Stressful life events, PTSD symptoms and mental health in people living 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.