Rural HIV, Real Results: Integrated Care Models Bring Hope to Aging Populations

In the rural South, growing older with HIV often means facing more than just the HIV virus. Many older adults in these communities manage multiple chronic conditions while contending with stigma and limited access to specialized care. Integrated care models offer a promising solution, bringing compassion and coordination under one roof. Patient-centered medical homes, for example, combine primary care, HIV treatment, and mental health support. This model helps patients age with dignity and improves treatment adherence among older people living with HIV (PLH)¹.

Federally Qualified Health Centers (FQHCs) and Ryan White Program providers have led the way in implementing integrated models in rural Southern communities. These clinics often employ community health workers and peer navigators who understand local cultural dynamics and can build trust with older PLH. This approach helps reduce stigma and provides access to wraparound services such as housing, food, and behavioral health support. Addressing multiple social determinants of health through a single point of care is both cost-effective and essential in areas with limited provider availability².

The Role of Transportation and Mobile Health Units

Transportation remains a major barrier to care for older PLH in rural areas. Many lack access to reliable vehicles or public transit. This often leads to missed appointments and delayed treatment. Some communities have responded with partnerships between healthcare providers and local transportation services, including non-emergency medical transportation (NEMT) programs funded through Medicaid. These services help reduce care gaps by providing scheduled rides to clinics, pharmacies, and support groups³.

Mobile health units have also been deployed to reach older PLH in underserved areas. Equipped with exam rooms, testing tools, and telehealth connections, these units deliver antiretroviral therapy, screenings, and mental health consultations directly to patients. In Alabama and Mississippi, mobile clinics supported by university health systems and nonprofits have helped normalize care and build trust in communities that may be hesitant to engage with traditional health systems⁴.

Cultural Sensitivity and Community Engagement Strategies

Cultural and religious beliefs in the rural South contribute significantly to HIV stigma, particularly in communities where churches are central to social life. Fear of judgment often leads to social isolation and untreated health conditions. In response, organizations have partnered with faith leaders to promote education and compassion-based care⁵.

Training local health workers and clergy to discuss HIV and aging openly has helped shift perceptions. In Georgia and Louisiana, health departments have hosted workshops for religious leaders focused on HIV education and supportive care. These leaders then act as advocates, reducing shame and encouraging care-seeking. Locally-led efforts that refle