The incidence of HIV is disproportionately high in rural areas, but these communities often lack access to evidence-based interventions to prevent new HIV diagnoses such as PrEP. Using Medicaid claims data and the Centers for Medicare & Medicaid Services Provider file, this study will determine geographic disparities (by rurality and region) in the need for PrEP and PrEP availability and identify whether PrEP availability meets the needs across geography.

Leveraging the Medicaid data, the proposed work has three aims:

1. Investigate spatial distributions of the PrEP need and availability by residence rurality and Census regions using bivariate mapping.
2. Examine rural-urban differences in spatial accessibility to PrEP across ZIP code tabulation areas (ZCTAs) in the United States.
3. Identify the associations between the density of PrEP need and spatial accessibility to the nearest available PrEP service provider by residence rurality and census region.