Rural and remote health最新文献

{"title":"Exploring the ideas of young healthcare professionals from selected countries regarding rural proofing.","authors":"Ian Couper, Manoko Innocentia Lediga, Ndivhuho Beauty Takalani, Mayara Floss, Alexandra E Yeoh, Alexandra Ferrara, Amber Wheatley, Lara Feasby, Marcela A de Oliveira Santana, Mercy N Wanjala, Mustapha A Tukur Deceased, Sneha P Kotian, Veronika Rasic, Vuthlarhi Shirindza, Alan Bruce Chater, Theadora Swift Koller","doi":"10.22605/RRH8294","DOIUrl":"10.22605/RRH8294","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, most countries struggle to meet the health needs of rural communities. This has resulted in rural areas performing poorly when compared to urban areas in terms of a range of health indicators. There have been few coherent or systematic strategies that target rural communities and address their needs within the rural context. Rural proofing, defined as the systematic application of a rural lens across policies and guidelines to ensure that they speak to these health needs, seeks to address this gap. The healthcare professionals (HCPs) who will be called upon to advocate for and lead the implementation of rural proofing efforts are those currently in training or early career stages. We thus sought to understand the perspectives of young HCPs regarding the concept of rural proofing.</p><p><strong>Methods: </strong>The study adopted an interpretivist paradigm. Data were collected using semi-structured individual interviews and focus group discussions (FGDs). Selected HCPs who are in leadership in Rural Seeds, a movement for young HCPs, participated in the study. FGDs in the form of Rural Cafés were led by some Rural Seeds leaders who participated in the interviews and who showed interest in organising the discussions. Eleven exploratory interviews and six FGDs were conducted using Zoom. HCPs were from Australia, Europe, Africa, North America, South America, and Asia. Interviews and FGDs were conducted in English, recorded, and transcribed verbatim. Thematic analysis was then undertaken.</p><p><strong>Results: </strong>Participants perceived the state of rural healthcare globally to be problematic. Access to care was seen as the most significant issue in rural health care, associated with the challenges of lack of equity in access, and limited funding and support for healthcare professionals and their career pathways. Despite varying understanding of the concept, rural proofing was seen to be of great value in improving rural health care. A number of ideas for applying rural proofing, with examples, were proposed from their perspectives as frontline healthcare providers. They particularly recognised the importance of addressing the local needs of rural communities and the needs of present and future HCPs. Implementation of rural proofing was seen to require the involvement of key stakeholders from a range of sectors at multiple levels.</p><p><strong>Conclusion: </strong>Given the state of rural health, young rural HCPs suggest that rural proofing strategies are needed as they have the potential to bring about equity in the delivery of health care in rural and remote communities. These strategies will assist in creating a more positive future for rural health care worldwide and motivate young HCPs to become involved in rural health care, as well as to increase their motivation to take an interest in health policy development. These strategies need to be applied at multiple levels, from national governm","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"23 4","pages":"8294"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138047803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case study of a novel longitudinal rural internship program.","authors":"Jessica Beattie, Debra Janet Hobijn, Lara Fuller","doi":"10.22605/RRH8327","DOIUrl":"10.22605/RRH8327","url":null,"abstract":"INTRODUCTION Rural medical training along all components of the medical training continuum has been shown to enhance rural workforce outcomes. However, due to the maldistribution of the Australian medical workforce, health services of increased rurality are limited in their ability to fulfil the supervision requirements for all levels of trainees, especially junior doctor training. Although longitudinal program design and pedagogy has flourished in medical school education through the Longitudinal Integrated Clerkship model, this has not yet been widely translated to prevocational training. This study describes how a longitudinal program design was conceptualised and implemented within a rural health service to create a novel internship program. METHODS A descriptive case study methodology was employed to describe and evaluate the longitudinal integrated internship program. Relevant program documents such as rosters and accreditation submissions were reviewed to aid in describing the program. Interviews with participants involved in the program were conducted during the middle (May) and end (November) points of the program's first year (2021) to investigate perspectives and experiences of the internship model. RESULTS Each week, interns were rostered for 1 day in the hospital's emergency