title: Perceived need for and use of mental health services by women living with or at risk of human immunodeficiency virus infection.
abstract: OBJECTIVE
  To determine prevalence of and factors associated with perceived need for and use of mental health services and use of psychotherapeutic medications among women in the Human Immunodeficiency Virus Epidemiology Research Study (HERS).
  
  
  METHODS
  We interviewed 871 HIV-seropositive and 439 demographically and behaviorally similar seronegative women at baseline regarding demographics, psychosocial measures, substance use, medical history, and use of health care services and medications.
  
  
  RESULTS
  Thirty-eight percent of HIV-seropositive women and 35% of seronegative women (p = 0.33) reported needing mental health services in the prior six months. Women who were older, were white or Latina (compared with African American), had some college education, had less social support, and reported recent negative life events or had CES-D scores higher than 15 (suggesting depression) were more likely to report needing mental health services. Sixty-seven percent of seropositive and 65% of seronegative women who reported needing services (p = 0.69) reported obtaining services. Women who were white (compared with Latina or African American) and had more education, more social support, and health insurance were more likely to obtain services. Eighteen percent of seropositive and 13% of seronegative women (p = 0.006) reported current use of psychotherapeutic medications, especially antidepressants and antianxiety medications. Women who reported use of medications were more likely to report recent negative life events; were older, white, or Latina; had more education, less social support, CES-D scores higher than 15, and health insurance.
  
  
  CONCLUSIONS
  Women both living with or at risk of HIV perceived a need for and used mental health services in association with negative life events, social isolation, and depressive symptoms. Need for and use of services differed by race/ethnicity, education, and availability of social support.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Wayne State University School of Medicine, Detroit, USA.
authors.forename: P
authors.initials: P
authors.lastname: Schuman
authors.forename: S E
authors.initials: SE
authors.lastname: Ohmit
authors.forename: J
authors.initials: J
authors.lastname: Moore
authors.forename: E
authors.initials: E
authors.lastname: Schoenbaum
authors.forename: R
authors.initials: R
authors.lastname: Boland
authors.forename: A
authors.initials: A
authors.lastname: Rompalo
authors.forename: L
authors.initials: L
authors.lastname: Solomon
mesh_terms: D000293:Adolescent; D000328:Adult; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D020380:Needs Assessment; D012944:Social Support; D014481:United States; D014932:Women's Health Services