Prevalence of probable post-traumatic stress disorder and experiences of trauma in emerging adults living with HIV in Zimbabwe.

BACKGROUND

Little is known about the prevalence of post-traumatic stress disorder (PTSD) in emerging adults living with HIV in low-income countries.

AIMS

Determine prevalence of trauma exposure, prevalence of probable PTSD and conditional prevalence of probable PTSD for different traumatic events; and better understand the experiences of individuals with HIV and PTSD.

METHOD

This mixed method study used secondary data from a cross-sectional survey of people ( = 222) aged 18 to 29 living with HIV in Zimbabwe and primary qualitative data collection. The PTSD Checklist for DSM-5 (PCL-5) and the Life Events Checklist for DSM-5 (LEC-5) were used to measure PTSD and exposure to traumatic events, both translated to Shona. In-depth interviews ( = 8) with participants who met the criteria for probable PTSD were analysed using thematic analysis.

RESULTS

In all, 68.3% [95% CI (61.4-74.1)] of participants reported exposure to at least one traumatic event. The observed prevalence of probable PTSD was 8.6% [95% CI (5.2-13.0)], most observed following exposure to fire or explosion 29.0% [95% CI (13.0-45.0)] and sexual assault 27.8% [95% CI (7.2-48.7)]. Probable PTSD was also more prevalent following multiple exposure to trauma; four and six events, = 4 (21%) [95% CI (5.1-8.8)] each, two and three events = 3 (15.7%) [95% CI (5.9-9.2)] each, and five events = 1 (5.4%) [95% CI (7.5-9.6)]. Qualitative results indicated that HIV stigma exacerbated psychological distress from trauma.

CONCLUSIONS

Despite trauma exposure being common, prevalence of probable PTSD was not high, but was higher in those with multiple exposures. Participants described coping strategies, including social support and religious thinking.