A cross-cultural comparison of psychological distress among individuals with HIV/AIDS

Background: Given that HIV-related care in developing countries continues to be influenced by care systems in western countries like the U.S., it is important to continue understanding the differences in the HIV-related needs between societies to ensure that systems of care are attentive to cultural differences and local needs.

Methods: A comparison of psychological distress symptoms among individuals with HIV in two independent samples was conducted. These samples included individuals who had self-enrolled in mental health care; one in an HIV-related medical clinic in Kenya and one in an HIV-related mental health clinic in the U.S. Samples were matched to include those who enrolled into care between November 2004 and November 2005.

Results: The Kenyan sample included 257 individuals and the U.S. sample included 279 individuals; participants were similar with regard to gender, age, and HIV-related characteristics. The Brief Symptom Inventory was used to measure symptoms of psychological distress. Distress levels were significantly higher in the U.S. sample for depression (F = 34.50, p < 0.00), anxiety (F = 8.54, p = 0.004), psychoticism (F = 8.23, p = 0.004), and the Global Severity Index (F = 14.06, p < 0.000), while the Kenyan sample reported significantly higher levels of phobic anxiety (F = 8.54, p = 0.004).

Discussion: These data suggest that dimensions of psychological distress may be expressed differently across populations living with the same disease and highlights the need to understand these manifestations when developing systems of care and subsequently providing services to those in these populations.