title: Prevalence of psychological trauma and association with current health and functioning in a sample of HIV-infected and HIV-uninfected Tanzanian adults.
abstract: BACKGROUND
  In high income nations, traumatic life experiences such as childhood sexual abuse are much more common in people living with HIV/AIDS (PLWHA) than the general population, and trauma is associated with worse current health and functioning. Virtually no data exist on the prevalence or consequences of trauma for PLWHA in low income nations.
  
  
  RESULTS
  We recruited four cohorts of Tanzanian patients in established medical care for HIV infection (n = 228), individuals newly testing positive for HIV (n = 267), individuals testing negative for HIV at the same sites (n = 182), and a random sample of community-dwelling adults (n = 249). We assessed lifetime prevalence of traumatic experiences, recent stressful life events, and current mental health and health-related physical functioning. Those with established HIV infection reported a greater number of childhood and lifetime traumatic experiences (2.1 and 3.0 respectively) than the community cohort (1.8 and 2.3). Those with established HIV infection reported greater post-traumatic stress disorder (PTSD) symptomatology and worse current health-related physical functioning. Each additional lifetime traumatic experience was associated with increased PTSD symptomatology and worse functioning.
  
  
  CONCLUSIONS
  This study is the first to our knowledge in an HIV population from a low income nation to report the prevalence of a range of potentially traumatic life experiences compared to a matched community sample and to show that trauma history is associated with poorer health-related physical functioning. Our findings underscore the importance of considering psychosocial characteristics when planning to meet the health needs of PLWHA in low income countries.
authors.affiliation: Center for Health Policy & Inequalities Research, Duke Global Health Institute, Department of Community and Family Medicine, Duke University, Durham, North Carolina, United States of America. brian.pence@duke.edu
authors.forename: Brian W
authors.initials: BW
authors.lastname: Pence
authors.forename: Kristen
authors.initials: K
authors.lastname: Shirey
authors.forename: Kathryn
authors.initials: K
authors.lastname: Whetten
authors.forename: Bernard
authors.initials: B
authors.lastname: Agala
authors.forename: Dafrosa
authors.initials: D
authors.lastname: Itemba
authors.forename: Julie
authors.initials: J
authors.lastname: Adams
authors.forename: Rachel
authors.initials: R
authors.lastname: Whetten
authors.forename: Jia
authors.initials: J
authors.lastname: Yao
authors.forename: John
authors.initials: J
authors.lastname: Shao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D018023:HIV Seronegativity; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000453:epidemiology; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult