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High Trauma Rates in PWH-MSM, Women, Drug Users
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Download the PDF here
Download the PDF here
Trauma-Informed HIV Care Interventions: Towards a Holistic Approach
PLWH are disproportionately affected by psychological, emotional, physical, and sexual trauma [1, 5] and tend to have higher prevalence estimates of trauma compared to the general population. For example, studies have shown that among US populations, up to 95% [9, 10] of people living with HIV report at least one traumatic stressor [11] and up to almost two-thirds (64%) have posttraumatic stress disorder (PTSD) [12]. The pooled prevalence of PTSD among PLWH found in this study heightened the high rate of comorbidity between HIV infection and PTSD, which is consistent with previous demonstrations.8 7
PTSD as a serious and costly health problem in the general population is well recognised, and impairs a person's physical health, and greatly influences social functioning.11
The illness experience of PTSD, such as persistent avoidance and re-experiencing the traumatic event, may also compromise quality of life and cause significant distress in PLWH.
"A study conducted with 104 WLH in a San Francisco clinic showed that 97.1% had experienced lifetime trauma (including adverse childhood experiences) and those with more lifetime trauma were more likely to report PTSD, depression, anxiety, and substance abuse, especially alcohol and drugs."
"men who have sex with (MSM) especially those living with HIV are disproportionately affected by trauma"......."The trauma emanates from a lifetime of living with HIV, especially in the early days of the epidemic when there was little hope for survival (i.e., prior to 1995/1996), which led to seemingly endless loss of those in one's social circle."
"African American WLH are disproportionately affected by interpersonal violence, substance abuse and adverse mental health outcomes, which is often associated with poor HIV care outcomes "
Social isolation and stigma might exacerbate symptoms of PTSD.81 In high-income countries, PLWH may experience 'compound' or 'layered' stigma, where stigmatising beliefs are associated with HIV infection and related to sexual orientation, commercial sexual behaviours, etc.
MSM living with HIV may experience higher levels of stigma and trauma related to their sexual orientation.
women living with HIV exhibited a higher prevalence of PTSD (35%) in comparison with both MSM (33%) and non-MSM male (20%) groups.
Compared with heterosexual counterparts, MSM reported higher risk for suicidal ideation,89 which also indicates greater psychological stress and mental health problems (ie, PTSD and depression). Given that these data are from a small number of studies and/or participants, this finding should be interpreted with caution. Nonetheless, given the high prevalence of PTSD in this group, future efforts should be made to obtain more prevalence data on PTSD among MSM living with HIV.
There are many factors which may explain the high levels of PTSD among PLWH such as early exposure to trauma, including childhood sexual abuse [13], and revictimization [14]. One factor which may also contribute to PTSD is the diagnosis of HIV [14]. Over one-third of individuals living with HIV among a South African population have stated that the worst traumatic event that they experienced was being diagnosed with HIV [15].
Stigma, racial discrimination, poor neighborhood, gender identity, social status, socio-economic status, family background.
Ageism perpetuates the invisibility of older adults and, in turn, renders current medical and social service systems unprepared to respond to patients' needs.
older people living with HIV are more likely to be members of racial, ethnic, and sexual minorities and that, as a result, many of them will have "navigated the realities of homophobia, sexism, racial/ethnic discrimination, and economic discrimination.
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