department and 3 days in general surgery or general medicine, swapping disciplines after 6 months. In this way, interns completed core rotations longitudinally, meeting accreditation and supervision requirements. Additionally, 1 day per week was spent parallel consulting in general practice. Participants described program enablers as the organisational vision and staff buy-in, as well as the longitudinal attachments to disciplines. Barriers identified were the tenuous nature of the medical workforce and long-term sustainability of the program. Benefits of the program included value-adding and preparedness for practice, particularly in a rural context. CONCLUSION Intern programs that meet the accreditation, supervision and learning requirements can be successfully delivered at rural health services through longitudinal models of medical education. As the intern year is a key component of the rural generalist training pathway, development of similar innovative models provides the opportunity for rural communities to grow their own future medical workforce.","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"23 4","pages":"8327"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89719417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translating research into rural health practice: a qualitative study of perceived capability-building needs.","authors":"Olivia A King, Alesha Sayner, Alison Beauchamp, Danielle Hitch, Drew Aras, Anna Wong Shee","doi":"10.22605/RRH7751","DOIUrl":"10.22605/RRH7751","url":null,"abstract":"<p><strong>Introduction: </strong>The timely translation of research into practice and local policy is critical to improving healthcare delivery in rural and regional settings, and remains a concern for researchers, health professionals, health managers and policymakers alike. Successful and sustained research translation does not occur without concerted effort, support and strategies to build research translation capacity and capability. Research capacity comprises individual and organisational capabilities. This study is primarily focused on individual capabilities. Health professionals working in rural and regional settings, where research activity and infrastructure are generally less mature than that seen in metropolitan areas, need additional support and skills to build their capability to engage in translation-focused research. This study aimed to explore rural health research stakeholders' perspectives on capability-building needs for emerging researchers to enable the translation of research into health practice.</p><p><strong>Methods: </strong>A qualitative description methodology was used to conduct three online focus groups to explore participants' understanding of research translation, and their perceptions of the supports that are needed to build capability for emerging health professional researchers to undertake translation-focused research. Emerging health professional researchers (emerging researchers hereafter) are health professionals who have little or no formal training or experience undertaking research. Data were analysed by a five-stage framework approach.</p><p><strong>Results: </strong>Participants included emerging researchers (n=12), research mentors (n=3) and health managers (n=4) from six rural or regional organisations, including four health services, one university and one primary health network in Victoria, Australia. Participants' conceptualisation of research translation reflected previously documented definitions; that is, research grounded in health practice and characterised by adaptation of existing research evidence to local settings via implementation. Four key themes related to research translation support for rural and regional health researchers were identified: understanding the study and translation context is vital to enacting change; engaging with stakeholders identifies research and translation priorities and suitable approaches; mentor and managerial support assists navigation of research translation activities; and access to clinical and research networks promotes research translation partnerships and collaborations. Participants highlighted the need to identify and train appropriate research mentors and health leaders who can support translation-focused research at the emerging researcher level. The need for training that targets fundamental research translation skills, including systematic processes for engaging stakeholders and collaborative priority setting, and the processes to analyse both","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"23 4","pages":"7751"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72015258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing early career professionals' representation and engagement at international conferences: WONCA \"Rural Early Career Ambassador Integration\" project.","authors":"Shagun Tuli, Victoria M Sparrow-Downes, Marcela A de Oliveira Santana, Robert Scully, Patrick O'Donnell, Peter Hayes, Liam Glynn","doi":"10.22605/RRH7999","DOIUrl":"10.22605/RRH7999","url":null,"abstract":"<p><strong>Introduction: </strong>International conferences offer an excellent opportunity for career development and are global academic opportunities with the potential to foster educational and professional growth. However, equitable access to participation and meaningful involvement in such events remains an issue. In this article we describe the novel Rural Early Career Ambassador Integration project and its implications for the 2022 World Rural Health Conference, held at the University of Limerick, Ireland.