Abstract
BackgroundWe aimed to describe the prevalence of PTSD symptoms and its associated factors in persons living with HIV (PLWH) in Uganda who engage in heavy alcohol use.MethodsWe analyzed baseline data from the Drinkers Intervention to Prevent Tuberculosis study which enrolls PLWH with latent tuberculosis who engage in heavy alcohol consumption. Using the primary care Post Traumatic Stress Disorder (PTSD) screening scale from the DSM-5 (PC-PTSD-5), probable PTSD was defined as reporting ≥3 of 5 assessed symptoms. We conducted the Alcohol Use Disorders Identification Test-Consumption and assessed demographics, smoking, symptoms of depression, and spirituality/religiosity.ResultsOf 421 participants enrolled from 2018 through 2020, the majority (68.2%) were male, median age was 40 years (interquartile range [IQR]: 32–47), and median AUDIT-C score was 6 [IQR: 4–8]. Half (50.1%) of the participants reported ever experiencing a traumatic event, and 20.7% reported ≥3 symptoms of PTSD. The most commonly reported PTSD symptoms in the past 1 month in the entire sample were avoidance (28.3%), nightmares (27.3%), and being constantly on guard (21.6%). In multivariable logistic regression analyses, level of alcohol use was not associated with probable PTSD (adjusted odds ratio [AOR] for each AUDIT-C point: (1.02; 95% CI: 0.92–1.14; p = 0.69); however, lifetime smoking (AOR 1.89; 95% CI: 1.10–3.24) and reporting symptoms of depression (AOR 1.89; 95% CI: 1.04–3.44) were independently associated with probable PTSD.Conclusions and recommendationsA history of traumatic events and probable PTSD were frequently reported among persons who engage in heavy drinking, living with HIV in Uganda. Level of alcohol use was not associated with probable PTSD in this sample of PLWH with heavy alcohol use, however other behavioral and mental health factors were associated with probable PTSD. These data highlight the high prevalence of PTSD in this group, and the need for screening and interventions for PTSD and mental health problems.
Highlights
Post-traumatic stress disorder (PTSD) is a significant worldwide health concern, and is highly prevalent in sub-Saharan Africa [1]
Eligibility further includes being positive for heavy alcohol use via the Alcohol Use Disorder Identification TestConsumption (AUDIT-C) (≥3 for women; ≥4 for men); positive for recent alcohol use based on a urine ethyl glucuronide (EtG) dipstick test (300 ng/mL cutoff, by Confirm Biosciences, San Diego, California); having alanine transaminase (ALT) and aspartate transaminase (AST) levels
Self-reported level of alcohol use was not associated with probable PTSD
Summary
Post-traumatic stress disorder (PTSD) is a significant worldwide health concern, and is highly prevalent in sub-Saharan Africa [1]. A recent meta-analysis showed that the pooled prevalence of probable current PTSD across 10 countries in sub-Saharan Africa was 22% [1]. While HIV has become a chronic illness, due to the wide spread roll out of antiretroviral therapy (ART), and mortality from AIDS greatly reduced [4], mental health issues remain common among persons living with HIV (PLWH) [5]. These issues include PTSD, depression, substance use disorders, eating disorders, and anxiety disorders, and they commonly co-occur [6, 7]. We aimed to describe the prevalence of PTSD symptoms and its associated factors in persons living with HIV (PLWH) in Uganda who engage in heavy alcohol use
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