Future Directions for Interventions Targeting PTSD in HIV-infected Adults

Abstract

Although studies consistently report high rates of comorbid Post Traumatic Stress Disorder (PTSD) and HIV infection, development and testing of PTSD treatment interventions in HIV-infected adults is limited. As such, the purpose of this review was twofold. First, this review augments the 3 existing reviews of research for PTSD in HIV-infected adults conducted within the past 10 years. We found 2 empirically supported cognitive-behavioral therapy (CBT)-based interventions for the treatment of trauma-related symptoms in HIV-infected adults. Due to the continued limited number of effective interventions for this population, a second aim of our review was to draw from the expansive field of effective PTSD interventions for the general population to propose ways that future clinical intervention research may be tailored for HIV-infected adults. Therefore, in addition to a review, we conceptualized this paper as an opportunity to generate an ideal preview of the field of intervention research in this population.

Post-traumatic Stress Disorder Symptoms Among People Living with HIV/AIDS in Rural China

“…In 2015, there were approximately 36.9 million PLHA worldwide (2). Although the prevalence of PTSD among PLHA varies across studies, ranging from 10% to 74% (3–8), these numbers are all much higher than those reported for the general population (1,9,10). Moreover, a significant number of PLHA, although do not meet the diagnostic standard for PTSD, demonstrated symptoms associated with PTSD (11).…”

“…In addition, PLHA are more likely than other individuals to experience other traumatic events, such as physical violence and sexual assault, which place them at risk of developing PTSD (3,16). Moreover, the presence of mental health problems such as PTSD symptoms may lead to the faster progression of HIV infection, worse physical problems, social phobia, and poor adherence to medication (1,11,17–20).…”

“…Previous HIV-related PTSD studies were mostly conducted among certain populations (e.g. MSM and heterosexual women) in western countries and Africa (3–7). These studies have limited ability to generalize the findings to PLHA in rural China, where a sizable proportion of HIV-positive individuals were infected with HIV via infusion of contaminated blood products during paid plasma donation in 1990s (26), and where the social-economic status and the access to healthcare resources are relatively low.…”

Impact of Sexual Trauma on HIV Care Engagement: Perspectives of Female Patients with Trauma Histories in Cape Town, South Africa

“…Effective evidence-based approaches for treating trauma are primarily cognitive-behavioral in nature and include psychoeducation, exposure techniques, cognitive processing therapy (CPT), and management of anxiety and stress through coping skills training (48-50). Very few rigorous intervention studies have provided targeted trauma treatment for HIV-infected women (51). Effective interventions have reduced traumatic stress symptoms (27, 52, 53), sexual risk behaviors (54, 55), and substance use (56), but none have thus far identified impacts on HIV care engagement.…”

A Review of Recent Literature on Trauma Among Individuals Living with HIV

“…PLWH: multidimensional cognitive behavioral therapy (CBT) approaches, prolonged exposure treatment, CBT for substance abuse, cognitive processing therapy, written emotional disclosure, and cognitive behavioral stress management [59]. …”