Rural Project Examples: HIV and AIDS
Evidence-Based Examples
Project ECHO® – Extension for Community Healthcare Outcomes
Updated/reviewed October 2022
Updated/reviewed October 2022
- Need: Increase medical management knowledge for New Mexico primary care providers in order to provide care for the thousands of rural and underserved patients with hepatitis C, a chronic, complex condition that has high personal and public health costs when left untreated.
- Intervention: Project leveraging an audiovisual platform to accomplish "moving knowledge, not patients" that used a "knowledge network learning loop" of disease-specific consultants and rural healthcare teams learning from each other and learning by providing direct patient care.
- Results: In 18 months, the urban specialist appointment wait list decreased from 8 months to 2 weeks due to Hepatitis C patients receiving care from the project's participating primary care providers. Improved disease outcomes were demonstrated along with cost savings, including those associated with travel. The project model, now known as Project ECHO® – Extension for Community Healthcare Outcomes — has evolved into a telementoring model used world-wide.
Chronic Disease Self-Management Program
Updated/reviewed December 2019
Updated/reviewed December 2019
- Need: To help people with chronic conditions learn how to manage their health.
- Intervention: A small-group 6-week workshop for individuals with chronic conditions to learn skills and strategies to manage their health.
- Results: Participants have better health and quality of life, including reduction in pain, fatigue, and depression.
Effective Examples
HoMBReS
Updated/reviewed February 2022
Updated/reviewed February 2022
- Need: To reduce the risk of HIV/STDs among Latino men living in rural regions of the United States.
- Intervention: Soccer team leaders are elected and trained as lay health advisors to promote sexual health education among team members.
- Results: Program participants report an increase in HIV testing, an increase in condom use, and an increase in awareness of how to prevent the transmission of HIV.

Updated/reviewed November 2020
- Need: Provision of medical care access and follow-up for rural North Carolina HIV patients with mental health, substance abuse, and unstable housing/homelessness challenges.
- Intervention: Medical home staff model expanded to a care coordination program with a core Network Navigator and Continuum of Care Coordinator assisting with medical, behavioral health, and basic life needs.
- Results: To date, the program has advanced three aspects of medical home patient care for this target population: provided further understanding of the spectrum of homelessness, including "hidden" homelessness; implemented outreach with creation of new community partnerships and a community housing coalition; and integrated medical care and behavioral health care for HIV.
Strong African American Families-Teen Program
Updated/reviewed April 2019
Updated/reviewed April 2019
- Need: There is a lack of interventions that addresses teenager behavioral problems, particularly for rural African American adolescents.
- Intervention: Rural, locally trained leaders administered five 2-hour meetings for teenagers and their primary caregivers. Trainings focused on reducing risks that prevent positive development, specifically sexual risk-taking that can lead to HIV and other STIs.
- Results: Teens reported reduced conduct problems, depressive symptoms, and substance abuse. Families were strengthened, and SAAF-T reduced unprotected intercourse and increased condom efficacy.

Updated/reviewed November 2018
- Need: Rural Alabama residents with HIV/AIDS face stigma, poverty, and transportation barriers, limiting their access to expert HIV/AIDS healthcare.
- Intervention: Medical Advocacy & Outreach utilizes telemedicine to remove these barriers and offers cost-effective care to rural patients living with HIV/AIDS.
- Results: This telehealth network has expanded to reach rural patients in 12 Alabama counties. Patients are staying engaged due to its convenience and cost-effective nature.
Promising Examples
TelePrEP
Updated/reviewed January 2023
Updated/reviewed January 2023
- Need: To prevent new cases of HIV in rural Iowa.
- Intervention: TelePrEP provides preventive care via telehealth and prescription delivery.
- Results: Between February 2017 and August 2020, TelePrEP received 456 referrals, with 403 patients completing an initial visit.
Other Project Examples
It's a Girl Thing: Making Proud Choices
Updated/reviewed February 2023
Updated/reviewed February 2023
- Need: Teen pregnancy and sexually transmitted diseases, including HIV, in young girls were concerns for members of Union Parish, Louisiana.
- Intervention: Union General Hospital, a Critical Access Hospital, created the program It's a Girl Thing: Making Proud Choices to teach prevention, self-confidence, and personal responsibility to teen girls.
- Results: Teen pregnancy rates in Union Parish have dropped by 18%, exceeding the program's initial goal of 5%. Graduation rates have also increased the longer girls remain in the program.

Updated/reviewed February 2023
- Need: To improve and increase prevention and care services for HIV, STDs, hepatitis C, and other infectious diseases.
- Intervention: PAETC-NV provides clinical and didactic trainings, conferences, technical assistance, capacity building, webinars, and other services to providers and healthcare organizations statewide.
- Results: In 2022, PAETC-NV trained more than 1,400 healthcare providers across Nevada to increase clinical capacity in the care, screening, and prevention of HIV, other sexually transmitted diseases, COVID-19, and hepatitis C.

Added February 2023
- Need: Black women living with HIV in rural southeastern Louisiana face challenges in accessing care and other needed resources, often while dealing with other life stressors such as poverty, physical and mental health comorbidities, and a history of trauma.
- Intervention: Implementing three evidence-informed interventions simultaneously ensures success in linking, treating, and retaining Black women in HIV care to improve health outcomes.
- Results: As of February 2023, Stepping Stones has recruited 38 participants.