Annals of Behavioral Medicine

, Volume 24, Issue 2, pp 141–148

Thoughts of suicide among HIV-infected rural persons enrolled in a telephone-delivered mental health intervention


    • Department of PsychologyOhio University
    • Medical College of Wisconsin
  • Jeffrey Miller
    • Medical College of Wisconsin
  • Arlene Kochman
    • Medical College of Wisconsin
    • Yale University School of Medicine
  • Seth C. Kalichman
    • Medical College of Wisconsin
  • Bruce Carlson
    • Yale University School of Medicine
  • Monica Silverthorn
    • Yale University School of Medicine

DOI: 10.1207/S15324796ABM2402_11

Cite this article as:
Heckman, T.G., Miller, J., Kochman, A. et al. ann. behav. med. (2002) 24: 141. doi:10.1207/S15324796ABM2402_11


This study characterized rates and predictors of suicidal thoughts among HIV-infected persons living in rural communities of eight U.S. states. Self-administered surveys were completed by 201 HIV-infected persons living in communities of 50,000 or fewer that were located at least 20 miles from a city of 100,000 or more. All participants were clients of rural AIDS service organizations and had recently enrolled into a randomized clinical trial of a telephone-delivered, coping improvement-group intervention designed specifically for HIV-infected rural persons. At baseline, participants reported on thoughts of suicide, psychological symptomatology, life-stressor burden, ways of coping, coping self-efficacy, social support, and barriers to health care and social services. Thirty-eight percent of HIV-infected rural persons had engaged in thoughts of suicide during the past week. A logistic regression analysis revealed that participants who endorsed thoughts of suicide also reported more depressive symptoms(odds ratio [OR] = 2.19; 95% confidence interval [CI] = 1.32-3.63, p < .002), less coping self-efficacy (OR = 0.70; 95% CI = 0.56-0.88, p < .002), more frequently worried about transmitting their HIV infection to others (OR = 1.66, 95% CI = 1.14-2.40, p < .008), and experienced more stress associated with AIDS-related stigma (OR = 1.58, 95% CI = 1.07-2.35, p < .03). As AIDS prevalence rates increase in rural areas, interventions that successfully identify and treat geographically isolated HIV-infected persons who experience more frequent or serious thoughts of suicide are urgently needed.

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© The Society of Behavioral Medicine 2002