Hi I am Juan Fernando Maestre from Indiana University.
I’m excited to discuss our paper “Examining Mobility Among People Living with HIV in Rural
Areas”.
Transportation in rural areas in the US has been characterized by a limited access to
public transportation as well as private transportation such as taxi or ridesharing services like
Uber or Lyft.
It has also been characterized by a prominent dependency on cars.
Human computer interaction research has focused on urban areas primarily in order to design
technologies to disclose/advertise/make known the local and available transportation methods
and how people could benefit from ridesharing services like Uber.
Fewer research has focused on rural areas, especially when it comes to people living
with HIV for whom transportation access is critical as it has been linked to successful
care and treatment and medication adherence.
With the help of an HIV support center located in the study region, we conducted 14 interviews
with people living with HIV and 4 case coordinators.
The data collection period took place from March to July of 2020; you can find more details
about our approach in our paper.
The focus of our research is people living with HIV in rural Indiana.
We wanted to look at the transportation methods that they use to get to healthcare appointments,
the grocery store, and employment.
We also wanted to look at the barriers and facilitators that underlie these transportation
methods.
Finally, we wanted to understand the role of community-based and healthcare organizations
in these forms of travel.
The most common form of transportation was driving to get to the different destinations.
If they couldn’t drive they would then ask their family members or friends for rides.
If they couldn’t drive or get rides from family and friends, participants attempted
to use public transportation or paratransit transportation.
These forms of transportation allowed them to call ahead of time to get rides to their
healthcare appointments or go to the grocery store.
If participants could not use or have access to any of these transportation methods, they
relied on their case coordinators for rides to their healthcare appointments, and in some
cases, to the grocery store.
In fact, case coordinators were considered as a ‘last line of defense’, if case coordinators
could not provide rides to their clients, they could give them vouchers for taxis or
ridesharing services like Uber or Lyft.They could also help their clients to find and
coordinate rides from their own social circles.
Private transportation methods like taxi or ride sharing services were not really present
in the communities where participants lived.
And if they did exist in those areas, especially taxi services, they were often too expensive.
In the case of ridesharing services like Uber and Lyft, participants mentioned that they
would not use them, even if they were available, because of their lack of trust in strangers
giving them rides.
Participants mentioned that they would be interested in trying alternative methods of
transportation that other people in their communities are using at the moment (in particular
retired people) like golf carts.
Participants mentioned that people in their communities would use these alternative transportation
methods to go to the grocery store.
Our findings also suggest the presence of a neighborly altruism amongst participants
that have tightly-knit social networks; these allow them to compensate transportation favors
via light reciprocity or no payment at all, and ensure confidentiality about their medical
condition while getting to their destinations.
So the key and common facilitators for the various transportation models used by participants
were to own a car, have a support network i/n place, and when there are no risks of
breach of confidentiality regarding their HIV status.
The key barriers were Lack of infrastructure in rural areas, coordination breakdowns between
drivers and riders, lack of knowledge of transportation services in the area, fear of potential enactments
of HIV-related Stigma, lack of interpersonal trust between riders and drivers, and lack
of independence for riders.
For more detail about all the facilitators and barriers, please refer to our paper.
Based on our findings, we propose the design of crowdsource-based systems that could deliver
contextualized information about the different transportation models available to riders
including potential facilitators and barriers.
In addition, we propose the design of favor-based systems that could integrate reputation to
help increase trust amongst riders and drivers.
The system could also integrate a timebanking-based system to help riders connect to trusted community
members who are willing to provide transportation services in exchange for other services.
Finally, we propose the design of telehealth systems that would reduce the need for traveling
to healthcare appointments.
I would like to thank all my coauthors and the NSF for funding this research.
Thank you!