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06:55
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Mental Health Status and Healthcare Utilization Inequity Among People Living With HIV: A Cross-Sectional Study Using
Ji Ma1,2, Ticheng Xiao3, Hang Chen3
1Department of Social Medicine, School of Public Health, Southwest Medical University, Luzhou, Sichuan, China, swmu.edu.cn.
Depression and Anxiety
|July 8, 2026
Summary
People living with HIV (PLHIV) experiencing psychological distress have poorer health but lower healthcare use, revealing significant inequities. Targeted interventions are crucial to address these disparities and improve care access for this population.
Area of Science:
- Public Health
- Mental Health Research
- Health Services Research
Background:
- Psychological distress is common in people living with HIV (PLHIV) and affects healthcare use.
- Understanding mental health's role in healthcare utilization inequity among PLHIV is limited, especially in resource-limited settings.
Purpose of the Study:
- To investigate the association between mental health status and healthcare utilization inequity in PLHIV.
- To identify factors contributing to healthcare utilization disparities in this population.
Main Methods:
- Cross-sectional study of 418 PLHIV on antiretroviral therapy (ART) in China.
- Assessed mental health using PHQ-9 and GAD-7; measured healthcare utilization via self-rated health, morbidity, chronic disease, and hospitalization.
- Employed Inverse Probability Treatment Weighting (IPTW) and concentration indices (CIs) for analysis, including decomposition.
Main Results:
- Symptom-positive PLHIV (48.3%) reported poorer self-rated health, higher morbidity, and more chronic diseases than symptom-negative individuals.
- Paradoxically, the symptom-positive group had lower hospitalization rates (82.1% vs. 88.2%).
- Concentration indices showed pro-rich inequities in all outcomes, particularly hospitalization (CI = -0.2379). Drug use history, physical activity, and health record establishment were key drivers of inequity.
Conclusions:
- PLHIV with psychological distress face significant disparities, experiencing worse health but reduced healthcare service utilization.
- Pro-rich inequities in healthcare access persist, with distinct patterns for symptom-positive individuals.
- Integrated mental health and HIV services, systematic management, and targeted interventions are essential to overcome healthcare barriers for PLHIV.
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