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The Prevalence of Post-Traumatic Stress Disorder among People Living with HIV/AIDS: a Systematic Review and Meta-Analysis

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Abstract

Numerous studies have reported that the prevalence estimates of post-traumatic stress disorder (PTSD) might be substantially high among people with HIV/AIDS (PLWHA) when compared to the general population. However, there are no previous systematic reviews and meta-analysis studies that reported the pooled prevalence of PTSD among PLWHA. To fill this gap in research, this study aims to analyze data from observational studies concerning the prevalence of PTSD among PLWHA and formulate a recommendation for future research and clinical practice. Three electronic databases (PubMed, EMBASE, and SCOPUS) were searched to identify relevant studies that reported the prevalence of PTSD among PLWHA. A comprehensive meta-analysis software was used to conduct the meta-analysis. Subgroup and sensitivity analysis was conducted the I2 test was utilized to evaluate heterogeneity. Publication bias was assessed by using Egger’s test and visual inspection of the symmetry in funnel plots. Nineteen-studies with 9094 participants were included in this systematic review and meta-analysis. The pooled prevalence estimate of PTSD among PLWHA was found to be 32.67% (95% CI; 25.29–41.01). The prevalence of PTSD was 25.17% (95% CI; 19.72–31.55) for studies that used diagnostic instrument to assess PTSD and it was 34.68% (95% CI; 25.42–45.26) for studies that used screening instruments. Furthermore, the prevalence of PTSD among PLWHA was comparable between high-income (31.19%) and low, and middle-income countries (34.87%). We also found that the pooled prevalence of PTSD was remarkably higher for moderate and low-quality studies (42.64%) than for high-quality studies (24.84%). The prevalence of PTSD among PLWHA in the current study showed a significant variation by the location of the studies, the instruments used to measure PTSD as well as the quality of the included studies. The present review demonstrated that the prevalence estimates of PTSD among PLWHA (32.67%) was notably high and requires clinical attention. The estimated prevalence of PTSD was found to be comparable between high income and low, and middle-income countries. In addition, we found that the prevalence of PTSD was notably lower when measured by the diagnostic instrument than the screening instrument, although the variation was not statistically significant. Early screening and treatment of PTSD among PLWHA is needed to alleviate suffering.

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Data Availability

All data generated or analysed during this study are included in this article.

Abbreviations

PTSD:

Post-traumatic stress disorder

PRISMA:

Preferred reporting items for systematic reviews and meta-analyses

DSM-IV:

Diagnostic and statistical manual of mental disorders, 4th edition

SPSS:

Statistical package for the social sciences

CI:

Confidence interval

PCL-C:

PTSD checklist-civilian version

HTQ:

Harvard trauma questionnaire

IES-R:

Impact of Event Scale-Revised

PC PTSD:

Primary Care post-traumatic stress disorder symptoms scale

PTDS:

The Post-Traumatic Diagnostic Scale

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Authors and Affiliations

  1. School of Public Health, Curtin University, Kent Street, Bentley, Perth, Western Australia, 6102, Australia

    Getinet Ayano & Bereket Duko

  2. Research and Training Department, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

    Getinet Ayano

  3. Faculty of Health Sciences, College of Medicine and Health Sciences, Hawassa University, Awasa, Ethiopia

    Bereket Duko & Asres Bedaso

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  1. Getinet Ayano
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  3. Asres Bedaso
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The author (GA) conceptualize the study, conducted the analyses and drafts and approval of the final manuscript. AB performed a search, data extraction, analyses and approved the final manuscript. BD participated in discussion and consensus and approved the final manuscript.

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Correspondence to Getinet Ayano.

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Ayano, G., Duko, B. & Bedaso, A. The Prevalence of Post-Traumatic Stress Disorder among People Living with HIV/AIDS: a Systematic Review and Meta-Analysis. Psychiatr Q 91, 1317–1332 (2020). https://doi.org/10.1007/s11126-020-09849-9

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