Mental health service use and shortages among a cohort of women living with HIV in Canada.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

HIV Infections*/epidemiology ; HIV Infections*/therapy ; Mental Health Services*/statistics & numerical data ; Mental Health Services*/supply & distribution ; Health Services Accessibility*/statistics & numerical data; Humans ; Female ; Canada/epidemiology ; Adult ; Middle Aged ; Cohort Studies

Background: The prevalence of mental health conditions among women with HIV in Canada ranges between 29.5% and 57.4%, highlighting the need for accessible mental health care. We aimed to (1) describe the availability and use of mental health services among women with HIV and (2) identify characteristics associated with reporting that shortages of these services presented a problem in their care.
Methods: Baseline data from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study were analysed. Self-reported availability and use of mental health services were examined using descriptive statistics. Participants indicated whether a lack of mental health support was a problem in their care. Logistic regression models were constructed to determine associations between sociodemographic, clinical, and psychosocial characteristics and reported problematic shortages.
Results: Of 1422 women, 26.7% (n = 380) used mental health services in the last year, which most accessed through their HIV clinic. Thirty-eight percent (n = 541) reported that a shortage of mental health support was a problem in their care. Among this subset, 22.1% (n = 119) used services at their HIV clinic, 26.5% (n = 143) reported available services but did not use them, and 51.4% (n = 277) either indicated that these services were unavailable, did not know if such services were available, or were unengaged in HIV care. Factors associated with reporting problematic shortages included rural residence [adjusted odds ratio (aOR): 1.69, 95% confidence interval (CI): 1.03-2.77], higher education level (aOR: 1.43, 95% CI: 1.02-2.02), and higher HIV stigma score (aOR: 1.03, 95% CI: 1.02-1.03). Conversely, African/Caribbean/Black identity (aOR: 0.37, 95% CI: 0.26-0.54), history of recreational drug use (aOR: 0.56, 95% CI: 0.39-0.81), and Quebec residence (aOR: 0.69, 95% CI: 0.50-0.96) were associated with lower odds of reporting service shortages.
Conclusion: Our findings highlight the HIV clinic as the primary location of mental health service use. However, existing services may not be sufficient to reach all patients or meet specific needs. Furthermore, the low uptake among those reporting a shortage suggests a lack of connection to services or patient knowledge about their availability. Characteristics associated with reporting shortages reflect geographic and socioeconomic disparities that must be accounted for in future service design.
(© 2024. The Author(s).)

