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. 2024 Jun;40(3):419-429.
doi: 10.1111/jrh.12799. Epub 2023 Sep 27.

Rural Veterans with HIV and Alcohol Use Disorder receive less video telehealth than urban Veterans

Alan Z Sheinfil  1   2   3 , Giselle Day  1   2 , Annette Walder  1   2 , Julianna Hogan  1   2   3 , Thomas P Giordano  2   4 , Jan Lindsay  1   2   3   5 , Anthony Ecker  1   2   3
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Rural Veterans with HIV and Alcohol Use Disorder receive less video telehealth than urban Veterans

Alan Z Sheinfil et al. J Rural Health. 2024 Jun.

Abstract

Purpose: Alcohol use disorder (AUD) is highly prevalent among Veterans with HIV. Rural Veterans with HIV are at especially high risk for not receiving appropriate treatment. This retrospective cohort cross-sectional study aimed to investigate patterns of mental health treatment utilization across delivery modality among Veterans diagnosed with HIV and AUD. It was hypothesized that rural Veterans with HIV and AUD would receive a lower rate of mental health treatment delivered via video telehealth than urban Veterans with HIV and AUD.

Methods: A national Veterans Health Association administrative database was used to identify a cohort of Veterans diagnosed with HIV and AUD (N = 2,075). Geocoding was used to categorize rural Veterans (n = 246) and urban Veterans (n = 1,829). Negative binomial regression models tested associations between rurality and mental health treatment delivered via face-to-face, audio-only, and video telehealth modalities.

Findings: Results demonstrated that rural Veterans with HIV and AUD received fewer mental health treatment sessions delivered via telehealth than urban Veterans with HIV and AUD (incidence rate ratio = 0.62; 95% confidence intervals [0.44, 0.87]; P < .01). No differences were found in terms of treatment delivered face-to-face or by audio-only.

Conclusions: Rural Veterans with HIV and AUD represent a vulnerable subpopulation of Veterans who may most benefit from video telehealth. Efforts to increase access and improve the uptake of evidence-based mental health treatment delivered via video telehealth are needed.

Keywords: HIV; Veterans; alcohol use disorder; rural mental health; telehealth.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Mental health treatment by delivery modality.
See this image and copyright information in PMC

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