August 17, 2010

PTSD Symptoms Common Among People With HIV

One third of HIV-positive men participating in a U.K. survey met the criteria for an HIV-related diagnosis of post-traumatic stress disorder (PTSD), according to a report published in the August 16 issue of AIDS Patient Care and STDs. A particularly notable finding was that starting antiretroviral therapy can be a PTSD trigger among people living with HIV.

PTSD is a frequently debilitating psychological disorder stemming from experiencing or witnessing traumatic events, such as physical violence. People with PTSD experience symptoms of depression and anxiety, have intrusive memories of the traumatic event, and often begin avoiding places and activities that trigger such memories. Taken together, these symptoms can significantly affect a person’s ability to function in life and experience pleasure.

Various studies have examined whether HIV-related experiences, such as the threat of physical or psychological harm, increase the risk of developing PTSD. With HIV, harm can come from the threat of illness or death due to disease progression or opportunistic infection or from social rejection due to a person’s HIV status. Rates of PTSD in people with HIV have ranged from 13 to 64 percent, depending on the group being studied.

To determine the frequency and causes behind PTSD in HIV-positive gay and bisexual men, Anthony Theuninck, a doctor of clinical psychology, and his colleagues from the NHS Foundation Trust in London, surveyed 100 gay and bisexual men in the United Kingdom.

Theuninck’s team found that 33 percent of the surveyed men met the criteria for HIV-related PTSD, in that they experienced threats to their physical health from HIV or witnessed someone else’s death from HIV, and that they had profound feelings of fear and helplessness related to these events.

Three HIV-related events most strongly predicted developing PTSD. They were: experiencing physical symptoms, witnessing HIV-related death and, unexpectedly, receiving antiretroviral (ARV) treatment. Though 55 percent of the survey respondents rated being diagnosed with HIV as a traumatic event, this was not correlated strongly with the development of PTSD, nor were feelings of shame or guilt over becoming HIV positive.

Theuninck and his colleagues stated that receiving HIV treatment was both “the strongest predictor and an unexpected finding. The emotional distress evoked by receiving treatment was more highly correlated with [post-traumatic stress symptoms] than any other stressor.”

The authors hypothesized that receiving ARV treatment “could include catastrophic expectations about the limitations a medication regime may impose on social or occupational functioning thus leading to traumatic fear, or the perceived failure of alternative medicines and lifestyle remedies leading to traumatic helplessness.”

As for the treatment implications of their findings, the authors recommend that clinicians become familiar with the diagnostic criteria of PTSD and remain on the lookout for these symptoms in their patients. Given previous findings about the increased likelihood for poor adherence among people with PTSD, this may be critical.

In cases where PTSD comes on within a month of a traumatic event, immediate intervention is not recommended by current guidelines, the authors noted. People whose symptoms persist beyond one month, however, should receive professional treatment specific to PTSD.

The authors also recommended that people with HIV receive education about the symptoms of PTSD and the kinds of events that can increase a person’s vulnerability to developing the condition.

“Further research is needed to determine the conditions that contribute to some HIV-related events being more likely to be traumatic than others,” the authors concluded. “Such research may benefit from being guided by psychological PTSD models…to inform further service and treatment development.”

Search: Post-traumatic stress disorder, PTSD, trauma, psychological, Anthony Theuninck

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Previous Comments:

Scott, Louisville, 2010-08-23 00:44:08
Just wanted to say more. I've had the fears of suddenly being unable to breath like I did when I was rushed to hospital with pneumonia--even when I'm not sick. I quit smoking which is good for my health; however, I had this irrational fear that smoking one cigarette would trigger that problem not being able to breath. I'm glad I quit, but it isn't healthy to think irrational thoughts like that. If my back hurts, I think it is pneumonia again and it triggers anxiety. The mind is so powerful.

Scott, Louisville, 2010-08-23 00:39:44
I learned my HIV status after getting sick and being hospitalized with bacterial pneumonia. I didn't recognize the signs and it got bad. They said I would have died if I hadn't come when I did. After that, my numbers rebounded, and a nurse told me she was certain I had a false-positive and that I was actually neg. Well, she turned out to be very wrong and it was like being told all over again. My therapist has diagnosed me with PTSD. I have depression with bad panic attacks. It is real!

