New study on rural HIV shows significant stigma and discrimination in the rural medical referral system

An Indiana University study found that HIV care providers in rural Indiana report significant stigma and discrimination in the rural medical referral system surrounding issues of HIV and substance abuse. Providers felt that these factors impeded their ability to offer quality care to their patients.

"The findings of this study demonstrate inefficiencies in our public health care system and our inability to link people easily to a range of health care providers in rural areas," said Michael Reece, lead investigator of the study and director of The Center for Sexual Health Promotion in Indiana University Bloomington's School of Health, Physical Education and Recreation. "This also has an important economic impact given that our investments in the public health system may not be achieving the outcomes we need, such as improvements in health status."

While most studies involving HIV and stigma rely on patient perspectives, this study focused solely on the perspectives of providers serving rural Indiana residents. Providers reported that some rural physicians refused to provide care for their patients. They also reported widespread stigmatizing comments and behavior from the rural medical community.

The study, "HIV Provider Perspectives: The Impact of Stigma on Substance Abusers Living with HIV in a Rural Area of the United States," appears in the latest issue of the journal AIDS Patient CARE and STDs. For Reece, focusing research locally is important.

"As the incidence of new HIV infections continues to increase in more diverse areas of the country, researchers can make incredible contributions to public health by focusing some of their attention to what is happening in the backyards of their own universities," Reece said. "Take Indiana, for example. While there is a great deal of research on HIV in other communities, very little research has focused on what is happening right here in southern Indiana. It must become a priority for us in order to help our neighbors deal with the ongoing challenges of the epidemic."