Rural and urban differences in people living with HIV/AIDS and their caregivers : social support, types of need, and caregiver burden

This study examines: (1) rural versus urban differences in social support and types of need for people living with HIV/AIDS (PLAs) and (2) rural versus urban differences in social support and burden for caregivers of PLAs. Structured interviews were conducted with a sample of 83 PLAs and 25 caregivers.

Two instruments were used to measure social support: The Multidimensional Scale of Perceived Social Support (MSPSS) (Zimet et al., 1988) and the Network Orientation Scale (NOS) (Vaux et al., 1986). The Caregiver Burden Interview (CBI) (Zarit, 1990) was used to measure caregiver burden. A needs assessment was constructed to examine PLA types of need.

Multiple regression and t tests were used to test hypotheses concerning rural and urban differences in social support and caregiver burden. Rural and urban differences in PLA types of need were explored by examining percentage distributions. Rural versus urban residence was not significantly related to social support for PLAs. However, PLAs who have a caregiver were significantly more likely to have higher levels of social support than PLAs who do not have a caregiver and PLAs who are gay or bisexual were more likely to have higher levels of social support than PLAs who are heterosexual.

The results of the needs assessment indicate that rural PLAs had a greater proportion of unmet need than urban PLAs. Moreover, almost one-fourth of PLA needs were unmet.

On the NOS measure of social support caregivers in urban areas had significantly lower levels of social support than caregivers in rural areas. In addition, urban caregivers had significantly higher levels of burden than rural caregivers.

Study findings indicate the need to acknowledge the increasing occurrence of HIV/AIDS in other populations and to adjust programs and services accordingly. Currently the Family and Medical Leave Act of 1993 applies only to persons who are legally married to the person who is ill or who are biological family members. Social work and other health and human service professionals need to be aware of the psychosocial characteristics of PLAs, especially regarding the support network, caregiver status, sexual orientation, and mode of HIV/AIDS infection.