RESUMO
Using baseline data from a survey of 309 Canadian women recently separated from an abusive partner, we investigated patterns of access to health, social, legal, and violence-specific services and whether abuse history and social and health variables predict service use. We compared rates of service use to population rates, and used logistic regression to identify determinants of use. Service use rates were substantially higher than population estimates in every category, particularly in general and mental health sectors. Although women were confident in their ability to access services, they reported substantial unmet need, difficulty accessing services, and multiple barriers. The strongest unique predictors of use varied across service type. Health variables (high disability chronic pain, symptoms of depression and PTSD), low income, and mothering were the most consistent predictors. Service providers and policy makers must account for social location, abuse history, and health status of Intimate Violence (IPV) survivors. Strategies to enhance access to primary health care services, and to create a system of more integrated, accessible services, are required.
RESUMO
Investigation on the mental health of HIV-positive immigrants is severely limited. We examine the independent and combined effects of HIV symptom and coping resources on depressive symptoms among HIV-positive immigrants (n = 259). Ordinary Least Squares regression models were estimated with data from a survey of clinical and social-psychological outcomes in people receiving treatment for HIV infection. We tested for the impact of two HIV-related stressors, one life events stressor and three buffering resources on depressive symptoms, controlling for thirteen demographic, clinical and acculturative factors. HIV-related stressors were found to be positively related to depressive symptom severity. Coping resources, namely self-mastery, mediate the relationships between HIV-related stressors and depressive symptoms. Results from this study provide the first empirical assessment of stress processes for immigrants living with HIV. Although more research is needed to understand mental health among HIV-positive immigrants, the study results suggest that health care providers focus on self-mastery enhancement among HIV-positive immigrants.