Psychosocial Differences Between Whites and African Americans Living With HIV/AIDS in Rural Areas of 13 US States

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ABSTRACT:  Context: Acquired immunodeficiency syndrome (AIDS) prevalence rates are increasing rapidly in rural areas of the United States. As rural African Americans are increasingly affected by human immunodeficiency virus (HIV), it is important to identify psychosocial factors unique to this group so that AIDS mental health interventions can be culturally contextualized to meet their unique needs. Purpose: The current study characterized psychosocial functioning in 43 rural African Americans living with HIV/AIDS and compared their levels of functioning to those of 196 HIV‐infected rural white persons. Methods: All participants were recruited through AIDS service organizations in 13 US states. Surveys were completed as part of a preintervention phase of a randomized clinical trial evaluating 2 mental health interventions for HIV‐infected rural persons. Findings: Compared to their white counterparts, fewer African Americans had progressed to AIDS. African American participants also reported higher levels of coping self‐efficacy, more support from family members, and marginally fewer depressive symptoms, and they engaged in more active coping. African Americans who had greater HIV disease severity also received less support from family members and experienced more loneliness. Conclusions: Study findings caution that rural African Americans and whites living with HIV disease should not be considered a homogeneous group.

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