Prevalence and predictors of posttraumatic stress disorder and depression in HIV-infected and at-risk Rwandan women.

Autor:	Cohen MH; Departments of Medicine, John Stroger (formerly Cook County) Hospital and Rush University, Chicago, Illinois, USA. mardge.cohen@gmail.com, Fabri M, Cai X, Shi Q, Hoover DR, Binagwaho A, Culhane MA, Mukanyonga H, Karegeya DK, Anastos K
Jazyk:	angličtina
Zdroj:	Journal of women's health (2002) [J Womens Health (Larchmt)] 2009 Nov; Vol. 18 (11), pp. 1783-91.
DOI:	10.1089/jwh.2009.1367
Abstrakt:	Objective: During the 1994 Rwandan genocide, rape was used as a weapon of war to transmit HIV. This study measures trauma experiences of Rwandan women and identifies predictors associated with posttraumatic stress disorder (PTSD) and depressive symptoms. Methods: The Rwandan Women's Interassociation Study and Assessment (RWISA) is a prospective observational cohort study designed to assess effectiveness and toxicity of antiretroviral therapy in HIV-infected Rwandan women. In 2005, a Rwandan-adapted Harvard Trauma Questionnaire (HTQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess genocide trauma events and prevalence of PTSD (HTQ mean > 2) and depressive symptoms (CES-D > or = 16) for 850 women (658 HIV-positive and 192 HIV-negative). Results: PTSD was common in HIV-positive (58%) and HIV-negative women (66%) (p = 0.05). Women with HIV had a higher prevalence of depressive symptoms than HIV-negative women (81% vs. 65%, p < 0.0001). Independent predictors for increased PTSD were experiencing more genocide-related trauma events and having more depressive symptoms. Independent predictors for increased depressive symptoms were making < $18 a month, HIV infection (and, among HIV-positive women, having lower CD4 cell counts), a history of genocidal rape, and having more PTSD symptoms. Conclusions: The prevalence of PTSD and depressive symptoms is high in women in the RWISA cohort. Four of five HIV-infected women had depressive symptoms, with highest rates among women with CD4 cell counts < 200. In addition to treatment with antiretroviral therapy, economic empowerment and identification and treatment of depression and PTSD may reduce morbidity and mortality among women in postconflict countries.
Databáze:	MEDLINE
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