title: Prevalence of PTSD and depression, and associated sexual risk factors, among male Rwanda Defense Forces military personnel.
abstract: OBJECTIVE
  To assess depression and PTSD prevalence among the Rwanda Defense Forces (RDF) and evaluate whether sexual risk behaviour, STIs, HIV and alcohol use were significantly higher among those who screened positive.
  
  
  METHODS
  Consenting active-duty male RDF personnel, aged ≥21 years, completed an anonymous sexual risk survey linked to HIV rapid testing that included standardised assessments for PTSD (PCL-M), depression (CES-D) and alcohol use (AUDIT). PTSD and depression prevalence were calculated (data available for 1238 and 1120 participants, respectively), and multivariable regression analyses were conducted.
  
  
  RESULTS
  22.5% screened positive for depression, 4.2% for PTSD and 3.4% for both. In adjusted analyses, odds of either depression or PTSD were significantly higher in participants reporting STI symptoms (OR = 2.27, 2.78, respectively) and harmful alcohol use (OR = 3.13, 3.21, respectively). Sex with a high-risk sex partner, lower rank and never deploying were also significantly associated with depression in adjusted analyses.
  
  
  CONCLUSIONS
  Nearly one-fourth of RDF participants screened positive for PTSD or depression, which impacts sexual risk behaviour, HIV acquisition risk and military readiness. Findings may extend to other deploying militaries and provide additional evidence of an association between mental health status and sexual risk behaviour. Effective mental health treatment interventions that also include alcohol use assessments, STI identification/treatment and sexual risk behaviour reduction are needed.
authors.affiliation: Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, CA 92106, USA. judith.harbertson@med.navy.mil
authors.forename: Judith
authors.initials: J
authors.lastname: Harbertson
authors.forename: Michael
authors.initials: M
authors.lastname: Grillo
authors.forename: Eugene
authors.initials: E
authors.lastname: Zimulinda
authors.forename: Charles
authors.initials: C
authors.lastname: Murego
authors.forename: Terry
authors.initials: T
authors.lastname: Cronan
authors.forename: Susanne
authors.initials: S
authors.lastname: May
authors.forename: Stephanie
authors.initials: S
authors.lastname: Brodine
authors.forename: Marcellin
authors.initials: M
authors.lastname: Sebagabo
authors.forename: Maria Rosario G
authors.initials: MR
authors.lastname: Araneta
authors.forename: Richard
authors.initials: R
authors.lastname: Shaffer
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012432:Rwanda / Q000453:epidemiology; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Depression and sexual risk in the Rwanda Defense Forces; PTSD