With new eyes: Using telemedicine to dissolve the structural barriers to HIV/AIDS care in the rural southeastern United States

Issues: The battle line of America's continuing fight against HIV runs through the South. However, despite the South's disproportionate disease burden, the region exhibits shockingly anemic treatment resources (e.g., only 1 AAHIVM-credentialed physician for every 1,607,341 Alabamians).

The challenge, therefore, reduces to: effectively delivering care within an exceedingly fragile care-delivery structure. Funded by AIDS United, our intervention addresses this challenge by using technology to bridge the gap between "need" and "resources" - leveraging urban-based HIV expertise through telemedicine, effectively providing rural communities with access to high quality HIV care, at the speed of light.

Description: Focusing on consumers living in disproportionately-impacted, under-resourced, rural locations, we created eight telemedical treatment centers throughout Alabama. Using encrypted connections, rural-site RN support, and high-definition diagnostic tools, our providers are able to hold real-time encounters frequently and consistently, increasing both access to care and the fullness of care available.

Lessons Learned: We discovered that our consumers, regardless of age, education, or rurality, are willing to embrace technology for the sake of complete care. We were reminded that endemic HIV-related stigma continues to hinder progress in the South. Ultimately, we learned that telemedicine works to connect those in need with the care that they deserve.

Recommendations: While point-to-point, provider-to-consumer telemedical encounters work to create access in previously unreachable communities, the transformative potential of our telemedical network lies in its ability to operate as a didactic tool – a tool by which we can organically grow treatment expertise among local providers scattered across rural Alabama.