title: Mental health differences between rural and urban men living with HIV infection in various age groups.
abstract: Despite the disproportionate increase in rural, Southern residents and older persons during the third era of the HIV/AIDS epidemic, no known study has examined whether older, rural men living with HIV infection face a double jeopardy and have poorer psychosocial profiles than other subgroups of men. We investigated whether area of residence (rural, urban), age (young, middle-age, old), and the interaction of residence and age would be related to mental health factors by using two measurement methods to categorize rural and urban residence (US Census Bureau classification and The Office of Rural Health Policy's, Rural Urban Commuting Area Codes [RUCAs]). We conducted 2-3 hour-long, face-to-face interviews with all but 43 patients who met the study criteria and kept their clinic appointments at three different types of healthcare facilities (i.e., VA, university clinic, public health department) over a 20-month period. The sample consisted of 226 men living in the southeastern US. Rural and urban men of various age groups did not differ in socioeconomic factors, travel distance to clinics, use of medications, satisfaction with care, types of severe stressors, and confidentiality concerns. Using two methods to categorize area of residence, we found that rural men as compared to urban men had similar levels of total stress, AIDS-related stress, social support, active coping and avoidance coping, but higher rates of risk for depression. Rural men had higher levels of non-AIDS-related stress only when the US Census Bureau's categorization was used, which highlights the importance of carefully selecting and describing methods to categorize rural versus urban residence.
authors.affiliation: Rehabilitation Outcomes Research Center, North Florida/South Georgia Veterans Health System, Research Department, Gainesville, FL 32608-1197, USA. Connie.Uphold@med.va.gov
authors.forename: Constance R
authors.initials: CR
authors.lastname: Uphold
authors.forename: Deepali
authors.initials: D
authors.lastname: Rane
authors.forename: Kimberly
authors.initials: K
authors.lastname: Reid
authors.forename: Scott L
authors.initials: SL
authors.lastname: Tomar
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011446:Prospective Studies; D012424:Rural Population; D014505:Urban Population; D014768:Virginia