272385 Prevalence and predictors of PTSD in a large cohort of women with and at risk for HIV

Monday, October 29, 2012 : 1:30 PM - 1:45 PM

Kathleen Weber, RN , Departments of Medicine/CORE Center at John H. Stroger Jr Hospital of Cook County, Cook County Health & Hospital System, Chicago, IL
Jane Burke-Miller, PhD , CORE Center, Women's Interagency HIV Study, Chicago, IL
Pauline Maki, PhD , Department of Psychiatry, University of Illinois at Chicago, Chicago, IL
Rebecca Schwartz, PhD , SUNY Downstate, Brooklyn, NY
Kathryn Anastos, MD , Medicine, Montefiore Medical Center, Bronx, NY
Joel Milam, PhD , University of Southern California Los Angeles, Los Angeles, CA
Mary Young, MD , Medical Center, Georgetown University, Washington, DC
Susan Meffert, MD, MPH , Department of Psychiatry, University California at San Francisco, San Francisco, CA
Amber D'Souza, PhD , School of Public Health Department of Epidemiology, Johns Hopkins University, Baltimore, MD
Mardge H. Cohen, MD , Women's Equity in Access to Care and Treatment, Boston, MA
     
Background: PTSD prevalence is 5.2% among U.S. women. Women living with or at risk for HIV have high rates of traumatic life events or stressors, including exposure to physical and sexual violence. Trauma and PTSD are associated with health risk behaviors, depression, somatic symptoms, HIV disease progression, and mortality. Methods: We administered the civilian post-traumatic stress disorder (PTSD) checklist (PCL-C) in the Women's Interagency HIV Study, a large cohort of U.S. women with or at risk for HIV, to determine the probable prevalence and predictors of PTSD. Results: Among 1,725 (1221 HIV+ and 504 HIV-), 11% endorsed the number and severity of symptoms by cluster (re-experiencing, avoidance, hyperarousal) consistent with a PTSD diagnosis, with no statistical difference by HIV serostatus. In a multivariable logistic regression, PTSD was significantly associated with depression, high perceived stress, poor health related quality of life, and unemployment. Among HIV+ women, PTSD was associated with depression, high perceived stress, and presence of HIV-related symptoms. Among at risk uninfected women, PTSD was significantly associated with depression, high perceived stress, unemployment, recent hospitalization, and history of injection drug use. Conclusion: The prevalence of PTSD symptom burden consistent with a diagnosis in women with and at risk for HIV is twice that of the general population and co-occurs with depression, psychosocial stress, and poor physical health. Assessing symptom number and severity by DSM clusters, the PCL-C can be used to screen HIV infected or at risk women for PTSD in clinical and research settings, thereby informing clinical treatment

Learning Areas:
Epidemiology
Public health or related research
Social and behavioral sciences

Learning Objectives:
• Evaluate the use of a civilian PTSD screening tool among women with or at risk for HIV in the U.S. • Discuss the implications of PTSD symptoms and probable diagnosis in the treatment of women with HIV/AIDS.

Keywords: HIV/AIDS, Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been Project Director of the Chicago Women's Interagency HIV Study for over 15 years. I am a published author in peer-reviewed journals and have made numerous presentations on HIV and women.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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