Case Study: Georgia’s Rural Versus Non-rural Populations

Rural Georgians are more likely to be living in poverty, underinsured or uninsured, have a chronic condition such as heart disease or diabetes, and live in an area with a shortage of mental health, dental, and medical primary care providers than their urban counterparts (SORH, 2015). Rural people living with HIV (PLWH) face additional challenges of stigma, shortage of HIV care providers, and isolation. In 2014, PLWH in rural Georgia managed to access HIV care at the same or higher proportion than their urban counterparts, but among those retained in care, a lower proportion of rural PLWH achieved viral suppression. Potential factors include patient-, provider-, and societal-level obstacles. Meeting the needs of an increasing number of PLWH in the face of a diminishing HIV workforce is a daunting task in Georgia, and likely to be exacerbated in rural areas in coming years, unless there is a paradigm shift in our public health and medical team model for HIV prevention and care.