</p><p><strong>Methods: </strong>The project offered vertical and cross-country collaborative opportunities to early career professionals with a passion for rural medicine. Three ambassadors of diverse nationalities, ethnicities and professional backgrounds were selected. They bore no personal cost for travel, transport or accommodation relating to the conference. Each ambassador was matched to and clinically shadowed an expert rural GP for a week preceding the conference, who provided mentorship. Mentors and ambassadors collaborated on goal-setting and work-planning throughout the conference, and were offered one-on-one career and networking support. The ambassadors were welcomed and integrated within a larger working party, the WONCA Working Party for Rural Health.</p><p><strong>Results: </strong>The project was well received by conference delegates and organisers, and achieved its stated goal of enhancing conference equity through the representation and meaningful involvement of diverse early career professionals. Vertical and cross-country collaboration generated actionable policy implications as is evidenced by the ambassadors' co-authorship on the Limerick Declaration on Rural Healthcare.</p><p><strong>Conclusion: </strong>Although sponsorship for these initiatives remains a challenge, this project highlights the importance of actively including early career professionals at international conferences.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"23 4","pages":"7999"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71426529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint exposure to urban-rural status and medically underserved area residence and risk of severe COVID-19 outcomes in 2020.","authors":"Lakin Mauch, Andrew D Williams","doi":"10.22605/RRH8373","DOIUrl":"10.22605/RRH8373","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study is to estimate the risk of severe COVID-19 among individuals residing in rural, medically underserved counties compared to those living in other counties.</p><p><strong>Methods: </strong>Individual-level COVID-19 hospitalization and death data and demographic variables were downloaded from the Centers for Disease Control and Prevention. The 2013 National Center for Health Statistics Urban-Rural Classification Scheme was used to classify urban and rural counties. Health Resources and Services Administration's medically underserved area (MUA) designation was used to identify underserved counties. County-level data were drawn from the 2015-2019 American Community Survey 5-year estimates. Analytic samples included data from Minnesota and Montana in 2020. Urban-rural/MUA joint exposure categories were created: rural/MUA, rural/non-MUA, urban/MUA, urban/non-MUA. Hierarchical logistic regression models estimated associations (odds ratios and 95% confidence intervals (CI)) between rurality, MUA status, joint urban-rural/MUA status, and severe COVID-19, overall and stratified by age and state. Models were adjusted for individual- and county-level demographics.</p><p><strong>Results: </strong>The odds of severe outcomes among those living in rural counties were 13% lower (95%CI: 0.83-0.91) than those in urban counties. The odds of severe outcomes among those living in MUA counties were 24% higher (95%CI: 1.18-1.30) than those in non-MUA counties. For joint exposure analyses, the odds of severe outcomes were highest among those living in urban/MUA counties compared to those in rural/non-MUA counties (adjusted odds ratio: 1.36, 95%CI: 1.27-1.44).</p><p><strong>Conclusion: </strong>In 2020, the risk of severe COVID-19 was more pronounced in urban counties and underserved areas. Results highlight the need for locality-based public health recommendations that account for rural and underserved areas and may inform future pandemic preparedness by identifying counties most in need of resources and education at various stages of the pandemic.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"23 4","pages":"8373"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138462459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telepathology in intraoperative frozen section consultation of breast cancer sentinel node biopsy in Fukushima, Japan following the 2011 triple disaster: diagnostic accuracy and required time during the early implementation phase.","authors":"Hiroaki Kawakami, Akihiko Ozaki, Yudai Kaneda, Shigeyuki Asano, Kouki Inai, Shinichi Hirooka, Ayumi Katoono, Riko Takagi, Makoto Kosaka, Anju Murayama, Toyoaki Sawano, Yasuteru Shimamura, Masaharu Tsubokura, Tomohiro Kurokawa, Kaznoshin Tachibana, Masahiro Wada, Tetsuya Tanimoto, Tohru Ohtake, Naoyuki Kitamura, Tomozo Ejiri, Hideyuki Magome, Hiroaki Shimmura, Norio Kanzaki","doi":"10.22605/RRH8496","DOIUrl":"10.22605/RRH8496","url":null,"abstract":"<p><p>In breast cancer surgery, some medical facilities lack the necessary resources to conduct sentinel lymph node biopsy and its intraoperative frozen section consultation. In the coastal rural area of Fukushima, Japan, which has suffered from physician undersupply following the 2011 triple disaster of earthquake, tsunami and nuclear disaster, we explored the feasibility of telepathology by evaluating the diagnostic accuracy in remote intraoperative frozen section consultation of sentinel lymph node biopsy and its required time. Although examination time has room for improvement, telepathology can be one possible solution in resource-limited areas.