Prevalence and predictors of posttraumatic stress disorder and depression in HIV-infected and at-risk Rwandan women

Mardge H. Cohen, Mary Fabri, Xiaotao Cai, Qiuhu Shi, Donald R. Hoover, Agnes Binagwaho, Melissa A. Culhane, Henriette Mukanyonga, Davis Ksahaka Karegeya, Kathryn Anastos

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Objective: During the 1994 Rwandan genocide, rape was used as a weapon of war to transmit HIV. This study measures trauma experiences of Rwandan women and identifies predictors associated with posttraumatic stress disorder (PTSD) and depressive symptoms. Methods: The Rwandan Women's Interassociation Study and Assessment (RWISA) is a prospective observational cohort study designed to assess effectiveness and toxicity of antiretroviral therapy in HIV-infected Rwandan women. In 2005, a Rwandan-adapted Harvard Trauma Questionnaire (HTQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess genocide trauma events and prevalence of PTSD (HTQ mean >2) and depressive symptoms (CES-D≥16) for 850 women (658 HIV-positive and 192 HIV-negative). Results: PTSD was common in HIV-positive (58%) and HIV-negative women (66%) (p=0.05). Women with HIV had a higher prevalence of depressive symptoms than HIV-negative women (81% vs. 65%, p<0.0001). Independent predictors for increased PTSD were experiencing more genocide-related trauma events and having more depressive symptoms. Independent predictors for increased depressive symptoms were making <$18 a month, HIV infection (and, among HIV-positive women, having lower CD4 cell counts), a history of genocidal rape, and having more PTSD symptoms. Conclusions: The prevalence of PTSD and depressive symptoms is high in women in the RWISA cohort. Four of five HIV-infected women had depressive symptoms, with highest rates among women with CD4 cell counts <200. In addition to treatment with antiretroviral therapy, economic empowerment and identification and treatment of depression and PTSD may reduce morbidity and mortality among women in postconflict countries.

Original languageEnglish (US)
Pages (from-to)1783-1791
Number of pages9
JournalJournal of Women's Health
Volume18
Issue number11
DOIs
StatePublished - Nov 1 2009

Fingerprint

Post-Traumatic Stress Disorders
HIV
Depression
Genocide
Rape
Wounds and Injuries
CD4 Lymphocyte Count
Cohort Studies
Weapons
Trauma Centers
Therapeutics
HIV Infections
Observational Studies
Epidemiologic Studies
Economics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Prevalence and predictors of posttraumatic stress disorder and depression in HIV-infected and at-risk Rwandan women. / Cohen, Mardge H.; Fabri, Mary; Cai, Xiaotao; Shi, Qiuhu; Hoover, Donald R.; Binagwaho, Agnes; Culhane, Melissa A.; Mukanyonga, Henriette; Karegeya, Davis Ksahaka; Anastos, Kathryn.

In: Journal of Women's Health, Vol. 18, No. 11, 01.11.2009, p. 1783-1791.

