Barriers to care for rural people living with HIV: a review of domestic research and health care models

J Assoc Nurses AIDS Care. Sep-Oct 2013;24(5):422-37. doi: 10.1016/j.jana.2012.08.007. Epub 2013 Jan 22.


Historically, the availability of heath care in rural areas has been sparse, and specialized care for people living with HIV (PLWH) has been especially problematic. Rural patients are faced with substantially greater barriers to care than their urban counterparts. A systematic review of empirical studies was conducted concerning barriers to care among patients infected with HIV in rural areas of the United States. This systematic review yielded 15 viable articles for analysis. Among the 27 barriers identified, the most commonly discussed were transportation needs, provider discrimination and stigma, confidentiality concerns, and affordability and lack of financial resources. Barriers to care must be addressed in conjunction with one another in order to alleviate their impacts. Key health care models addressing these concerns are highlighted and used to address the state of the field and provide suggestions for future research.

Keywords: HIV; barriers to care; health care models; rural.

Publication types

  • Research Support, N.I.H., Extramural
  • Review
  • Systematic Review

MeSH terms

  • Attitude of Health Personnel
  • Confidentiality
  • HIV Infections / therapy*
  • Health Services Accessibility
  • Humans
  • Models, Organizational*
  • Patient Acceptance of Health Care
  • Rural Health Services / organization & administration*
  • Rural Population*
  • Social Stigma
  • United States