(P160) HIV VIRAL LOAD MONITORING – RURAL BARRIERS TO CARE

Background:
The US engaged in an aggressive strategy to reverse the steep increase in HIV infections during the early 1980’s. It’s a multipronged approach including protective PrEP treatments, focal messaging, public health surveillance, partner services, and rigorous ART (antiviral therapy). Viral load monitoring is a supportive but integral element in the successful mitigation of HIV incidence but requires repeated visits. Many rural patients encounter barriers to consistent viral load monitoring (needed every 3-6months).

Methods:
This abstract is a literature review and discussion of HIV viral load testing in conjunction with ART. CDC and Pub Med articles were used, as well as a review of snowball articles. Fourteen studies were used, including both primary observation studies and meta-analysis. Inclusion criteria encompassed HIV monitoring strategies, rural barriers, mental health concerns, and treatment strategies for low-income HIV patients.

Results:
HIV patients who maintain an undetectable viral load, protect their partners and stop further proliferation of the virus. Adjusting and monitoring regimen may become complicated if a patient is unable to keep consistent blood draw appointments. Patients living in rural settings will often face transportation challenges, mental health concerns, financial instability, and lack insurance coverage.

Conclusion:
HIV patients often encounter barriers to consistent care which can seem overwhelming for rural public health offices and clinics. Addressing barriers one at a time will simplify community efforts. A strategic first step is addressing the need for consistent transportation. Unreliable transportation is a barrier most communities can address with limited resources. Rural communities can begin by concentrating on supplying medical transport services for patients. Medical transport services are the more economical solution than mobile medical units.