Characteristics of HIV-infected adults in the Deep South and their utilization of mental health services: A rural vs. urban comparison

Abstract

Insufficient utilization of mental health services has been described among HIV-infected individuals in urban areas; however, little is known about utilization of mental health services among rural-living HIV-infected individuals. This article examines use of mental health services by HIV-infected adults in the Southern U.S., where approximately two-thirds of rural HIV cases reside, and compares mental health services use between those in rural and urban areas. Data were obtained from surveys of HIV-infected individuals receiving care at tertiary Infectious Diseases clinics in the Southern U.S. (n = 474). Study findings indicated that participants living in areas with a higher proportion of rural-living individuals were less likely to report seeing a mental health provider (p<.001) in the last year even though there were no differences in level of psychological distress by degree of rurality. Participants living in more rural areas also reported significantly fewer mental health visits in the previous month (p=.025). Furthermore, rural living was significantly associated with being African-American, heterosexual, less educated, and having minor children in the home. Due to differences in characteristics and mental health services use by degree of rurality, efforts are needed to assess and address the specific mental health and other needs of HIV-infected individuals in rural areas.

Acknowledgments

This analysis was supported by the Health Resources and Services Administration (HRSA) Grant # H76HA00614 of the U.S. Department of Health and Human Services. The conclusions reached in this report are those of the authors and may not reflect the views of the funding agency. We thank Traci Dreher, Jeanette Johnson-Licon, Melinda Steele, and Jai Uberoi for collecting patient consents and Kristin Lowe for her editorial support. We also thank the clinicians and staff at each participating infectious disease clinic for their assistance in obtaining Institutional Review Board approval and enrolling patients, and for their general support of this research.