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Psychological Trauma and PTSD
in HIV-Positive Women: A Meta-Analysis
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Download the PDF here
Download the PDF here
Using meta-analytic technique to estimate rates of exposure to traumatic events and recent PTSD in HIV-positive women, we observed, Very high rates of all categories of trauma exposure and PTSD.
Conclusion
Effectively addressing trauma and PTSD may be an opportunity to make a transformational impact on the HIV epidemic. Given the high rates and known consequences of trauma and PTSD in HIV-positive women, screening and referrals for recent and past trauma and PTSD should be considered a core component of HIV treatment in this population, along with medication adherence, CD4 counts, and viral loads. Additional studies of trauma-prevention and trauma-recovery interventions in HIV-positive and at-risk women are greatly needed.
Abstract
Women bear an increasing burden of the HIV epidemic and face high rates of morbidity and mortality. Trauma has been increasingly associated with the high prevalence and poor outcomes of HIV in this population. This meta-analysis estimates rates of psychological trauma and posttraumatic stress disorder (PTSD) in HIV-positive women from the United States. We reviewed 9,552 articles, of which 29 met our inclusion criteria, resulting in a sample of 5,930 individuals.
The findings demonstrate highly disproportionate rates of trauma exposure and recent PTSD in HIV-positive women compared to the general population of women.
For example, the estimated rate of recent PTSD among HIV-positive women is 30.0% (95% CI 18.8-42.7%), which is over five-times the rate of recent PTSD reported in a national sample of women.
The estimated rate of intimate partner violence is 55.3% (95% CI 36.1-73.8%), which is more than twice the national rate. Studies of trauma-prevention and trauma-recovery interventions in this population are greatly needed.
We utilized categories of trauma exposure and PTSD that most specifically captured the categories used by the included studies. For trauma exposure, two variables were used for categorization. The first was stage of life at which trauma exposure occurred: (a) childhood, (b) adulthood, and (c) unspecified. The second variable was type of trauma exposure. Combining the first and second variables resulted in 10 categories: IPV, childhood sexual abuse (CSA), childhood physical abuse (CPA), childhood abuse (unspecified), adult sexual abuse, adult physical abuse, adult abuse (unspecified), lifetime sexual abuse, lifetime physical abuse, lifetime abuse (unspecified).
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