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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
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=63.4
    Physical 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

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02 Pamela Naidoo Ptsd & Hiv Sahara 09

  • 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. CONTACT DETAILS Pamela Naidoo pnaidoo@uwc.ac.za