title: Improvement in posttraumatic stress disorder in postconflict Rwandan women.
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<0.0001) 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.
authors: Stroger Hospital of Cook County, Chicago, IL 60612, USA. mardge.cohen@gmail.com
authors: Mardge H
authors: MH
authors: Cohen
authors: Qiuhu
authors: Q
authors: Shi
authors: Mary
authors: M
authors: Fabri
authors: Henriette
authors: H
authors: Mukanyonga
authors: Xiaotao
authors: X
authors: Cai
authors: Donald R
authors: DR
authors: Hoover
authors: Agnes
authors: A
authors: Binagwaho
authors: Kathryn
authors: K
authors: Anastos
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003376:Counseling / Q000706:statistics & numerical data; D003863:Depression / Q000523:psychology / Q000628:therapy; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D011569:Psychiatric Status Rating Scales; D011902:Rape / Q000523:psychology; D012432:Rwanda; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000628:therapy; D017741:Survivors / Q000523:psychology*; D014754:Violence / Q000523:psychology*; D014857:Warfare