HIV-related-post-traumatic stress disorder : psychological distress among a sample of individuals recently diagnosed with HIV
Thesis (MA (Psychology))--University of Stellenbosch, 2008.
Few studies have assessed the prevalence of Post-Traumatic Stress Disorder (PTSD) associated with the receipt of an HIV-positive diagnosis and no published studies in South Africa have used a structured clinical interview to assess the above-mentioned. The present cross-sectional study assessed the prevalence of HIV-related PTSD among a sample of recently diagnosed patients attending public health clinics in the Boland region of the Western Cape. The PTSD module of the Composite International Diagnostic Interview (CIDI), together with a battery of self-report instruments assessing symptoms of traumatisation, depression and anxiety were administered to 85 patients who had been diagnosed with HIV in the year preceding data collection. In addition, HIVrelated PTSD and symptomatology were assessed using an adapted version of the PTSD module of the CIDI. The self-report instruments administered were (a) a demographic questionnaire, (b) the Posttraumatic Stress Diagnostic Scale (PDS) which assessed current PTSD symptom severity, and (c) the 25-item Hopkins Symptom Checklist (HSCL-25) which assessed psychological distress, and symptoms and intensity of anxiety and depression. The primary aim of the present study was to determine the prevalence of HIV-related PTSD among a sample of recently diagnosed HIV-positive individuals attending HIV clinics in the Boland region. The second aim was to determine the lifetime prevalence of PTSD among the sample. The third aim was to determine the percentage of the sample that endorsed the DSM-IV’s PTSD A2 criterion and the subsequent HIV-related PTSD symptomatology among those who did and did not meet full criteria for HIV-related PTSD. The fourth aim was to determine the level of psychological distress reported by the sample. The prevalence of lifetime PTSD was 29.4% (95% confidence interval [CI], 20.7% - 39.8%). Sixty-nine of the eighty-five participants (81.2%) endorsed the DSM-IV’s PTSD A2 criterion. Of the total sample, 34 participants (40%) (95% CI, 30.2% - 50.6%) met the full criteria for HIV related PTSD. The majority of participants reported mild PTSD symptom severity (45.8%). Over half the sample (51.4%) experienced clinically significant distress. Of those participants diagnosed with HIV-related PTSD, 82.4% were clinically distressed, and 76.5% and 58.8% experienced high levels of depression and anxiety, respectively. The present study’s findings suggest that receiving an HIV-positive diagnosis and/or being HIVpositive may be considered a traumatic stressor that frequently results in HIV-related PTSD. Findings of the present study indicate the need for adequate support and care for HIV-positive individuals. Given the various barriers to efficient mental health interventions and services in South Africa, there are significant challenges that need to be addressed in order to ensure that the mental health and welfare of HIV-positive individuals are both adequately assessed and appropriately maintained.