Global estimate of the prevalence of post-traumatic stress disorder among adults living with HIV: a systematic review and meta-analysis

Tang, Chulei; Goldsamt, Lloyd A.; Meng, Jingjing; Xiao, Xueling; Zhang, Li; Williams, Ann B.; Wang, Honghong

doi:10.1136/bmjopen-2019-032435

Cited by 42 publications

(43 citation statements)

References 86 publications

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“…Participants with a history of traumatic events were most likely to experience the negative impact of COVID-19 prevention measures and more likely to have comorbid disorders associated with an increased risk of severe COVID-19. Previous studies have illustrated greater prevalence of trauma among PWH 39 – 42 and have highlighted the far-reaching consequences of trauma on overall health. 43 , 44 Expanding training and capacity in trauma aware care for HIV care providers, especially through virtual platforms, may be a useful strategy for better health outcomes for affected individuals.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Burden and Risk Among People With HIV

Morgan

Martínez

Rodriguez

et al. 2021

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: This study evaluated COVID-19 risk and burden among people with HIV (PWH) in a US city with high rates of HIV and SARS-CoV-2 transmissions and examined the interrelationship between psychosocial factors and COVID-19 risk and burden. Setting: Participants were drawn from an existing consent to contact database of PWH. Database candidates were PWH, adults older than 18 years, people who had received HIV care at the University of Miami HIV clinics, people who spoke English or Spanish, and people who had agreed to be contacted for future research. Methods: An adapted version of the Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study COVID-19 survey was telephonically administered, requiring 15–30 minutes. Results: Psychological stress was a predictor of COVID-19 burden (financial and social burden) and COVID-19 risk (health factors associated with an increased risk of severe health outcomes due to infection with COVID-19). Having a history of traumatic events was associated with increased COVID-19 risk, and stress was associated with increased COVID-19 burden and COVID-19 risk. Conclusions: Overall, results suggest that the intersection of the HIV and COVID-19 pandemics may be most profound among those who have experienced traumatic events; and traumatic events may be associated with heightened vigilance regarding illness and infection.

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Section: Discussionmentioning

confidence: 99%

COVID-19 Burden and Risk Among People With HIV

Morgan

Martínez

Rodriguez

et al. 2021

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“… 1 Traumatic stress occurs in 9% to 27% of patients who experience an acute medical event. Medical PTS is most often explored among patients with cancers, 6 , 7 cardiovascular disease, 8 , 9 and HIV/AIDS, 10 , 11 with multiple studies showing persistent trauma symptoms. Because patients with severe inflammatory bowel disease (IBD) often have repeated emergency department visits and emergency surgeries and may utilize treatments with rare but serious adverse effects, it is possible that a proportion of these patients will develop PTS.…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic Stress in Patients With Inflammatory Bowel Disease: Prevalence and Relationships to Patient-Reported Outcomes

Taft

Quinton

Jedel

et al. 2021

Inflammatory Bowel Diseases

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Background Patients with chronic illness are at increased risk for traumatic stress because of medical trauma. Initial studies of posttraumatic stress (PTS) in patients with inflammatory bowel disease (IBD) have found that approximately one-third of patients may experience significant PTS symptoms including flashbacks, nightmares, hypervigilance, disrupted sleep, and low mood. We aim to better characterize PTS in IBD and its relationship with patient outcomes in a large cohort of patients with IBD. Methods Adult patients registered with the Crohn’s & Colitis Foundation/University of North Carolina IBD Partners database were invited to complete a supplementary survey between February and July 2020. The Post Traumatic Stress Disorder Checklist-5th edition was administered as a supplemental survey. Additional data from IBD Partners included disease severity, surgery and hospital history, demographics, and health care utilization. Results A total of 797 patients participated (452 with Crohn disease, 345 with ulcerative colitis). No impacts on response patterns because of the COVID-19 pandemic were found. Although 5.6% of the sample reported an existing PTS diagnosis because of IBD experiences, 9.6% of participants met the full IBD-related PTS diagnostic criteria per the Post Traumatic Stress Disorder Checklist-5th edition. Female patients, younger patients, those with less educational attainment, non-White patients, and Hispanic patients reported higher levels of PTS symptoms. Patients with higher PTS symptoms were more likely to have been hospitalized, have had surgery, have more severe symptoms, and not be in remission. Increased PTS was also associated with increased anxiety, depression, pain interference, fatigue, and health care utilization. Conclusions The present findings support prior research that approximately one-quarter to one-third of patients with IBD report significant symptoms of PTS directly from their disease experiences, and certain demographic groups are at higher risk. In addition, PTS is associated with several IBD outcomes. Patients with higher PTS symptoms are less likely to be in remission and may utilize more outpatient gastrointestinal services. Intervention trials to mitigate PTS symptoms in patients with IBD are warranted.

