Improvement in posttraumatic stress disorder in postconflict rwandan women

Mardge H. Cohen, Qiuhu Shi, Mary Fabri, Henriette Mukanyonga, Xiaotao Cai, Donald R. Hoover, Agnes Binagwaho, Kathryn Anastos

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background: Depression and posttraumatic stress disorder (PTSD) are common in developing and postconflict countries. The purpose of this study is to examine longitudinal changes in PTSD in HIV-infected and uninfected Rwandan women who experienced the 1994 genocide. Methods: Five hundred thirty-five HIV-positive and 163 HIV-negative Rwandan women in an observational cohort study were followed for 18 months. Data on PTSD symptoms were collected longitudinally by the Harvard Trauma Questionnaire (HTQ) and analyzed in relationship to demographics, HIV status, antiretroviral treatment (ART), and depression. PTSD was defined as a score on the HTQ of ≥2. Results: There was a continuing reduction in HTQ scores at each follow-up visit. The prevalence of PTSD symptoms changed significantly, with 61% of the cohort having PTSD at baseline vs. 24% after 18 months. Women with higher HTQ score were most likely to have improvement in PTSD symptoms (p<0.0001). Higher rate of baseline depressive symptoms (p<0.001) was associated with less improvement in PTSD symptoms. HIV infection and ART were not found to be consistently related to PTSD improvement. Conclusions: HIV care settings can become an important venue for the identification and treatment of psychiatric problems affecting women with HIV in postconflict and developing countries. Providing opportunities for women with PTSD symptoms to share their history of trauma to trained counselors and addressing depression, poverty, and ongoing violence may contribute to reducing symptoms.

Original languageEnglish (US)
Pages (from-to)1325-1332
Number of pages8
JournalJournal of Women's Health
Volume20
Issue number9
DOIs
StatePublished - Sep 1 2011

ASJC Scopus subject areas

  • General Medicine

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