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"23 4","pages":"8496"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71485641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological safety and self-regulated learning through near-peer learning for the sustainability of rural community-based medical education: grounded theory approach.","authors":"Ryuichi Ohta, Takuji Katsube, Chiaki Sano","doi":"10.22605/RRH8488","DOIUrl":"10.22605/RRH8488","url":null,"abstract":"<p><strong>Introduction: </strong>Difficulties in improving psychological safety in medical education can be attributed to the hierarchy among medical professionals. Near-peer learning (NPL) can increase learning between students and residents, and improve psychological safety. Rural community-based medical education (CBME) can use an NPL framework to improve psychological safety and compensate for the lack of resources, leading to sustainability. This qualitative study aimed to clarify the effects of NPL on the psychological safety and learning of medical trainees in rural CBME.</p><p><strong>Methods: </strong>This study used a grounded theory approach. Thirty-eight medical students, 12 second-year residents, and eight family medicine residents participated in this study. Purposive sampling was used to address the research objectives, followed by ethnographic and semi-structured interviews.</p><p><strong>Results: </strong>Three themes were identified: facilitating learning, change in perception, and change in learning. Rural NPL-based CBME drove learners' engagement in clinical practice through constant participation and reflection. Respecting and supporting learners' motivation and participation and effectively accepting them increased their sense of ownership and psychological safety. Furthermore, NPL supported participants in becoming self-regulated learners.</p><p><strong>Conclusion: </strong>Rural CBMEs lack healthcare and educational resources, but implementing NPL could make rural medical education sustainable, increasing the motivation of healthcare students and the number of medical staff working in rural contexts.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"23 4","pages":"8488"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71485640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of concomitant hypertension and diabetes among adults and elderly living in rural riverside areas in the Amazon.","authors":"Jordana Herzog Siqueira, Luiza Garnelo, Rosana Cristina Pereira Parente, Sully de Souza Sampaio, Amandia Sousa, Fernando J Herkrath","doi":"10.22605/RRH8249","DOIUrl":"10.22605/RRH8249","url":null,"abstract":"<p><strong>Introduction: </strong>Considering the scarcity of information on the assessment of chronic diseases in traditional Amazonian populations, as well as public health policies focused on their specificities, this study aimed to estimate the prevalence of at least one of the chronic diseases (systemic arterial hypertension (SAH) or diabetes mellitus (DM)) and their concomitant occurrence in a rural riverside population of the Amazon, and determine the associated factors.</p><p><strong>Methods: </strong>A household-based cross-sectional survey was conducted with a sample of adults and elderly people living in rural riverside locations along the left bank of the Negro River, in the municipality of Manaus, Amazonas, Brazil. The outcomes evaluated were the presence of at least one of the evaluated chronic diseases and the concomitant occurrence, based on the self-reported medical diagnosis of SAH and DM. Analysis of associated factors (sociodemographic, behavioral, and access to health services variables) was performed by Poisson regression with robust variance.</p><p><strong>Results: </strong>The sample consisted of 495 individuals (young adults (n=257; 51.9%), middle-aged (n=132; 26.7%), and elderly (n=106; 21.4%)), of whom 51.5% were women (n=255), mean age 43.3&plusmn;17.1 years. The monthly household income was on average R$1100&plusmn;902 (A$345&plusmn;283). The diagnosis of any chronic disease was reported by 18.8% of the sample, with a preponderance of SAH (17.4%). The occurrence of at least one of the chronic diseases was associated with higher average age and worse health self-assessment. Regarding concomitant occurrence of SAH and DM, prevalent in 4.4% of the sample, the same associations were observed.