Post-traumatic stress disorder symptomatology and alcohol use among HIV-seropositive adults in Haiti

Abstract

Psychological trauma resulting from natural disasters can negatively affect the health of persons living with HIV/AIDS (PLWH). This study examined relationships of alcohol use and exposure to the 2010 Haiti earthquake on symptoms of post-traumatic stress disorder (PTSD) among HIV-positive adults enrolled in an intervention study. Baseline data was collected from male and female PLWH, 19–56 years old on: alcohol consumption and related harms; anxiety; and coping strategies used to deal with HIV. Two to three months post-earthquake, data was collected from 104 of the study participants on PTSD and earthquake-related impacts. Most participants had less than secondary education (66%) and very low income (92% ≤ H$10,000 or ≤ US$1,250/year). Over two-thirds of participants felt at some point that they should cut down on drinking. Fifty two (50.5 %) met criteria for PTSD. More than 83% lost their belongings and 64% had someone close to them hurt or killed during the earthquake. Bivariate analysis showed that women, younger participants, those who lost all belongings, and those with greater overall alcohol impact were more likely to report PTSD symptoms. In the multivariate model, participants more likely to meet PTSD criteria (p<0.05) were those who reported feeling a need to cut down on drinking (OR=3.14, [CI=1.16, 8.49]) and participants who used behavioral disengagement as a coping mechanism (OR=1.49, [CI=1.15, 1.92]). Following a natural disaster, it is important to address trauma-related mental health needs of PLWH—particularly women and individuals who abuse alcohol.

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

“…In addition, the study demonstrated that participants with older age or higher family income had relatively lower level of PTSD symptoms as mediated by social functioning. This finding indicates that such individuals may have stronger social connections and better abilities to handle and recover from traumatic life events (45,46). …”

Mental health impact of the 2010 Haiti earthquake on the Miami Haitian population: A random-sample survey

“…These instruments have not been validated in Haitian populations or any Creole-speaking community, although PCL-C and CES-D have already been used in adult Haitians. 5,6,64 For example, because Haiti has few mental health services, and mental illness is stigmatized, psychological symptoms are likely to be underre-ported by participants. Likewise, the central role of religion within all spheres of life in the Haitian culture, including health, emotional, and psychological problems, 1,11,12,53 might diminish the likelihood that respondents would speak openly about their psychological pain with a lay interviewer who is grounded on a western, academic approach to mental health matters.…”

“…Still, self-selection of respondents cannot be excluded; for example, the over-representation of women in our study might have yielded higher rates of symptoms of PTSD, generalized anxiety, and depression, because women (Haitian and non-Haitian) tend to report higher levels of these symptoms than men. 5,6,9,14,31,41 Likewise, we cannot exclude selection bias introduced by non-responding households: 36% declined to participate and 10% were unreachable. Both rates of non-participation are in the low end of the range of recent health surveys, and empirical evidence has shown that response rate is a weak predictor of non-response bias.…”

Determinants of HIV Serostatus Disclosure to Sexual Partner Among HIV-Positive Alcohol Users in Haiti

“…Prior to the earthquake, Haiti had the highest rate of PLWH in the Caribbean with an estimated 120,000 PLWH (9). A number of researchers have begun to document the immediate structural and psychological effect of the earthquake on Haitians living with HIV/AIDS, including on substance use, access and adherence to treatment, however the long term effects of the earthquake on the country’s HIV/AIDS trajectory may not be fully understood for many years (10–14). …”