HIV/AIDS in the Rural US Prevalence and Service Availability Janice - - PowerPoint PPT Presentation
HIV/AIDS in the Rural US Prevalence and Service Availability Janice Probst, PhD Medha Iyer, PhD, MD Saundra Glover, PhD Deshia Leonhirth, MBA S outh C arolina Rural Health Research Center At the Heart of Public Health Policy HIV/AIDS Basics
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At the Heart of Public Health Policy
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Human Immunodeficiency Virus (HIV) reduces
CD4 count < 200, or selected diagnoses, considered to
Treatment protects CD4 cells, immune system At any level, person is contagious and should be
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Estimated 1.2 million persons living with
Disproportionately affects minorities, women,
Could it become a rural disease?
Prevalence in rural America Service availability in rural America
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County data retrieved from state department of
28 states, 2,012 counties SCRHRC Study, available at rhr.sph.sc.edu
County data from 2013 RWJ County Rankings
Data provided by CDC’s National Center for
County-level data from AIDSVu, 2010 data, also
Limitations: non-reporting and data suppression
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HIV is present in rural as well as urban counties
“High” is in relation to the national median rate.
HIV tracks closely with poverty and with minority
HIV rates in rural are growing
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Q1 <33.50 Q2 ≥33.50 < 63.81 Q3 ≥63.81 < 135.24 Q4 ≥135.24
Rates per 100,000 Source: HIV/AIDS in Rural America, rhr.sph.sc.edu
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Source: SCRHRC analysis of RWJ County Rankings data, http://www.countyhealthrankings.org/rankings/data.
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Source: SCRHRC analysis of AIDSVu data (aidsvu.org)
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Kansas, Oklahoma
Kansas, Oklahoma
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100 200 300 400 500 600
South Carolina Mississippi Louisiana Florida North Carolina Maryland Virginia Illinois Massachusetts New York Arizona Colorado California Texas Pennsylvania New Hampshire Washington Maine Indiana Oklahoma Oregon Missouri Kansas Vermont Ohio Michigan Minnesota Iowa
HIV/AIDS Cases per 100,000 population
Statewide Prevalence of HIV/AIDS Prevalence of HIV/AIDS in Rural Counties
States:
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(Data from AidsVu.org)
100 200 300 400 500 600
Vermont Maine New Hampshire Pennsylvania Arizona Connecticut Alabama Maryland Hawaii North Carolina Massachusetts Louisiana New York Delaware South Carolina Florida
Source: AIDSVu. Restricted to 16 states with complete county data
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Chronic treatment with antiretroviral medications
Nearly half of PLWHA receive care through the
Current funding ~ $2.1 billion 30% of Ryan White funding specifically directed to
Ryan White providers a proxy for care
Limitation: no information VA, other providers
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Norton KS to Wichita
Guymon OK to
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Few Ryan White providers in rural counties
Research is needed to assess effects of local service
Research is needed to assess use of other
CHC’s, health departments may help, but: HIV is a complex condition requiring specialized
VA addresses non-specialist quality of care through