BMC Health Serv Res. 2021 Jan 8;21(1):49. (PMID: 33419443)
Qual Health Res. 2018 Jun;28(7):1077-1087. (PMID: 29478406)
J Behav Health Serv Res. 2004 Apr-Jun;31(2):149-63. (PMID: 15255223)
PLoS One. 2021 May 26;16(5):e0252338. (PMID: 34038490)
J Health Care Poor Underserved. 2015 May;26(2):505-18. (PMID: 25913347)
AIDS Patient Care STDS. 2011 Sep;25(9):525-32. (PMID: 21774689)
J Patient Exp. 2020 Aug;7(4):433-435. (PMID: 33062854)
Psychosom Med. 2008 May;70(4):505-11. (PMID: 18378865)
Gen Hosp Psychiatry. 1993 Sep;15(5):290-300. (PMID: 8307342)
AIDS Behav. 2012 Nov;16(8):2119-43. (PMID: 22644066)
J Community Health. 1996 Jun;21(3):183-98. (PMID: 8726209)
J Int AIDS Soc. 2015 Dec 01;18(Suppl 5):20289. (PMID: 26643460)
AIDS. 2021 Oct 1;35(12):2017-2024. (PMID: 34172673)
Nurs Res. 2013 May-Jun;62(3):185-94. (PMID: 23328705)
AIDS Patient Care STDS. 2013 Feb;27(2):114-22. (PMID: 23373665)
Am J Public Health. 2022 Jun;112(S4):S340-S343. (PMID: 35763739)
J Affect Disord. 2015 Mar 15;174:619-26. (PMID: 25574781)
Am J Public Health. 2012 Sep;102(9):1751-7. (PMID: 22873480)
Qual Health Res. 2009 Nov;19(11):1589-601. (PMID: 19843967)
AIDS Behav. 2020 Apr;24(4):1212-1225. (PMID: 31486006)
AIDS Care. 2009 Jul;21(7):874-80. (PMID: 19504374)
Health Psychol. 2018 Jun;37(6):574-585. (PMID: 29781655)
Am J Public Health. 2010 Mar;100(3):435-45. (PMID: 20075321)
AIDS Care. 2016;28 Suppl 1:56-9. (PMID: 26888472)
J Ment Health Clin Psychol. 2021;5(2):1-7. (PMID: 34368814)
J Public Health Manag Pract. 2022 Mar-Apr 01;28(2):135-142. (PMID: 33208715)
J Nurs Meas. 1993 Winter;1(2):165-78. (PMID: 7850498)
J Int Assoc Provid AIDS Care. 2021 Jan-Dec;20:2325958221995612. (PMID: 33845677)
J Public Health Policy. 1991 Summer;12(2):165-74. (PMID: 1885758)
J Int Assoc Provid AIDS Care. 2021 Jan-Dec;20:2325958220985665. (PMID: 33472517)
AIDS Care. 2013 Aug;25(8):973-9. (PMID: 23252519)
Can J Psychiatry. 2019 Nov;64(11):761-769. (PMID: 31619055)
BMJ. 2009 Jun 29;338:b2393. (PMID: 19564179)
Qual Health Res. 2016 Jun;26(7):877-94. (PMID: 26848082)
Prev Med Rep. 2021 Oct 03;24:101580. (PMID: 34976641)
Prog Community Health Partnersh. 2015 Winter;9(4):561-9. (PMID: 26639382)
AIDS Behav. 2021 Oct;25(10):3097-3105. (PMID: 33598866)
Fed Pract. 2015 Feb;32(Suppl 2):10S-14S. (PMID: 30766106)
Lancet. 2017 Mar 4;389(10072):941-950. (PMID: 28271845)
West J Med. 2000 Feb;172(2):124-8. (PMID: 10693376)
BMC Med Res Methodol. 2016 Aug 19;16(1):101. (PMID: 27543135)
J Int AIDS Soc. 2019 Jul;22(7):e25341. (PMID: 31328891)
AIDS Patient Care STDS. 2008 Nov;22(11):869-77. (PMID: 19025481)
Health Econ. 2022 Oct;31 Suppl 2:22-39. (PMID: 35797349)
BMC Public Health. 2019 Dec 16;19(1):1683. (PMID: 31842822)
Res Nurs Health. 2001 Dec;24(6):518-29. (PMID: 11746080)
AIDS Care. 2021 Feb;33(2):192-200. (PMID: 32172609)
Can Commun Dis Rep. 2015 Dec 03;41(12):322-326. (PMID: 29769926)
Med Care. 1998 Feb;36(2):138-54. (PMID: 9475469)
AIDS Patient Care STDS. 2009 Jan;23(1):51-8. (PMID: 19046120)
Transgend Health. 2017 Jul 01;2(1):81-90. (PMID: 28861551)
AIDS Care. 2006 May;18(4):277-83. (PMID: 16809104)
AIDS Care. 2013;25(9):1083-91. (PMID: 23305552)
Harm Reduct J. 2019 Jul 18;16(1):47. (PMID: 31319894)
PLoS One. 2016 Jun 09;11(6):e0156652. (PMID: 27280751)
Psychol Med. 2009 Mar;39(3):355-63. (PMID: 18606051)
Prev Med. 2018 Feb;107:36-44. (PMID: 29277410)
J Pers Med. 2022 Aug 06;12(8):. (PMID: 36013243)
Int J Clin Pract. 2021 Jan;75(1):. (PMID: 32946641)
Womens Health Issues. 2017 Nov - Dec;27(6):721-730. (PMID: 28887140)
Addict Behav. 2010 Oct;35(10):896-9. (PMID: 20584573)
AIDS Res Ther. 2016 Nov 8;13:35. (PMID: 27826353)
AIDS Behav. 2019 Apr;23(4):984-1003. (PMID: 30600452)
Curr HIV/AIDS Rep. 2021 Dec;18(6):569-580. (PMID: 34792706)
AIDS Behav. 2012 Nov;16(8):2181-91. (PMID: 22246517)
AIDS Care. 2002 Aug;14 Suppl 1:S31-44. (PMID: 12204140)
PLoS One. 2018 Jul 19;13(7):e0200526. (PMID: 30024901)
Can J Psychiatry. 2023 Mar;68(3):200-207. (PMID: 36113102)
J Acquir Immune Defic Syndr. 2018 Oct 1;79(2):226-236. (PMID: 29916960)
Health Policy Plan. 2017 Nov 1;32(suppl_4):iv13-iv26. (PMID: 28666336)
J Community Health. 1993 Feb;18(1):11-23. (PMID: 8450090)
J Int Assoc Provid AIDS Care. 2016 Jan-Feb;15(1):23-35. (PMID: 24899261)
PLoS One. 2017 Sep 28;12(9):e0184708. (PMID: 28957412)
Healthc Manage Forum. 2020 Nov;33(6):282-287. (PMID: 32613867)
Health Promot Chronic Dis Prev Can. 2021 Sep;41(9):245-253. (PMID: 34549916)
Rural Remote Health. 2018 Jul;18(3):4522. (PMID: 30037269)
Arch Gen Psychiatry. 2001 Aug;58(8):721-8. (PMID: 11483137)

Keywords: Mental health care; Mental health needs; Service use; Women living with HIV

Date Created: 20240812 Date Completed: 20240813 Latest Revision: 20240815

20250114

PMC11321070

10.1186/s12913-024-11396-z

39135046