</p><p><strong>Conclusion: </strong>The data for the occurrence of chronic diseases in the studied Amazon rural riverside populations are worrying, because these people live in areas of socioeconomic vulnerability, with a lack of basic sanitation infrastructure, difficult geographic access, and limited access to health care. Health policies fail to recognize the specificities of these populations, which implies deficiencies in the provision of necessary regular care. The findings also reinforce the need to strengthen health promotion and chronic disease prevention strategies in the context of primary care.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"23 4","pages":"8249"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136398964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food consumption profile of rural riverside populations.","authors":"Ana Carolina da Silva Medeiros, Evelyne Marie Therese Mainbourg","doi":"10.22605/RRH7730","DOIUrl":"10.22605/RRH7730","url":null,"abstract":"<p><strong>Introduction: </strong>The uniqueness of the way of life of rural riverside populations is of interest because they are the largest traditional Amazonian population. Their eating habits reveal their life conditions and relationship with the urban environment and is a poorly investigated subject. This research aimed to describe and analyze the food consumption of Amazonian riverside populations based on the food types consumed and reported by the families.</p><p><strong>Methods: </strong>A cross-sectional study was carried out on the rural riverside population occupying part of the riverbank of Rio Negro, in Manaus County, North Brazil. This population can only be accessed by river. Random, systematic, stratified sampling was conducted on 287 households. A questionnaire about consumed food, socioeconomic conditions and food obtainment was applied. The analysis was performed in R software. Descriptive statistical analysis and log-binomial regression were carried out.</p><p><strong>Results: </strong>It was observed that eating habits were mainly based on in natura (unprocessed) or minimally processed foods, according to the food classification system NOVA. Food diversity was low and the most consumed food types were coffee, flour and rice. The influence of small local markets, income and traditional practices on food intake based on food processing level was also observed. Thus, the chances of eating fish in locations with a small grocery shop were lower (p=0.009) and of eating chicken were higher (p&le;0.001). The chances of consuming in natura or minimally processed foods among the literate population (p=0.041) with higher income (p&le;0.001) were higher. The chances of eating processed foods were lower where fishing (p=0.007) and farming (p=0.009) were practiced.</p><p><strong>Conclusion: </strong>Based on these unexpected results, the present research highlights the food consumption of a riverside population and reduces the shortage of information about the largest traditional Amazonian population.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"23 4","pages":"7730"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71426530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distance as a barrier to HIV testing among sexual and gender minority populations in the rural southern US: a cross-sectional study.","authors":"Alyssa Clausen, Rob B Stephenson, Patrick S Sullivan, O Winslow Edwards, Leland Merrill, Cristian Acero Martinez, Jeb Jones","doi":"10.22605/RRH8227","DOIUrl":"10.22605/RRH8227","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual and gender minority people who live in rural areas are less likely to have had a HIV test in the previous 12 months compared with those who live in non-rural areas. We assessed the independent contribution of distance and time required to travel to receive a HIV test on recent uptake of HIV testing.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of sexual and gender minority populations in the southern US. We used Poisson regression with robust standard errors to estimate prevalence ratios to compare uptake of HIV testing in the previous 12 months among those who traveled more than 20 miles (~32 km) and more than 30 minutes to their most recent HIV test compared with those who traveled less distance and time to their most recent test, respectively.</p><p><strong>Results: </strong>A total of 508 (n=155 rural, n=348 non-rural) participants completed the survey. Of these, 398 (78.5%) had received a HIV test in the previous 12 months. Those who traveled more than 20 miles (~32 km) to their most recent test were more likely to have not received a HIV test in the previous 12 months compared with those who traveled 20 miles (~32 km) or less (adjusted prevalence ratio 2.25; 95% confidence interval 1.22-4.17). There were no differences based on travel time to the most recent test.</p><p><strong>Conclusion: </strong>Distance, but not time, to travel to receive a HIV test is independently associated with reduced HIV testing. More geographically proximal options or access to home-based testing might reduce this barrier.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"23 4","pages":"8227"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138291731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}