Oklahoma’s Ending the HIV Epidemic Efforts Extend Reach to People in Rural Areas

State and local partners in Oklahoma are collaborating to advance the Ending the HIV Epidemic in the U.S. (EHE) initiative. Oklahoma is one of seven states with a substantial number of HIV diagnoses in rural areas prioritized in the EHE initiative. Partners’ work to meet the needs of individuals with or experiencing risk for HIV in rural areas were highlighted during a visit by staff of the HHS Office of the Assistant Secretary for Health (OASH).

During the visit, CAPT John Oguntomilade, BDS, MPH, PhD, EHE Initiative Coordination Lead for OASH, conferred with staff at the Oklahoma State Department of Health (OSDH) responsible for implementing aspects of the EHE initiative, visited community providers, and participated in a community engagement session.?

During a briefing, OSDH staff noted that while most of the state’s HIV cases are concentrated in Oklahoma City and Tulsa, people with diagnosed HIV live in 73 of the state’s 77 counties, many of which are designated medically underserved areas. State officials also highlighted challenges associated with stigma, transportation, food and housing insecurity, and the few health professionals serving rural communities.

Strategies to Reach Rural Populations

CAPT Oguntomilade commended OSDH strategies and outreach efforts to reach people who need HIV services in all 77 counties, these include:

• Providing clinical outreach: OSDH staff conduct one-on-one visits with clinicians to expand their capacity to routinize opt-out HIV testing, deliver HIV care, and provide HIV prevention services, including PrEP.
• Expanding care capacity: The state’s EHE and STIs Tele-ECHOExit Disclaimer, a tele-mentoring program managed by a team of HIV specialists at Oklahoma State University, helps clinicians provide HIV services in primary care settings.
• Offering transportation support: To support engagement in HIV care for people who experience transportation barriers, OSDH has contracted to provide rides to clinic appointments and pharmacies.

During visits to four community organizations and clinics involved in EHE implementation, the local partners discussed work in their communities and beyond, including these efforts to reach and serve people who need HIV services in rural parts of the state:

• Tulsa CaresExit Disclaimer serves clients from the city and 22 rural counties in northeastern Oklahoma. They provide HIV and hepatitis C medical care with wraparound services that include health care navigation, Medicaid enrollment assistance, transportation assistance, mental health services, food services, and housing services.
• H.O.P.E. Testing ClinicExit Disclaimer in Tulsa deploys mobile vans to provide HIV testing, PrEP information, and linkage to rapid start treatment to clients in rural areas.
• Oklahoma City Indian ClinicExit Disclaimer, an Urban Indian Clinic funded by the Indian Health Service, operates a state-of-the-art pharmacy so clients can pick up PrEP, HIV treatment, and other prescriptions during clinic visits or request refills by mail. The clinic also supports HIV and STI services in rural areas.
• New Hope Wellness CenterExit Disclaimer in Oklahoma City serves minority and LGBTQ+ communities. Among its services are delivery of at-home rapid HIV test kits to rural clients and a mobile clinic. With support of EHE funding, New Hope expanded its HIV services to serve clients who were facing wait times to be seen at the other area HIV clinic.

Participants on the visit included LT Erica Bussey-Jones, Analyst (OASH Region 6). Staff from OSDH’s Sexual Health and Harm Reduction Service participating included, Director Terrainia Harris, MPH; Atonbara Sowemimo, Administrative Program Manager, Prevention and Harm Reduction; Maria Mancebo, Prevention and EHE Programs Manager; Kyle Boston, Administrative Program Manager, Interventions; and others.