BARRIERS TO CARE AMONG PERSONS LIVING WITH HIV AIDS IN URBAN AND RURAL-AREAS/

People living with HIV disease, particularly those in small towns and rural areas, face many barriers that prevent them from receiving impor tant life-care services. We developed the Barriers to Care Scale (BACS ) to delineate the problem severity of factors that impede care and se rvice provision among a sample of 226 men and women living with HIV di sease in a single midwestern state. Both urban and rural respondents i ndicated that barriers to life-care services included the lack of know ledge about HIV among citizens in the community, insufficient personal supportive and financial resources, the lack of employment opportunit ies for people living with HIV, and the lack of supportive and underst anding work environments. Rural persons living with HIV disease, compa red to their urban counterparts, assigned significantly higher problem severity ratings to the following barriers: the need to travel long d istances to medical facilities and personnel; a shortage adequately tr ained medical and mental health professionals; a lack of personal or p ublic transportation; and community residents' stigma towards people l iving with HIV. The large number of barriers to care identified in the present study indicates that innovative programmes designed to remove these barriers and improve the life quality of rural persons living w ith HIV are urgently needed.