Symptoms of Psychological Distress: A Comparison of Rural and Urban Individuals Enrolled in HIV-Related Mental Health Care

Abstract

Over the past decade, the number of individuals who have been diagnosed with HIV in nonmetropolitan areas (population of less than 50,000 individuals) has increased; however, the majority of the research has been conducted in metropolitan areas. Even less research has examined the levels of psychological distress among rural individual living with HIV. The purpose of this study was to explore the nature and range of psychological distress symptoms experienced by individuals living in rural areas who had self-enrolled into HIV-related mental health care and to compare their levels of distress to their urban counterparts accessing care at the same clinic. Data were collected from 95 individuals who self-enrolled in HIV-related mental health at either a rural (n = 47) or urban (n = 48) clinic. All participants completed the Brief Symptom Inventory (BSI), the instrument used in this study to assess symptoms of psychological distress. Rural participants had significantly higher mean scores on the hostility dimension of the BSI, F(1, 93) = 8.77, p = 0.004, than their urban counterparts. Furthermore, the rural participants had a greater proportion of individuals who had a T-score >or=63, a level indicative of a need for further psychological evaluation, for generalized anxiety, hostility, and psychoticism. The results indicated that rural individuals presented with higher levels of symptoms of psychological distress than their urban counterparts. These differences may be reflective of situational circumstances in rural areas where access to care, social isolation, and perceived stigma may delay screening for, and treatment of, psychological distress.

Prevalence and correlates of psychological distress of middle-aged and older women living with HIV

“…Fifteen percent of the sample reported psychological distress beyond the threshold considered clinically significant for the BSI. This value is similar to those reported by other studies in which the same measure has been used (Basta, Shacham, & Reece, 2009;Shacham, Basta, & Reece, 2008).…”

“…The cross-sectional design, which precludes any causal associations, and the convenience sample require caution in interpreting and generalizing these findings. Psychological distress was assessed with the BSI, a self-reported screening tool that has been frequently used in HIV research (Basta et al, 2009;Brown et al, 2015). Although the BSI is a well-known and reliable index of psychological distress and assesses a wide range of psychological symptoms, the validity of its factorial structure has been questioned (Loutsiou-Ladd, Panayiotou, & Kokkinos, 2008).…”

The Impact of Anticipated HIV Stigma on Delays in HIV Testing Behaviors: Findings from a Community-Based Sample of Men Who Have Sex with Men and Transgender Women in New York City

“…34 Many studies have documented associations between stigma, discrimination, delays in seeking care when testing HIV positive, and poor HIV treatment adherence. [52][53][54] One of potential reasons that people may not take an HIV test result is fear. This fear is not surprising, as there are real social consequences of acquiring HIV, such as rejection by, and isolation and discrimination from significant others and providers.…”

HIV Testing Among Deep South Residents With Serious Psychological Distress

“…Because poverty has been associated with both mental illness and HIV/AIDS, 34 and the rural South is often characterized as not only being poor but largely African American–concentrated, our finding that rural residents with serious psychological distress were less likely to have been tested for HIV underscores the importance of efforts to increase HIV prevention efforts among nonurban residents and to raise awareness about mental illness in the black community. Whereas only predisposing factors (ie, race/ethnicity, urbanization) were demonstrated to be potential confounders of the uptake of HIV testing among females with serious psychological distress, other potential confounders for their male counterparts included enabling factors such as income and health care access.…”