Location
University of Nebraska Medical Center
Event Date
3-31-2026
Abstract
Background: In 2020, Nebraska’s HIV prevalence was 146 per 100,000 individuals, with 107 new diagnoses in 2021. Of the 2,497 people living with HIV (PWH) statewide, 23% resided in rural areas. Rural diagnoses nearly doubled in 2021, accounting for 35% of new cases. At presentation, rural PWH had significantly lower mean CD4 counts compared to their urban counterparts (378 vs. 953 cells/mm³), suggesting delays in diagnosis and care. In response, the University of Nebraska Medical Center (UNMC) Specialty Care Clinic implemented the Extension for Community Healthcare Outcomes (ECHO) model to enhance rural provider support through virtual lectures and case-based learning. Methods: An anonymous, cross-sectional survey was distributed to healthcare professionals engaged in HIV care. Survey domains included demographics, clinical role and setting, years of experience, geographic region, perceived barriers to HIV education, and topic preferences. Associations were assessed using Fisher’s exact or Chi-square tests (p< 0.05), with analyses conducted in SAS 9.4. Results: Rural respondents reported greater barriers to accessing HIV education (p< 0.02). Urban professionals expressed higher interest in Harm Reduction (p< 0.008) and Transgender Health (p< 0.02), while rural respondents prioritized Rural Health topics (p< 0.0001). Professionals aged 19–35 more frequently identified educational needs in Perinatal Transmission (p< 0.006), Transgender Health (p< 0.02), Sexual and Gender Minoritized Populations (p< 0.03), Harm Reduction (p< 0.01), and System-Impacted Individuals (p< 0.02). Direct patient care providers reported lower interest in Retention in Care (p< 0.03), Sexual and Gender Minority Populations (p< 0.0002), and Transgender Health (p< 0.03). Discussion: Findings highlight the need for adaptable HIV educational initiatives tailored to professional, geographic, and generational differences. Rural providers faced greater barriers to accessing training and education, indicating an urgent need to expand educational infrastructure and resources in underserved areas. HIV education topic interests varied greatly justifying diverse ECHO sessions and warrants further investigation.
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Outcomes of a Learning Needs Assessment Survey in the Development of the Extension for Community Health Outcomes Model for HIV Training in Midwestern Non-Metropolitan Areas
University of Nebraska Medical Center
Background: In 2020, Nebraska’s HIV prevalence was 146 per 100,000 individuals, with 107 new diagnoses in 2021. Of the 2,497 people living with HIV (PWH) statewide, 23% resided in rural areas. Rural diagnoses nearly doubled in 2021, accounting for 35% of new cases. At presentation, rural PWH had significantly lower mean CD4 counts compared to their urban counterparts (378 vs. 953 cells/mm³), suggesting delays in diagnosis and care. In response, the University of Nebraska Medical Center (UNMC) Specialty Care Clinic implemented the Extension for Community Healthcare Outcomes (ECHO) model to enhance rural provider support through virtual lectures and case-based learning. Methods: An anonymous, cross-sectional survey was distributed to healthcare professionals engaged in HIV care. Survey domains included demographics, clinical role and setting, years of experience, geographic region, perceived barriers to HIV education, and topic preferences. Associations were assessed using Fisher’s exact or Chi-square tests (p< 0.05), with analyses conducted in SAS 9.4. Results: Rural respondents reported greater barriers to accessing HIV education (p< 0.02). Urban professionals expressed higher interest in Harm Reduction (p< 0.008) and Transgender Health (p< 0.02), while rural respondents prioritized Rural Health topics (p< 0.0001). Professionals aged 19–35 more frequently identified educational needs in Perinatal Transmission (p< 0.006), Transgender Health (p< 0.02), Sexual and Gender Minoritized Populations (p< 0.03), Harm Reduction (p< 0.01), and System-Impacted Individuals (p< 0.02). Direct patient care providers reported lower interest in Retention in Care (p< 0.03), Sexual and Gender Minority Populations (p< 0.0002), and Transgender Health (p< 0.03). Discussion: Findings highlight the need for adaptable HIV educational initiatives tailored to professional, geographic, and generational differences. Rural providers faced greater barriers to accessing training and education, indicating an urgent need to expand educational infrastructure and resources in underserved areas. HIV education topic interests varied greatly justifying diverse ECHO sessions and warrants further investigation.