There is a high prevalence of post-traumatic stress disorder (PTSD) in people living with HIV, according to the first comprehensive systematic review and meta-analysis from researchers at Central South University in China and New York University Rory Meyers College of Nursing, on the topic.
PTSD occurs when a person has experienced a traumatic event and is unable to process the shock properly. Such events could include a serious injury, illness, or accident; being abused or sexually assaulted; multiple bereavements; being rejected because of stigma or prejudice; war, political violence or forced migration.
PTSD can cause flashbacks, nightmares, a powerful sense of dread, nervousness and an avoidance of reminders of the event. Memories of the event can also be affected and people often say they have difficulty concentrating as they are easily distracted by worries.
Most of the 38 studies were from the US (21 studies) or sub-Saharan Africa (11 studies). Most were small (two-thirds had fewer than 300 participants and only three had more than 1000).
Across the 38 studies, the average prevalence of PTSD was 28%.
Abstract
Objectives: Although people living with HIV (PLWH) have been disproportionately affected by post-traumatic stress disorder (PTSD), the global prevalence of PTSD among PLWH is unknown. This study aimed to systematically review the prevalence of PTSD among PLWH worldwide and explore variation in prevalence across sociodemographic and methodological factors.
Design: A meta-analysis using a random-effects model was conducted to pool the prevalence estimated from individual studies, and subgroup analyses were used to analyse heterogeneities.
Setting, participants and measures: Observational studies providing PTSD prevalence data in an adult HIV population were searched from January 2000 to November 2019. Measurements were not restricted, although the definition of PTSD had to align with the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases diagnostic criteria.
Results: A total of 38 articles were included among 2406 records identified initially. The estimated global prevalence of PTSD in PLWH was 28% (95% CI 24% to 33%). Significant heterogeneity was detected in the proportion of PLWH who reported PTSD across studies, which was partially explained by geographic area, population group, measurement and sampling method (p<0.05).
Conclusion: PTSD among PLWH is common worldwide. This review highlights that PTSD should be routinely screened for and that more effective prevention strategies and treatment packages targeting PTSD are needed in PLWH.
Authors
Chulei Tang, Lloyd Goldsamt, Jingjing Meng, Xueling Xiao, Li Zhang, Ann Bartley Williams, Honghong Wang
[link url="http://www.aidsmap.com/news/may-2020/quarter-people-hiv-may-have-post-traumatic-stress-disorder"]Aidsmap report[/link]
[link url="https://bmjopen.bmj.com/content/10/4/e032435"]BJM Open abstract[/link]