Post-traumatic stress disorder (PTSD) after stigma related events in HIV infected individuals in Nigeria

• Published in: Social Psychiatry and Psychiatric Epidemiology 2009-09, Vol.44 (9), p.761-766
• Main Authors: Adewuya, Abiodun O., Afolabi, Mohammed O., Ola, Bola A., Ogundele, Olorunfemi A., Ajibare, Adeola O., Oladipo, Bamidele F., Fakande, Ibiyemi
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Africa South of the Sahara; Anxiety disorders. Neuroses; Biological and medical sciences; Comorbidity; Epidemiology; Female; Health Status; HIV Infections - epidemiology; HIV Infections - psychology; HIV Infections - rehabilitation; HIV Seropositivity - epidemiology; HIV Seropositivity - psychology; HIV Seropositivity - rehabilitation; Human viral diseases; Humans; Infectious diseases; Life Change Events; Male; Medical sciences; Medicine; Medicine & Public Health; Mental Disorders - epidemiology; Mental Disorders - psychology; Nigeria - epidemiology; Original Paper; Personality Inventory; Post-traumatic stress disorder; Psychiatric Status Rating Scales - statistics & numerical data; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self Concept; Severity of Illness Index; Social Support; Socioeconomic Factors; Stereotyping; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - etiology; Stress Disorders, Post-Traumatic - psychology; Surveys and Questionnaires; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-009-0493-7

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.