Rural Americans with HIV Suffer Emotional Damage (Reuters Health
By Keith Mulvihill
Originally published by Reuters Health, April 18, 2001
NEW YORK (Reuters Health) — HIV-infected individuals living in rural parts of the United States are likely to suffer depression and loneliness and have suicidal thoughts, according to a four-year study of this little-studied population.
The findings were presented by Dr. Timothy Heckman, a psychologist at Ohio University in Athens, last month at the Annual Conference of the Society of Behavioral Medicine meeting in Seattle, Washington.
Heckman and his colleagues interviewed 201 HIV-infected people by telephone. The group included 152 men and 49 women, all of whom lived in towns with 50,000 or fewer people located at least 20 miles from towns of more than 100,000. Nearly two-thirds lived in towns of 10,000 or fewer residents.
Thirty-eight percent of the people interviewed reported thoughts of suicide in the past week. One in 16, or 6%, reported that they would like to kill themselves or would have killed themselves if they had the chance in the past week.
"HIV-infected rural persons who (had) more thoughts of suicide also reported more depressive symptoms, less ability to cope with life stressors, experienced more stress associated with the possibility of transmitting their infection to others and experienced more stress due to more frequent incidents of HIV-related stigma and discrimination," Heckman told Reuters Health.
In rural America, AIDS-related discrimination occurs at unacceptably high rates, Heckman said.
"Almost every HIV-infected rural person I've talked to can recount disturbing incidents of AIDS-related discrimination. It is important for residents of rural communities to realize that, when they stigmatize or discriminate against a rural person living with HIV/AIDS, they may very well be contributing to his or her psychological demise (and possibly increase thoughts of suicide among the individual)," said Heckman.
"I often ask HIV-infected rural persons to describe for me the one thing they need in order to be able to enjoy a better quality of life. Interestingly, they don't talk about better physical health, and they don't talk about having more money or a better job," said Heckman.
"Instead, most of them talk about the need to reduce AIDS-related stigma and discrimination in rural communities. Unfortunately, our society has not even begun to address this issue."
Heckman stresses that HIV-infected rural persons should be made aware that there are effective treatments for depression, including therapy and antidepressant drugs.
"If at all possible, emotionally vulnerable HIV-infected rural persons should participate in one or both (types of) treatment," he said.
"People living with HIV disease in rural areas are not alone—although they may feel like they are," said Heckman.
"There are tens of thousands of individuals who, like them, are living with HIV disease in geographically-remote communities. If they can identify and access a support network, and receive proper medical and mental health care, their adjustment efforts will be much easier," he concluded.
