Strategies to increase HIV testing in rural areas of the United States: A Systematic Review


Purpose: HIV incidence continues to increase, with a large portion of new diagnoses found in rural areas of the United States. The worsening statistics in rural areas may be attributed to stigma alone and contribute to the lack of testing available for patients. The objective of this systematic review is to identify accessible and feasible strategies to increase HIV testing within the rural communities in the United States.

Methods: A systematic literature search of CINAHL Complete, MEDLINE with Full Text, and PsycINFO with restrictions of the English language and rural communities outside of the United States through August 2, 2018.  Two independent investigators screened articles using predetermined inclusion and exclusion criteria. This systematic review is registered through PROSPERO: CRD42018108637.

Findings: There were 14 different studies with specific interventions attempting to increase the rate of HIV testing in rural communities in the United States. Technology, faith-based stigma reduction, access, and provider interventions emerged as themes regarding HIV testing and stigma improvement.

Conclusion:  There exists a body of literature that supports a number of specific interventions focusing on access, provider and patient perspective, and ways to decrease stigma that improve HIV testing and could be implemented in rural communities.

Keywords: Rural, HIV/AIDS, HIV testing/screening, stigma


Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share (for non-commerical purposes) the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).