Speaker
Description
Background: Young people living with HIV (YPLHIV) are highly vulnerable to post-traumatic stress disorder (PTSD) due to cumulative trauma exposures, including HIV diagnosis, stigma and discrimination, disclosure-related stress, bereavement, violence, and other adverse childhood experiences. In addition to psychosocial stressors, the neuropsychiatric effects of HIV may further exacerbate mood and cognitive disturbances, increasing susceptibility to PTSD. PTSD in this population is associated with maladaptive coping strategies, poor antiretroviral therapy (ART) adherence, risky health behaviors, and impaired immune functioning, ultimately compromising viral suppression and progress toward the UNAIDS 95-95-95 targets. Despite the high burden of HIV in Sub-Saharan Africa and limited access to specialized mental health services, PTSD among YPLHIV remains underexplored. This study sought to determine the prevalence of PTSD and associated factors among YPLHIV.
Methods: Between April and June 2025, we conducted a cross-sectional study among YPLHIV aged 10-24 years in Arusha City, Tanzania. Participants were eligible if they were aware of their HIV stauts and provided consent or assent for participation. All participants who attended the clinic during the study period were enrolled. Face to face Interviews were conducted using questionnaires. Stigma and discrimination and perceived social support were assessed using Multidimensional Perceived Social Support Scale (MPSS) and HIV stigma and discrimination scale, respectively. The WHO Adverse childhood questionnaire and the University of California Los Angeles (UCLA) PTSD Reaction Index for DSM-5 was used to identify childhood trauma and screen for PTSD symptoms. A multivariable logistic regression model was used to examine factors associated with PTSD. Variables with a p-value of <0.05 in the multivariable analysis were considered statistically significant. The analysis was performed using Stata version 17. The study was approved by th Tanzanian National Health Research Ethics Commmittee.
Results: A total of 153 YPLHIV were enrolled in the study.The mean age was 18.5 years and majority were females (54.9%). 20(13.1%) out of the enrolled participants screened positive for PTSD. About 55.6% reported high perceived social support, 21.6% reported high HIV related stigma and 10.4% has 4 or more Adverse childhood adversity. Individuals with an ACE score of 4+ had 8.8 times higher odds of PTSD compared to those without history of ACE (aOR = 8.8; p = 0.040). Additionally, death of a parent significantly increased the odds of PTSD compared with those with both parents alive (aOR = 4.6; p = 0.022).Individuals with longer time since disclosure which mark long duration of illness had higher odds of PTSD symptoms with each unit increase in time, the odds of PTSD increased by 1.14 (aOR=1.14,P=0.017).Lastly High HIV-related stigma had 4.3 times higher odds of PTSD symptoms compared with individuals with low HIV-related stigma (aOR=4.3,P=0.041).
Conclusion: In line with recommendations from the World Health Organization and national HIV care guidelines that emphasize integrated and person-centered HIV services, routine screening for PTSD symptoms should be incorporated into comprehensive care for YPLHIV. Findings further highlight the need for trauma-informed mental health services within HIV care programs. Policies should incorporate structured post-disclosure counseling,stigma-reduction interventions and address childhood adversities to improve overall well-being among YPLHIV.