PSYCHOSOCIAL OUTCOMES OF HIV ILLNESS IN MALE AND FEMALE AFRICAN-AMERICAN CLIENTS

With the rapid growth of HIV infection among African Americans, the is sue of how medical problems relate to psychological functioning in the black community population has acquired new meaning and urgency for h ealth care policy. To develop effective strategies to meet the mental health needs of infected African Americans we need a better understand ing of the pattern of association between HIV and psychological distre ss. The objective of this study is to test several hypotheses that pre dict depression and anxiety in black adults infected with HIV. Our con ceptual model is derived from learned helplessness theory (Seligman, 1 975), the concept of perceived coherence (Antonovsky, 1980; Lewis & Ga llison, 1989), and social support theory (Cohen & Willis, 1985). Instr uments used in the study include: The Center for Epidemiological Studi es-Depression (CES-D) Scale (Radloff, 1977), the Anxiety Scale (Lewis, Firsich, and Parsell, 1979), and the Perceived Coherence Scale (Lewis , 1989). Data were obtained from 255 HIV infected black males and fema les (age greater than or equal to 18) who sought support, counseling, and maintenance services from one of three HIV care and referral cente rs in the Mid-South. The results of the study emphasize the relative i mportance of perceived physical symptoms over stage of illness for psy chological functioning among African American adults with HIV. Further , the findings also demonstrate the potential importance of perceived coherence for psychological functioning. Black clients who reported hi gher perceived coherence, regardless of the stage of illness or level of HIV symptoms, had lower anxiety and depression. Significant gender differences in depression are also observed and implications are drawn for strategies to address HIV related mental health care needs of Afr ican Americans.