The care of HIV-infected adults in rural areas of the United States

Objective: This study describes the population of HIV-infected adults recei ving care in rural areas of the United States and compares HIV care receive d in rural and urban areas. Methods: Interviews were conducted with a nationally representative sample of 367 HIV-infected adults receiving health care in rural areas and 2806 HI V-infected adults receiving health care in urban areas of the contiguous Un ited States. Results: We estimate that 4800 HIV-infected persons received medical care i n rural areas during the first half of 1996. Patients in rural HIV care wer e more likely than patients in urban HIV care to receive care from provider s seeing few (< 10) HIV-infected patients (38% vs. 3%;p < .001). Rural care patients were less likely than urban care patients to have taken highly ac tive antiretroviral agents (57% vs. 73%; p < .001) or Pneumocystis carinii pneumonia prophylactic medication when indicated (60% vs. 75%-, p = .006). Conclusions: Few American adults received HIV care in rural areas of the Un ited States. Our findings suggest ongoing disparities between urban and rur al areas in access to high-quality HIV care.