FutureSurvivor21, South Texas, 2010-08-20 18:37:39
to know that there may be other clinical reasons behind it and also to know that your not the only one can be impowering and also gives you an understanding of symptoms and feelings in the cloud of confusion and also provides real live data that can help you to cope and moce forward. ;)

FutureSurvivor21, South Texas, 2010-08-20 18:33:41
I find this article to be very uplifting due to the research being performed as well as the comments. Being recently diagnosed was hard enough for me to comprehend at 20yrs old thinking I was just recenlty infected then coming to find i've been infected 6-8yrs prior to was really hard for me to digest; as well as knowing ppl that have passed, the austrisism they recieved along with the general stigma. I've gone into extream bouts of depression and still struggle with it everyday, but it's nice

Jerry Burger, South Africa, 2010-08-20 02:05:59
thanks to the researchers, and the amazing poz ppl. that commented, I feel an amount of gratitude,one tends to always want to suffer alone or think you are the only one, I feel enlightened and thankful for the research and poz friends across the world,you are my hero's.

Mike, NJ, 2010-08-19 19:30:29
Yes, Fred, it is time for new doctors. they are causing you great harm.

Fred, NYC, 2010-08-19 14:08:40
I have been diagnosed with PTSD. I am a cancer survivor also. I have asked my doctors about the connection between these conditions, including Generalized Anxiety Disorder and depression, all have said that the connection was insignificant at best...perhaps it's time for new doctors.

Erik, San Diego, 2010-08-19 13:36:11
Well, D-UH! after the Holocaust of the 80s and early 90s,funerals every week, multiple illnesses, debilitating side efx of the drugs, watching those close to you die slow painful ugly deaths, AND symptoms of the disease, wondering if that sniffle is going to turn into pneumonia and kill you, if that spot is ks, watching people now die from long term effects of the drugs while their bodies deteriorate, wondering if you're next, survival guilt, etc.... They're JUST realizing this? sheesh!!!!

Frederick Wright, Tampa, 2010-08-19 12:46:56
PTSD. However again a study that is not needed for me and others to know that HIV/AIDS in the trauma, stigma, daily fight to live and demand life for the other 50 million plus with HIV are Post-Pre and Now in Stress. After 20 years of some rubbing the heads of many on their death bed to insure them that their new journey is going to be loving and then in the next moment fighting a war of Hate, Greed and Judgment.Think again, how can the HIV person not be in Trauma, Stress and Pain. OMG HM AMEN

KMtampa, , 2010-08-19 11:50:25
When I was initially diagnosed my shrink at the VA ( yeah I said shrink since I can never spell psychiatrist right) diagnosed me with PTSD concerning HIV. Now 6 years later, my new shrink was promoted and as a parting gift he declared me cured and removed the reference from my medical records.

Rosetta M., Buffalo, NY, 2010-08-19 10:41:59
Because of the lack of specialist is this area, MD's, PA's, & NP's barely have time to address HIV, so primarly care is hardly address....so when are they going to address emotional issues?...it is really sad...we know the problem...but who has the solution...put money on that! What are we going to do with all the new cases of HIV when testing is offered by all care providers;again...really sad. Great in theory, but not realistic at all.

Celestial, Bay are, CA, 2010-08-18 20:54:41
I find it interesting that these research studies never include women. Studies show that a lot of HIV+ women lived in abusive relationships or in fear of their lives in general. As a woman whom has PTSD from an extremely abusive BF when I was 15-19, whom also gave me HIV, the meds & my lifestyle changes to accommodate them have increased my PTSD. Here's to 10-15 years on anti-anxiety drugs!!! That ADAP no longer covers!

Keith, Portland, OR, 2010-08-18 19:25:52
I have had alopecia since age 5. Upon hitting puberty I grew hair everywhere except for a full head of hair. I used to wear a full wig, but after starting meds became allergic to the adhesives that attatched it. I have also had the side effect of losing all of my hair. It has brought back the memories of abuse I suffered as a child. Talk about PTSD. I now avoid most social groups because of it.

Pat Johnson, Austin, Texas, 2010-08-18 15:03:11
Like Mark, nearly 30 years also with the HIV, and now AIDS, I find this report has merits. But, like any chronic illness, some people have problems dealing with their own upcoming death.

Robert Cole, Seattle, 2010-08-18 14:29:41
I have found recent research into psychological issued surrounding hiv enlightening. I am in the process of going to school and hopefully returning to work, but often get overwhelmed with anxiety and fear. This explains what I've been experiencing. thank you