Center for Health Policy & Inequalities Research, Duke Global Health Institute, Department of Community and Family Medicine, Duke University, Durham, North Carolina, United States of America.
PLoS One. 2012;7(5):e36304. doi: 10.1371/journal.pone.0036304. Epub 2012 May 14.
In high income nations, traumatic life experiences such as childhood sexual abuse are much more common in people living with HIV/AIDS (PLWHA) than the general population, and trauma is associated with worse current health and functioning. Virtually no data exist on the prevalence or consequences of trauma for PLWHA in low income nations.
METHODOLOGY/PRINCIPAL FINDINGS: We recruited four cohorts of Tanzanian patients in established medical care for HIV infection (n = 228), individuals newly testing positive for HIV (n = 267), individuals testing negative for HIV at the same sites (n = 182), and a random sample of community-dwelling adults (n = 249). We assessed lifetime prevalence of traumatic experiences, recent stressful life events, and current mental health and health-related physical functioning. Those with established HIV infection reported a greater number of childhood and lifetime traumatic experiences (2.1 and 3.0 respectively) than the community cohort (1.8 and 2.3). Those with established HIV infection reported greater post-traumatic stress disorder (PTSD) symptomatology and worse current health-related physical functioning. Each additional lifetime traumatic experience was associated with increased PTSD symptomatology and worse functioning.
CONCLUSIONS/SIGNIFICANCE: This study is the first to our knowledge in an HIV population from a low income nation to report the prevalence of a range of potentially traumatic life experiences compared to a matched community sample and to show that trauma history is associated with poorer health-related physical functioning. Our findings underscore the importance of considering psychosocial characteristics when planning to meet the health needs of PLWHA in low income countries.
在高收入国家，与普通人群相比，艾滋病毒/艾滋病（PLWHA）患者中更常见到童年期性虐待等创伤性生活经历，而创伤与当前健康和功能更差有关。在低收入国家，几乎没有关于 PLWHA 创伤的流行率或后果的数据。
方法/主要发现：我们招募了四个在既定的艾滋病毒感染医疗中接受治疗的坦桑尼亚患者队列（n=228）、新检测出艾滋病毒阳性的个体（n=267）、同一地点检测出艾滋病毒阴性的个体（n=182）和一个随机抽取的社区成年人群体（n=249）。我们评估了终生创伤经历、近期生活应激事件以及当前心理健康和与健康相关的身体功能。那些已确诊 HIV 感染的患者报告了更多的童年和终生创伤经历（分别为 2.1 和 3.0），而社区队列报告的创伤经历则较少（分别为 1.8 和 2.3）。那些已确诊 HIV 感染的患者报告了更多的创伤后应激障碍（PTSD）症状和更差的当前与健康相关的身体功能。每增加一次终生创伤经历，就会增加 PTSD 症状和更差的功能。
结论/意义：本研究是我们首次在来自低收入国家的 HIV 人群中进行的研究，与匹配的社区样本相比，报告了一系列潜在创伤性生活经历的流行率，并表明创伤史与较差的与健康相关的身体功能有关。我们的研究结果强调了在规划满足低收入国家 PLWHA 的健康需求时，考虑心理社会特征的重要性。