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“…The present meta-analysis of 12 studies found that there was elevated odds of ART non-adherence amongst HIV-infected participants with PTSD. Although the effect size for this association was small, from the perspective of public health, the result is still meaningful in making public health policy in terms of high prevalence (28%) of PTSD among PLWH worldwide ( 5 ). Moreover, there was a significant effect toward this association among younger participants and depression-unadjusted studies.…”

Section: Discussionmentioning

confidence: 92%

“…Compared with the general population, posttraumatic stress disorder (PTSD) is a commonly reported psychiatric disease among people living with HIV (PLWH) (1)(2)(3)(4). The estimated prevalence of PTSD in PLWH was 28% worldwide, and PTSD is a frequent encountered psychiatric comorbidity in HIV primary care setting (5). PLWH with PTSD symptoms may be tremendously affected by unaffordable public health cost, disabling psychological distress, worsened quality of life, and even increased odds of suicide (6,7).…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic Stress Disorder and Nonadherence to Treatment in People Living With HIV: A Systematic Review and Meta-analysis

Hou

Meng

et al. 2020

Front. Psychiatry

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Background: Posttraumatic stress disorder (PTSD) is a commonly reported and serious complication among people living with HIV (PLWH). PTSD may significantly increase unintentional non-adherence to antiretroviral therapy. In this systematic review and metaanalysis, we aimed to pool the observational studies exploring the association between PTSD and medication adherence among PLWH. Methods: Comprehensive searches were conducted in PubMed/Medline, Web of Science, PsycINFO, Google Scholar, and ProQuest to identify relevant articles and dissertations. A random effects meta-analysis with inverse variance weighting was used to summarize the odds ratio (OR) across studies. Meta-regression and subgroup analyses were also carried out to assess the moderation effects for potential factors. Results: By synthesizing 12 studies comprising 2489 participants, the pooled odd ratio of non-adherence to antiretroviral therapy was 1.19 (95% confidential interval (CI), 1.03-1.37, p = 0.02). No significant publication bias was detected by Egger's test (Intercept = 0.842, p = 0.284). Factors moderating the association were mean age of participants, depression adjustment, and depression (all p < 0.05). Conclusions: This meta-analysis supports that PTSD is related to adherence in PLWH. The hypothesized mechanisms (avoidant behavior and cognitive impairment) underlying this association need further investigation. Overall, this study highlights that clinicians should thoughtfully integrate timely mental health intervention into routine care.

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Global estimate of the prevalence of post-traumatic stress disorder among adults living with HIV: a systematic review and meta-analysis

Cited by 42 publications

References 86 publications

COVID-19 Burden and Risk Among People With HIV

COVID-19 Burden and Risk Among People With HIV

Posttraumatic Stress in Patients With Inflammatory Bowel Disease: Prevalence and Relationships to Patient-Reported Outcomes

Posttraumatic Stress Disorder and Nonadherence to Treatment in People Living With HIV: A Systematic Review and Meta-analysis

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