Brown L Lauren, Acuña Almariana J, Osman Amna, Williamson Lloyda B, Audet Carolyn M, Wilkins Megan L, Sales Jessica M, Hill Samantha V, Foster Jill, Pettit April C, Pichon Latrice C
School of Medicine, Meharry Medical College, Nashville, Tennessee, USA.
Nashville CARES, Nashville, Tennessee, USA.
Health Equity. 2025 Feb 25;9(1):131-141. doi: 10.1089/heq.2023.0251. eCollection 2025.
Compared with the general public, people with HIV (PWH) experience more psychological trauma and higher rates of post-traumatic stress disorder (PTSD), yet limited research explores how PWH may uniquely experience trauma. The primary goal of this study was to investigate trauma exposure typologies and sequelae among PWH to inform trauma screening and interventions.
Qualitative interviews were conducted with a convenience sample of 20 PWH with PTSD, receiving services from an urban, Tennessee-based HIV Service Organization. Interview guides were conducted to gain a rich understanding of exposure types from the Life Events Checklist-5 (LEC-5), explore potential social determinants of trauma, and uncover effects of chronic trauma or traumata. Thematic content analysis was used to examine typologies and effects.
Exposure typologies appeared as social determinants of trauma, including molestation as the most common followed by racial trauma, community violence, incarceration, addiction, interpersonal violence, poverty cycles, and stigma. Standard PTSD symptoms were reported in addition to emerging effects of complexity, synergism, and resilience. Complex effects spanned socioecological contexts and included sequelae of affective dysregulation, negative self-concept/self-organization, and disturbances in relationships.
Many typologies were not well accounted for in the LEC-5, underscoring the potential to miss exposure types and thus treatment indication. Similarly, effects expanded beyond standard PTSD symptoms, suggesting that nuanced treatment needs may also be overlooked. Findings are consistent with literature indicating the need for updated trauma screening and assessment measures to most comprehensively and accurately direct treatment needs.
与普通公众相比，感染艾滋病毒的人（PWH）经历更多的心理创伤，创伤后应激障碍（PTSD）发生率更高，但探索PWH如何独特地经历创伤的研究有限。本研究的主要目标是调查PWH中的创伤暴露类型和后遗症，以为创伤筛查和干预提供信息。
对20名患有创伤后应激障碍的PWH进行了定性访谈，这些患者来自田纳西州一个城市的艾滋病毒服务组织。通过访谈指南深入了解《生活事件清单-5》（LEC-5）中的暴露类型，探索创伤的潜在社会决定因素，并揭示慢性创伤或多种创伤的影响。采用主题内容分析法来检查类型和影响。
暴露类型表现为创伤的社会决定因素，包括骚扰是最常见的，其次是种族创伤、社区暴力、监禁、成瘾、人际暴力、贫困循环和耻辱感。除了复杂性、协同作用和恢复力的新出现影响外，还报告了标准的创伤后应激障碍症状。复杂影响跨越社会生态背景，包括情感失调、消极自我概念/自我组织以及人际关系紊乱的后遗症。
LEC-5没有很好地涵盖许多类型，这突出了可能遗漏暴露类型从而错过治疗指征的可能性。同样，影响超出了标准的创伤后应激障碍症状，表明细微的治疗需求也可能被忽视。研究结果与文献一致，表明需要更新创伤筛查和评估措施，以最全面、准确地指导治疗需求。
