Comparing Rural and Urban Care in HIV

Comparing Rural and Urban Care in HIV

Research suggests that the epidemiology of HIV/AIDS in rural areas of the United States differs from that of urban and peri-urban areas. Small studies have found that sub-populations in rural areas may be less likely to receive quality care and achieve optimal HIV outcomes when compared with individuals living in urban areas. However, generalizing HIV/AIDS care in rural areas may be misguided because each has its own unique characteristics. Concern is growing in the research community that patients in non-urban settings may be underrepresented in studies with regard to demographics and healthcare utilization. Trials typically draw more from urban populations because of easier access to participants and because HIV specialists and academic centers tend to be located in urban areas. Seeking Better Representation of HIV Care A study published in the August 2011 issue of AIDS Care examined the impact of geographic location—specifically urban, peri-urban, and rural locations—on clinical HIV outcomes using data from a multistate cohort. “The main caveat of the study is that the vast majority of rural and peri-urban patients actually received their care in urban areas,” says Lucy E. Wilson, MD, ScM, lead researcher of the investigation. “These patients may be very different from those who received all their HIV care in rural areas.”               The authors found that people who were living with HIV/AIDS in rural and peri-urban settings and traveled to urban areas for their care received a high level of appropriate HIV care and had similar rates of AIDS-defining illnesses when compared with patients living in urban areas. For the study, receipt of appropriate HIV care...

IDWeek 2012: HAART Dosing Errors Common in HIV Patients

The Particulars: Among patients with HIV who are admitted to the hospital, missed doses and inadvertent changes in highly active anti-retroviral therapy (HAART) can have devastating outcomes. In some cases, resistance or toxicity to HAART can emerge quickly. Data Breakdown: For a study, an infectious disease clinical pharmacist reviewed the medications of all HIV-infected patients receiving HAART within 12 to 24 hours of being admitted to a hospital. Of 155 HAART regimens evaluated, 75 required one or more modifications. Nearly half of these interventions (47.4%) were related to dosage modification. Relatively few modifications (5.0%) were related to addressing drug interactions. Take Home Pearl: Nearly one-half of HIV-infected patients on HAART who are admitted to a hospital appear to require modifications to their HAART...