A comparison of psychological distress symptoms among rural and urban individuals living with HIV

Background: The majority of HIV and mental health research has focused on urban populations; therefore, little is known about the symptoms of psychological distress experienced by individuals living in rural areas of the US. Methods: Data were collected from 100 individuals living with HIV who self-enrolled at either an urban (n = 50) or rural (n = 50) mental health clinic in the Southeastern United States. Participants in each group were matched on length of diagnosis at time of enrollment and age. Results: The urban sample had a significantly higher mean score indicative of hostility t(99) = 3.03, p = .003 compared to the rural sample. Furthermore, the urban sample had a statistically higher proportion of individuals who met the BSI criteria for “caseness,” an indicator of the need for further psychological evaluation, for: hostility, 2% (rural) vs. 26% (urban), z = 3.46, p<.05; psychoticism, 6% (rural) vs. 24% (urban), z = 2.52, p<.05; and the global severity index, 8% (rural) vs. 28% (urban), z = 2.60, p<.05. There were no statistically significant differences on demographic variables between the urban and rural samples. Conclusions: These results indicate that a significantly higher proportion of individuals in the urban sample presented for mental health care with higher levels of symptoms of psychological distress than their rural counterparts. This finding is important for providers because it suggests that, even though rural participants did not disclose high levels of distress, they still self-enrolled in mental health care, indicating a perception of need.