Use of mental health services by HIV-infected women.

In this study, the first to examine the use of mental health services among a large cohort of HIV-positive women, our objective was to quantify the use of such services by infected women enrolled at one site of the HIV Epidemiology Research Study and to describe the factors associated with such use. One hundred sixty-seven HIV-seropositive women and 67 seronegative women were interviewed between March and November 1995 during their semiannual study visit. Women were asked to report visits they had made to mental health counselors (psychiatrists, social workers, or psychologists) or HIV support groups and any psychiatric hospitalizations during the previous 6 months. About half the seropositive women had a history of injection drug use, were Caucasian, and lived with children, three quarters were insured, and one third were church members. A minority of seropositive women (38%) sought at least one outpatient mental health visit, and 4% had been hospitalized during the previous 6 months. Being a member of a church, having a high school education, and being Caucasian were significantly associated (p < 0.05) with seeing a mental health counselor. Among HIV-positive women who reported at least one visit, their CD4 cell count was the only factor associated with the number of mental health visits. Only 13% of women had attended an HIV support group. Among seronegative women, 27% had at least one outpatient mental health visit during the preceding 6 months. The use of mental health services by women with HIV has economic, not just therapeutic, implications for all HIV service delivery systems.