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I n Canada, health inequities have been well documented in rural, remote and northern areas. As a result, improving rural health is often a priority area for health research and service delivery. For example, rural, remote and northern areas in Canada have been found to have higher rates of all-cause mortality, chronic kidney disease, obesity, cerebrovascular disease and maternal morbidity. 1-4 In addition to higher incidence and prevalence of chronic diseases, disease-specific outcomes and use of evidence-based therapies are poorer in rural areas. 5-7 Infection with HIV is a chronic disease with many reported geographic discrepancies in care in high-income countries. With appropriate care and medications, the life expectancy of those living with HIV can approach that of the general population. 8 Despite advances in HIV care, people in rural areas experience more advanced disease at diagnosis, delayed linkage to care, more rapid disease progression and increased mortality. 9-14 The relation between rurality and health outcomes is complex and is driven by intersecting determinants, including poverty, education, industries that extract natural resources, colonialism, health human resources and travel distances. 15-21 Further complicating health analyses on rurality are heterogeneity among rural areas, varying definitions of rurality and authors' failure to justify selected definitions. 22,23 In Canada, common definitions rely on population census categorizations, postal codes or rurality indices. 24-26