%) of respondents reported contracting HIV through sexual contact. The majority (85%) reported receiving an AIDS diagnosis and almost all (93%) indicated that they were taking HIV medications. The majority of respondents (70%) perceived themselves as having good to excellent health, although 63% of respondents also reported HIV symptoms that interfered with quality of life or ability to work effectively. The majority of respondents were satisfied with their health care, although a significant number expressed concern about their provider’s level of HIV knowledge. The main clinical and psychosocial services needed by respondents are identified. Barriers to the provision and continuity of HIV care services will be discussed. Based on the results of the client needs assessment and interviews with key health providers, recommendations for improving the system of HIV care in this rural environment will be described. These recommendations helped to secure federal funding under the Ryan White Title III Early Intervention Services (EIS) Program to provide a system of rural primary care to this priority population.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Identify the clinical and psychosocial needs of individuals living with HIV in the mountain counties region of California.
• Describe an approach to delivering comprehensive HIV priority care to a rural priority population.
• Identify an innovative and confidential method of collecting needs assessment data in a rural environment.

Keywords: HIV/AIDS, Rural Health Care

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Consultant - Ryan White Title III Planning Grant

Recorded presentation