ArticleAIDS care2018
Structural barriers to comprehensive, coordinated HIV care: geographic accessibility in the US South.
Article in AIDS care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A systematic review of engagement in care and health care utilization among older adults living with HIV and non-communicable diseases.AIDS care · 2022Pooled it
- Access to specialty healthcare in urban versus rural US populations: a systematic literature review.BMC health services research · 2019Pooled it
- Study on the Effect of Positive Psychological Intervention Based on PERMA Model on Perioperative Patients with AIDS Complicated with Breast Cancer.Computational and mathematical methods in medicine · 2022Trial
- Trends and disparities in HIV before and after COVID-19 from 1999 to 2023.Annals of medicine and surgery (2012) · 2026Review
- Fatal inflammation: understanding meningitis mortality in the United States (1999-2020).BMC neurology · 2026Observational
- Post-transition Care Retention and Viral Suppression Outcomes Among Youth Living with HIV in South Carolina: A Real-World Data Research.AIDS and behavior · 2026Article
- Geospatial Accessibility Factors Influencing HIV Care Continuum Outcomes in South Carolina.AIDS and behavior · 2026Article
- Portable Low-Field Magnetic Resonance Imaging in People With Human Immunodeficiency Virus.Annals of clinical and translational neurology · 2026Article
- Trends and Disparities in Cardiovascular Mortality among HIV-Positive Adults in the United States (2004-2020): A CDC WONDER Database Analysis.Current HIV research · 2026Article
- Transportation, administrative burden, and COVID-19: A structural intersectional analysis of barriers to HIV care among Black sexual minority men living with HIV in the US South.SSM. Qualitative research in health · 2025Article
- A cross-sectional analysis of fingerstick blood self-microcollection for remote HIV suppression monitoring in Atlanta, Georgia, USA: a path to expanding access to continuum of care.AIDS research and therapy · 2025Article
- HIV Pre-exposure prophylaxis (PrEP) modalities and service delivery preferences among black cisgender emerging and older adult women in Baltimore, Maryland.BMC public health · 2025Article
- Impact of Travel Distance and Transportation Needs on Racial/Ethnic Differences in Achieving Sustained Viral Suppression in Miami-Dade County, 2017.Research square · 2025Article
- Who could benefit the most from long-acting antiretroviral therapy? perspectives of HIV care providers and people with HIV in Florida.AIDS care · 2025Article
- Drive time to care and retention in HIV care: Rural-urban differences among Medicaid enrollees in the United States South.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- A multi-informant qualitative analysis of desired features for an mHealth tool for youth living with HIV in South Carolina.Journal of pediatric psychology · 2024Article
- Travel Burden and Timely Linkage to Care Among People Newly Diagnosed with HIV Infection in South Carolina from 2005 to 2020.AIDS and behavior · 2024Article
- Population Density and Health Outcomes in Women with HIV in the Southern United States: A Retrospective Longitudinal Analysis.Journal of women's health (2002) · 2024Article
- Rural-Urban Differences in HIV Sexual Risk Behaviors and HIV Service Utilization Among Adolescent Sexual Minority Males in the United States.Archives of sexual behavior · 2024Article
- Measuring Spatial Access of Vulnerable Population to HIV Testing Facilities in the Baton Rouge Metropolitan Statistical Area, Louisiana.AIDS and behavior · 2024Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
Structural barriers to HIV care are particularly challenging in the US South, which has higher HIV diagnosis rates, poverty, uninsurance, HIV stigma, and rurality, and fewer comprehensive public health programs versus other US regions. Focusing on one structural barrier, we examined geographic accessibility to comprehensive, coordinated HIV care (HIVCCC) in the US South. We integrated publicly available data to study travel time to HIVCCC in 16 Southern states and District of Columbia. We geocoded HIVCCC service locations and estimated drive time between the population-weighted county centroid and closest HIVCCC facility. We evaluated drive time in aggregate, and by county-level HIV prevalence quintile, urbanicity, and race/ethnicity. Optimal drive time was ≤30 min, a common primary care accessibility threshold. We identified 228 service locations providing HIVCCC across 1422 Southern counties, with median drive time to care of 70 min (IQR 64 min). For 368 counties in the top HIV prevalence quintile, median drive time is 50 min (IQR 61 min), exceeding 60 min in over one-third of these counties. Among counties in the top HIV prevalence quintile, drive time to care is six-folder higher for rural versus super-urban counties. Counties in the top HIV prevalence quintiles for non-Hispanic Blacks and for Hispanics have >50% longer drive time to care versus for non-Hispanic Whites. Including another potential care source-publicly-funded health centers serving low-income populations-could double the number of high-HIV burden counties with drive time ≤30 min, representing nearly 35,000 additional people living with HIV with accessible HIVCCC. Geographic accessibility to HIVCCC is inadequate in the US South, even in high HIV burden areas, and geographic and racial/ethnic disparities exist. Structural factors, such as geographic accessibility to care, may drive disparities in health outcomes. Further research on programmatic policies, and evidence-based alternative HIV care delivery models improving access to care, is critical.
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