02 Pamela Naidoo Ptsd & Hiv Sahara 09
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Transcript of 02 Pamela Naidoo Ptsd & Hiv Sahara 09
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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
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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
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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)
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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
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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
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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
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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 -)
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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%
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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
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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
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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
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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)
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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
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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)
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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)
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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