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艾滋病护理差异:佐治亚州城乡医疗服务可及性与治疗依从性分析

Disparities in HIV Care: A Rural-Urban Analysis of Healthcare Access and Treatment Adherence in Georgia.

作者信息

Purcell Donrie J, Standifer Maisha, Martin Evan, Rivera Monica, Hopkins Jammie

机构信息

Satcher Health Leadership Institute, Morehouse School of Medicine, Atlanta, GA 30310, USA.

Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.

出版信息

Healthcare (Basel). 2025 Jun 9;13(12):1374. doi: 10.3390/healthcare13121374.

Abstract

: This study examines disparities in HIV-related healthcare access, support, and treatment adherence between rural and urban Black/African American populations in Georgia, USA, emphasizing structural, socioeconomic, and stigma-related barriers affecting health outcomes. : A cross-sectional quantitative study was conducted using structured surveys administered via RedCap from August to December 2023. Participants ( = 55) were recruited through community-based HIV organizations, healthcare providers, and advocacy networks. The survey assessed demographic factors, healthcare access, adherence to treatment, support systems, and experiences with stigma. Data were analyzed using IBM SPSS Statistics, version 28.0 (IBM Corp., Armonk, NY, USA), with chi-square tests examining associations between geographic location and HIV-related outcomes. : Findings indicate significant disparities in HIV care access and support. Urban participants were more likely to receive family and friend support ( < 0.01), financial assistance through the Ryan White Program ( = 0.01), and timely linkage to care within one week of diagnosis ( < 0.05). Rural participants reported lower educational attainment, income levels, and limited healthcare access, contributing to poorer health outcomes. No significant differences were observed in PrEP or condom use. : The study underscores the need for targeted interventions. Expanding telehealth, enhancing community outreach, and reducing stigma through policy reforms are critical to improving HIV-related health outcomes in rural Georgia.

摘要

本研究调查了美国佐治亚州农村和城市黑人/非裔美国人群体在与艾滋病毒相关的医疗保健获取、支持和治疗依从性方面的差异,重点关注影响健康结果的结构、社会经济和耻辱感相关障碍。

采用横断面定量研究方法,于2023年8月至12月通过RedCap进行结构化调查。参与者(n = 55)通过社区艾滋病毒组织、医疗保健提供者和宣传网络招募。该调查评估了人口统计学因素、医疗保健获取情况、治疗依从性、支持系统以及耻辱感经历。使用IBM SPSS Statistics 28.0版(美国纽约州阿蒙克市IBM公司)对数据进行分析,采用卡方检验来检验地理位置与艾滋病毒相关结果之间的关联。

研究结果表明,在艾滋病毒护理获取和支持方面存在显著差异。城市参与者更有可能获得家人和朋友的支持(p < 0.01)、通过瑞安·怀特项目获得经济援助(p = 0.01),以及在诊断后一周内及时获得护理(p < 0.05)。农村参与者的教育程度、收入水平较低,医疗保健获取有限,导致健康结果较差。在暴露前预防(PrEP)或避孕套使用方面未观察到显著差异。

该研究强调了有针对性干预措施的必要性。扩大远程医疗、加强社区外展以及通过政策改革减少耻辱感对于改善佐治亚州农村地区与艾滋病毒相关健康结果至关重要。

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