Symptoms of post-traumatic stress and associations with sexual behaviour and PrEP preferences among young people in South Africa, Uganda and Zimbabwe.

Journal: BMC infectious diseases

Volume: 22

Issue: 1

Year of Publication: 2022

Affiliated Institutions:  MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, WCE HT, London, UK. emily.webb@lshtm.ac.uk. Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda. Clinical Trials Research Centre, University of Zimbabwe, Harare, Zimbabwe. Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, WCE HT, London, UK. King's College London, London, UK.

Abstract summary 

It is not known whether post-traumatic stress disorder (PTSD) increases HIV-risk behaviours among young people in sub-Saharan Africa. We assessed associations of PTSD symptoms with sexual behaviour, HIV risk perception, and attitudes towards PrEP among young people taking part in the CHAPS community survey. We hypothesised that PTSD symptoms would increase sexual behaviours associated with HIV risk, hinder PrEP uptake and influence preference for daily versus on-demand PrEP.Young people without HIV, aged 13-24 years, were purposively recruited in Johannesburg and Cape Town in South Africa, Wakiso in Uganda, and Chitungwiza in Zimbabwe, and surveyed on socio-demographic characteristics, PrEP knowledge and attitudes, sexual behaviour, HIV perception and salience, and mental health. PTSD symptoms were measured using the Primary Care PTSD Screen for the Diagnostic and Statistical Manual of Mental Disorders 5 (PC-PTSD-5). Logistic and ordinal logistic regression was used to assess associations between PC-PTSD-5 score and socio-demographic characteristics, sexual behaviour, HIV risk perception, PrEP attitudes, and substance use, adjusting for age, sex, setting, depression and anxiety.Of 1330 young people (51% male, median age 19 years), 522 (39%) reported at least one PTSD symptom. There was strong evidence that having a higher PC-PTSD-5 score was associated with reported forced sex (OR 3.18, 95%CI: 2.05-4.93), self-perception as a person who takes risks (OR 1.12, 95%CI: 1.04-1.20), and increased frequency of thinking about risk of HIV acquisition (OR 1.16, 95%CI: 1.08-1.25). PTSD symptoms were not associated with willingness to take PrEP, preference for on-demand versus daily PrEP, or actual HIV risk behaviour such as condomless sex.Symptoms consistent with probable PTSD were common among young people in South Africa, Uganda and Zimbabwe but did not impact PrEP attitudes or PrEP preferences. Evaluation for PTSD might form part of a general assessment in sexual and reproductive health services in these countries. More work is needed to understand the impact of PTSD on HIV-risk behaviour, forced sex and response to preventive strategies including PrEP.

Authors & Co-authors:  Webb Emily L EL Dietrich Janan J JJ Ssemata Andrew S AS Nematadzira Teacler G TG Hornschuh Stefanie S Kakande Ayoub A Tshabalala Gugulethu G Muhumuza Richard R Mutonyi Gertrude G Atujuna Millicent M Bere Tarisai T Bekker Linda-Gail LG Abas Melanie A MA Weiss Helen A HA Seeley Janet J Stranix-Chibanda Lynda L Fox Julie J

Study Outcome 

Source Link: Visit source

Statistics
Citations :  UNAIDS. Global HIV & AIDS statistics—2020 fact sheet. 2020.
Authors :  18
Identifiers
Doi : 466
SSN : 1471-2334
Study Population
Male,Female
Mesh Terms
Adolescent
Other Terms
HIV;Mental health;Post-traumatic stress disorder;PrEP;Sub-Saharan Africa;Young people
Study Design
Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
England