title: 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.
authors.affiliation: Health Inequalities Program, Duke University, Durham, NC 27708, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Reif
authors.forename: Kathryn
authors.initials: K
authors.lastname: Whetten
authors.forename: Jan
authors.initials: J
authors.lastname: Ostermann
authors.forename: James L
authors.initials: JL
authors.lastname: Raper
mesh_terms: D000293:Adolescent; D000328:Adult; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012423:Rural Health / Q000639:trends*; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012931:Social Environment; D012959:Socioeconomic Factors; D015144:Southeastern United States / Q000453:epidemiology; D013315:Stress, Psychological / Q000628:therapy; D019037:Urban Health Services / Q000706:statistics & numerical data*