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Psychological Trauma and PTSD in HIV-Positive Women: A Meta-Analysis

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Abstract

Women bear an increasing burden of the HIV epidemic and face high rates of morbidity and mortality. Trauma has been increasingly associated with the high prevalence and poor outcomes of HIV in this population. This meta-analysis estimates rates of psychological trauma and posttraumatic stress disorder (PTSD) in HIV-positive women from the United States. We reviewed 9,552 articles, of which 29 met our inclusion criteria, resulting in a sample of 5,930 individuals. The findings demonstrate highly disproportionate rates of trauma exposure and recent PTSD in HIV-positive women compared to the general population of women. For example, the estimated rate of recent PTSD among HIV-positive women is 30.0% (95% CI 18.8–42.7%), which is over five-times the rate of recent PTSD reported in a national sample of women. The estimated rate of intimate partner violence is 55.3% (95% CI 36.1–73.8%), which is more than twice the national rate. Studies of trauma-prevention and trauma-recovery interventions in this population are greatly needed.

Resumen

Las mujeres enfrentan un incremento en la epidemia de VIH y altos índices de morbilidad y mortalidad. El trauma psicológico ha sido cada vez más asociado con la alta prevalencia y los resultados pobres de VIH en esta población. El presente metaanálisis estima la tasa de trauma y Trastorno por Estrés Postraumático (TPEP) en mujeres estadounidenses. Fueron revisados 9,552 artículos de los cuales 29 cumplieron los criterios, resultando en una muestra total de 5,930 individuos. Los resultados demuestran una tasa desproporcionalmente alta de exposición a trauma y reciente TPEP en mujeres VIH positivas en comparación con la población general de mujeres estadounidenses. La tasa estimada de reciente TPEP entre mujeres VIH positivas es 30.0% (95% IC 18.8–42.7%), lo cual es cinco veces la tasa de reciente TPEP reportada en una muestra nacional de mujeres. La tasa estimada de violencia del compañero íntimo (VCI) es 55.3% (95% IC 36.1–73.8%), lo cual es más del doble de la tasa nacional. Estudios de prevención de trauma e intervenciones de recuperación de trauma en esta población son enormemente necesitados.

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Acknowledgements

The authors extend special thanks to the following colleagues who contributed meaningfully to this manuscript: Alan Bostrom, Ph.D., Jennifer Cocohoba, Pharm.D, Susannah Empson, Tulia Gonzales-Flores, Starr Hilliard, Michael Kohn, MD, Vanessa Pascoe, and Gloria Won.

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Authors and Affiliations

  1. Department of Medicine, University of California, San Francisco, 400 Parnassus Avenue, Box 0320, San Francisco, CA, 94143, USA

    E. L. Machtinger & T. C. Wilson

  2. Department of Medicine, Massachusetts General Hospital and Center for Global Health, Boston, MA, USA

    J. E. Haberer

  3. Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA

    D. S. Weiss

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  1. E. L. Machtinger
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  2. T. C. Wilson
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Correspondence to E. L. Machtinger.

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E. L. Machtinger and T. C. Wilson—Co-principal authors.

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Machtinger, E.L., Wilson, T.C., Haberer, J.E. et al. Psychological Trauma and PTSD in HIV-Positive Women: A Meta-Analysis. AIDS Behav 16, 2091–2100 (2012). https://doi.org/10.1007/s10461-011-0127-4

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