The Relationship between the Number & Type of Traumatic Experiences & PTSD in HIV positive adults in HIV Care/Rx Centres in Cape Town

Naidoo, P; Damon-Morris, T; & Seedat, S

INTRODUCTION

� Study located in larger study entitled: Common Mental Health Disorders among HIV-Infected Individuals in SA: Prevalence, Predictors, & Validation of Brief Psychiatric Rating Scales

� High Prevalence of HIV infected individuals in SA/sub-Saharan Africa is unquestionable

� PLWHA suffer very high rates of mental illness, especially PTSD

INTRODUCTION cont.

� Diagnosis of PTSD arises out of the experience(s) of traumatic events

� HIV/AIDS affects families that have experienced multi-generational histories of victimization & trauma (historical t)

� Currently: SA considered to be one of the most violent countries (includes sexual violence e.g. rape)

INTRODUCTION cont.

� Stressful life events (including traumatic events) impacts disease course

� Presence of PTSD can hasten HIV disease progression. Imp to include mental health services in HIV care/Rx

INTRODUCTION cont.

� Aims (this study): to examine the relationships between (a) the types of traumatic experiences & PTSD in PLWHA (adults)

� (b) the number of traumatic experiences & PTSD in PLWHA

METHOD: Study Design, Sampling & Procedure

� Main study design: quantitative, cross sectional

� Convenience, non-probability sampling

� Tools: battery of questionnaires (demographic & screening tools for depression, PTSD & substance abuse)

� Structured clinical interview using MINI

METHOD: Study Design, Sampling & Procedure

� Ethical guidelines adhered to

� This study: secondary data analysis

� 528 participants data utilized

� 2 groups identified: those that met criteria for PTSD (PTSD +) & those that did not (PTSD -)

RESULTS

� Mean Age: 34 yrs (SD=8.0) Majority within age range 24-40yrs

� Females=74.4%

� Unemployed=34%

� Educational level: 83% between grades 8-12

� Married/in relationship=66%

� Heterosexual=96.5%

RESULTS

Participants’ Exposure to DSM-IV qualifying traumatic events (%)

Natural Disaster=88.0

Fire/ Explosion =55.0

Transport Accident= 57.2

Accident:home/work/sports=63.4Physical Assault = 44.4

RESULTS cont.

Assaulted with weapon=49

Sexual Assault=73.5

Other unwanted/uncomfortable sexual experience=77.7

Exposure to trauma in war-zone (combat/civilian)=86.8

Captivity =82.3

RESULTS cont.

Life-Threatening illness/injury=39.9

Exposure to sudden/violent death (murder/suicide)=72.5

Sudden/unexpected death of someone close=34.2

Serious injury/harm/death you caused to someone=77.7 Other life threats=86.7

RESULTS cont.

� Trauma & PTSD: Only sexual assault & exposure to trauma in war zone were significantly associated with PTSD

� Exposure to sexual assault had 10 times greater odds PTSD diagnosis (OR=10.0)

� Exposure to trauma in war zone had 6.9 times greater odds of PTSD diagnosis(OR=6.9)

RESULTS cont.

Sex Differences

� Men had significantly higher rates of exposure to physical assault & assault with weapon

� Women had significantly higher rates of exposure to sexual assault

DISCUSSION

� Demographic characteristics (mean age/>f): in keeping with national figures (despite convenience sampling)

� f of traumatic events overall was consistently high (increases burden of disease in already under-resourced communities)

DISCUSSION

� Sexual assault & exposure in war zone places PLWHA at risk for PTSD diagnosis: once again highlights nature of trauma & mental health aspects of HIV/AIDS. Supports existing lit

� Sex/gender differences: f (sexual assault), m (physical assault & assault with weapon)

CONCLUSION

� Study highlights burden of disease in PLWHA

� Mental ill-health (historical/current trauma exposure) fuels cycle of violence

� Need to re-conceptualize HIV/AIDS health care/intervention models

� HIV/AIDS Research: B-P-S/P model

CONTACT DETAILS

� Pamela Naidoo

� pnaidoo@uwc.ac.za