Delivering Care to Rural HIV / AIDS Patients

Abstract

With HIV/AIDS on the rise in rural areas, health care providers must find ways of delivering care with little or no increase in resource support. This paper examines the evolution of a rural HIV/AIDS alliance using a life cycle model to identify each stage of the alliance development and the specific issues associated with each stage. The data were collected through structured interviews and by review of background materials, including budgets, grant proposals, and program reports. The findings identify alliance strategies that can be used in other rural communities facing the challenge of serving an increasing number of HIV/AIDS patients with limited resources. Differing from other models, this rural HIV/AIDS alliance emerged from local government and community support into an independent, nonprofit organization operating through a network of interorganizational relationships.

To tell or not to tell: Men's disclosure of their HIV‐positive status to their mothers*

“…Our results may reflect important differences in how adults living in diverse regions of the country respond to HIV/AIDS. Although rural regions share commonalities, they are not culturally homogeneous; great diversity exists between rural areas across different regions of the United States (Topping & Hartwig, 1997).…”

An integrated program for comprehensive HIV care

“…Confidentiality for a seropositive individual, or for one who is receiving psychiatric or substance treatment, may be difficult to maintain. Furthermore, this model may not be as beneficial for certain HIV subpopulations, such as adolescents, who might require peer outreach programs (Huba and Melchior, 1998); rural populations, who might benefit more from interorganizational alliances (Topping and Hartwig, 1997); and women, who might prefer integrated reproductive health and counseling services (Daley, 1994).…”

AIDS in Rural America

“…Topping and Hartwig describe the successful development of a rural HIV/AIDS alliance and a clinic designed to provide community-based comprehensive care to HIV-infected paticnts in a rural county in Mississippi (Topping & Hartwig, 1997). The authors highlight strategies that other rural communities may find useful as they develop programs to provide care for H1V-infected people.…”

“…Others have reported increasing numbers of "homegrown" rural cases of IHIV (Cohn, Klein, Mohr, Van der Horst, & Weber, 1994;Rumley & Esinhart, 1993;Rumley, Shappley, Waivers, & Esinhart, 1991). Topping and Hartwig (1997) describe their rural HIV-infected patients as bcing more likely to have acquired HIV heterosexually or through injection drug use, more likely to be poor and to receive public assistance, and more likely to be black compared with national norms.…”

“…ed in this issue of The Iournal of Rural Health broaden our understanding of how best to characterize and compare rural communities (Berry, McKinney, & Marconi, 1997) and how best to deliver care to patients with AIDS in rural communities (Topping & Hartwig, 1997).…”