Stressful life events, PTSD symptoms and mental health in people living with HIV: Correlates of trauma in people with HIV.

BACKGROUND

People living with human immunodeficiency virus (HIV; PLWH) can perceive aspects of the disease as traumatic.

OBJECTIVES

1) This study examined the trauma profile and sociodemographic and clinical correlates of HIV-related trauma; 2) to compare the impact of a post-traumatic stress disorder (PTSD) on clinical variables and biological markers in PLWH with HIV-related trauma; 3) to investigate the factors associated with PTSD; 4) to examine the relationship between childhood maltreatment, dissociation, and psychopathology.

METHODS

93 Hospital del Mar Barcelona outpatient adults living with HIV with HIV-related trauma were included in this cross-sectional study. Participants were assessed with validated scales for PTSD, trauma, psychopathology, quality of life, functionality, and HIV-related stigma. CD4/CD8 ratio was also collected. PLWH with and without PTSD were compared in terms of clinical and sociodemographic factors and a pathway analysis was conducted.

RESULTS

PLWH with PTSD reported significantly more anxious, depressive, and general psychiatric symptoms, poorer health-related quality of life and more stigma related to HIV compared to those with trauma symptoms only (all p < 0.0024). Age (OR = 1.08, p = 0.045) and previous psychiatric disorder (OR = 15.57, p = 0.010) can predict a PTSD diagnosis. PLWH with PTSD showed stronger correlations between childhood maltreatment, dissociation, and psychiatric symptoms than those with trauma symptoms only.

CONCLUSIONS

PTSD is associated with more psychiatric symptoms, lower quality of life and increased HIV-related stigma. Dissociation and PTSD were identified as a potential mechanism linking childhood maltreatment and mental health outcomes, suggesting a target for intervention. These findings support the need for PTSD screening and trauma-focused treatments in HIV care settings.