Abstract
Background
One of the most distressing concerns of many people living with HIV in sub-Saharan Africa is the stigma. Intense stigma may be traumatic. This study aimed to investigate the probability and correlates of Posttraumatic stress disorder (PTSD) following intense stigmatizing events and situations in HIV infected individuals in Nigeria.
Methods
Adult sero-positive attendees of an HIV care centre (N = 190) completed questionnaires regarding sociodemographic and clinical details; the 12-item General Health Questionnaire (GHQ-12) and the Rosenberg’s Self-Esteem Scale. The clients were then interviewed for the presence of stigma related PTSD with a modified version of the mini international neuropsychiatry interview (MINI).
Results
About 2/3 of the participants had experienced at least an intense HIV-related stigmatizing event or situation. The rate of HIV-stigma related PTSD was 27.4%. Independent predictors of HIV stigma-related PTSD included past history of traumatic events (Single event, OR 2.28, 95% CI 1.08–4.73; Multiple events, OR 9.47, 95% CI 2.97–32.20), low self esteem (OR 6.52, 95% CI 2.59–16.55), poor level of social support (OR 3.33, 95% CI 1.24–9.79) and presence of general psychopathology (OR 2.18, 95% CI 1.07–4.44).
Conclusion
PTSD may not be specific to traumatic events alone. There is a possibility of PTSD after an intense stigmatizing event or situation. While the validity for the validity of HIV-stigma related PTSD warrants further investigation, stigma needs to be considered when planning rehabilitation strategies for HIV infected individuals in sub-Saharan Africa. A closer attention to self esteem, level of social support and presence of psychopathology is needed in these individuals.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC
Ben-Ezra M, Aluf D (2006) Traumatic events versus life events: does it really matter? Br J Psychiatry 188:83–84
Botha KF (1996) Posttraumatic stress disorder and illness behaviour in HIV+ patients. Psychol Rep 79:843–845
Cordova MJ, Studts JL, Hann M, Jacobsen PB, Andrykowski MA (2000) Symptom structure of post-traumatic stress disorder following breast cancer. J Trauma Stress 13:301–319
Goldberg DP, Hillier VF (1979) A scaled version of the general health questionnaire. Psychol Med 9:139–145
Gureje O (1991) Reliability and the factor structure of the Yoruba version of the 12-item general health questionnaire. Acta Psychiatr Scand 84:125–129
Herek GM, Capitalo JP, Widaman KF (2002) HIV-related stigma and knowledge in the US: prevalence and trends 1991–1999. Am J Public Health 92:371–377
Katz S, Nevid JS (2005) Risk factors associated with posttraumatic stress disorder symptomatology in HIV-infected women. AIDS Patient Care STDS 19:110–120
Kelly B, Raphael B, Judd F et al (1998) Posttraumatic stress disorder in response to HIV infection. Gen Hosp Psychiatry 20:345–352
Koopman C, Gore-Felton C, Azimi N et al (2002) Acute stress reactions to recent life events among women and men living with HIV/AIDS. Int J Psychiatry Med 32:361–378
Martinez A, Israelski D, Walker C, Koopman C (2002) Posttraumatic stress disorder in women attending human immunodeficiency virus outpatient clinics. AIDS Patient Care STDS 16:283–291
Mol SS, Amtz A, Metsemekers JF, Dinent GJ, Vitter-van Montfort PA, Knottnems JA (2005) Symptoms of post-traumatic stress disorder after non-traumatic events: evidence from an open population study. Br J Psychiatry 180:494–499
Olley BO, Zeier MD, Seedat S, Stein DJ (2005) Post-traumatic stress disorder among recently diagnosed patients with HIV/AIDS in South Africa. AIDS Care 17:550–557
Pedersen SS, Elklit A (1998) Traumatisation, psychological defence style, coping, symptomatology, and social support in HIV-positive: a pilot study. Scand J Psychol 39:55–60
Rosenberg M (1965) Society and adolescent self-image. Princeton University Press, Princeton
Safren SA, Gershuny BS, Hendriksen E (2003) Symptoms of posttraumatic stress and death anxiety in persons with HIV and medication adherence difficulties. AIDS Patient Care STDS 17:657–664
Sheehan DV, Lecrubier Y, Harnett-Sheehan K et al (1998) The mini international neuropsychiatric interview (MINI): the development and validation of a structured diagnostic psychiatric interview. J Clin Psychiatry, 59(suppl 20)Z:22–33
Sledjeski EM, Delahanty DL, Bogart LM (2005) Incidence and impact of posttraumatic stress disorder and comorbid depression on adherence to HAART and CD4+ counts in people living with HIV. AIDS Patient Care STDS 19:728–776
Smith MY, Egert J, Winkel G, Jacobson J (2002) The impact of PTSD on pain experience in persons with HIV/AIDS. Pain 98:9–17
Tedstone JE, Tarrier M (2003) Posttraumatic stress disorder following medical illness and treatment. Clin Psychol Rev 23:409–448
UNAIDS/WHO (2007). Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organization (WHO), AIDS Epidemic update. December
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Adewuya, A.O., Afolabi, M.O., Ola, B.A. et al. Post-traumatic stress disorder (PTSD) after stigma related events in HIV infected individuals in Nigeria. Soc Psychiat Epidemiol 44, 761–766 (2009). https://doi.org/10.1007/s00127-009-0493-7
Received:
Revised:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-009-0493-7