Statement of the problem - CDC's national system for surveillance of HIV infection has improved our understanding of the HIV epidemic as it evolved over the years. However, there is limited about HIV in rural areas of the US, of healthcare resources available for PLWHA living in these areas, and of the type of rural county most at risk for increases in the prevalence of HIV.

Project goals - The purpose of this study is to describe estimated number of PLWHA by county, or when county-level data are not available, by sub-state region or state, together with information on the availability of health services, including Ryan White Clinics. The prevalence of HIV will be categorized across levels of rurality. We will also investigate factors that place a county at risk for growth in the prevalence of HIV.

Methods - The study will use information regarding the numbers of PLWHA reported in publicly available HIV/AIDS surveillance reports from state health department websites (39 states). For states that do not report county-specific numbers (11 states), we will use sub-state regional or state numbers. Descriptive analysis will use information from 2007-2008 or the latest year for which the HIV/AIDS surveillance is available. Health care resources will be identified through the Area Resource File and, for Ryan White Clinics, through web-navigation. Modeling of risk factors for growth in HIV will be based on a subset of states for which at least three consecutive years of data in HIV prevalence are available (1400 counties).

Anticipated publications or products - A technical report will be communicate the results of this study. In addition, we will draft manuscripts for publication in peer-reviewed journals, policy-briefs for ORHP, and scholarly presentations for disseminating results in local, regional, and national conferences.

Publications

• HIV/AIDS in Rural America (Key Facts)
  Rural and Minority Health Research Center
  Date: 01/2013
  This report describes the proportion of the population affected by HIV/AIDS.
• HIV/AIDS in Rural America: Prevalence and Service Availability
  Rural and Minority Health Research Center
  Date: 01/2013
  This report examines the prevalence of HIV/AIDS in rural counties across 28 states in 2008 and the rural-versus-urban distribution of Ryan White providers.