02 Pamela Naidoo Ptsd & Hiv Sahara 09

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02 Pamela Naidoo Ptsd & Hiv Sahara 09

  1. 1. 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
  2. 2. 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
  3. 3. 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)
  4. 4. 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
  5. 5. 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
  6. 6. 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
  7. 7. 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 -)
  8. 8. 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%
  9. 9. 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=63.4 Physical Assault = 44.4
  10. 10. 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
  11. 11. 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
  12. 12. 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)
  13. 13. 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
  14. 14. 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)
  15. 15. 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)
  16. 16. 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
  17. 17. CONTACT DETAILS Pamela Naidoo pnaidoo@uwc.ac.za

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