Research output: Contribution to journalArticle

Cohen, MH, Fabri, M, Cai, X, Shi, Q, Hoover, DR, Binagwaho, A, Culhane, MA, Mukanyonga, H, Karegeya, DK & Anastos, K 2009, 'Prevalence and predictors of posttraumatic stress disorder and depression in HIV-infected and at-risk Rwandan women', Journal of Women's Health, vol. 18, no. 11, pp. 1783-1791. https://doi.org/10.1089/jwh.2009.1367
Cohen, Mardge H. ; Fabri, Mary ; Cai, Xiaotao ; Shi, Qiuhu ; Hoover, Donald R. ; Binagwaho, Agnes ; Culhane, Melissa A. ; Mukanyonga, Henriette ; Karegeya, Davis Ksahaka ; Anastos, Kathryn. / Prevalence and predictors of posttraumatic stress disorder and depression in HIV-infected and at-risk Rwandan women. In: Journal of Women's Health. 2009 ; Vol. 18, No. 11. pp. 1783-1791.
@article{54b0c53d2d5d451c8f30073472bb651d,
title = "Prevalence and predictors of posttraumatic stress disorder and depression in HIV-infected and at-risk Rwandan women",
abstract = "Objective: During the 1994 Rwandan genocide, rape was used as a weapon of war to transmit HIV. This study measures trauma experiences of Rwandan women and identifies predictors associated with posttraumatic stress disorder (PTSD) and depressive symptoms. Methods: The Rwandan Women's Interassociation Study and Assessment (RWISA) is a prospective observational cohort study designed to assess effectiveness and toxicity of antiretroviral therapy in HIV-infected Rwandan women. In 2005, a Rwandan-adapted Harvard Trauma Questionnaire (HTQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess genocide trauma events and prevalence of PTSD (HTQ mean >2) and depressive symptoms (CES-D≥16) for 850 women (658 HIV-positive and 192 HIV-negative). Results: PTSD was common in HIV-positive (58{\%}) and HIV-negative women (66{\%}) (p=0.05). Women with HIV had a higher prevalence of depressive symptoms than HIV-negative women (81{\%} vs. 65{\%}, p<0.0001). Independent predictors for increased PTSD were experiencing more genocide-related trauma events and having more depressive symptoms. Independent predictors for increased depressive symptoms were making <$18 a month, HIV infection (and, among HIV-positive women, having lower CD4 cell counts), a history of genocidal rape, and having more PTSD symptoms. Conclusions: The prevalence of PTSD and depressive symptoms is high in women in the RWISA cohort. Four of five HIV-infected women had depressive symptoms, with highest rates among women with CD4 cell counts <200. In addition to treatment with antiretroviral therapy, economic empowerment and identification and treatment of depression and PTSD may reduce morbidity and mortality among women in postconflict countries.",
author = "Cohen, {Mardge H.} and Mary Fabri and Xiaotao Cai and Qiuhu Shi and Hoover, {Donald R.} and Agnes Binagwaho and Culhane, {Melissa A.} and Henriette Mukanyonga and Karegeya, {Davis Ksahaka} and Kathryn Anastos",
year = "2009",
month = "11",
day = "1",
doi = "10.1089/jwh.2009.1367",
language = "English (US)",
volume = "18",
pages = "1783--1791",
journal = "Journal of Women's Health",
issn = "1540-9996",
publisher = "Mary Ann Liebert Inc.",
number = "11",

}

TY - JOUR

T1 - Prevalence and predictors of posttraumatic stress disorder and depression in HIV-infected and at-risk Rwandan women

AU - Cohen, Mardge H.

AU - Fabri, Mary

AU - Cai, Xiaotao

AU - Shi, Qiuhu

AU - Hoover, Donald R.

AU - Binagwaho, Agnes

AU - Culhane, Melissa A.

AU - Mukanyonga, Henriette

AU - Karegeya, Davis Ksahaka

AU - Anastos, Kathryn

PY - 2009/11/1

Y1 - 2009/11/1

N2 - Objective: During the 1994 Rwandan genocide, rape was used as a weapon of war to transmit HIV. This study measures trauma experiences of Rwandan women and identifies predictors associated with posttraumatic stress disorder (PTSD) and depressive symptoms. Methods: The Rwandan Women's Interassociation Study and Assessment (RWISA) is a prospective observational cohort study designed to assess effectiveness and toxicity of antiretroviral therapy in HIV-infected Rwandan women. In 2005, a Rwandan-adapted Harvard Trauma Questionnaire (HTQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess genocide trauma events and prevalence of PTSD (HTQ mean >2) and depressive symptoms (CES-D≥16) for 850 women (658 HIV-positive and 192 HIV-negative). Results: PTSD was common in HIV-positive (58%) and HIV-negative women (66%) (p=0.05). Women with HIV had a higher prevalence of depressive symptoms than HIV-negative women (81% vs. 65%, p<0.0001). Independent predictors for increased PTSD were experiencing more genocide-related trauma events and having more depressive symptoms. Independent predictors for increased depressive symptoms were making <$18 a month, HIV infection (and, among HIV-positive women, having lower CD4 cell counts), a history of genocidal rape, and having more PTSD symptoms. Conclusions: The prevalence of PTSD and depressive symptoms is high in women in the RWISA cohort. Four of five HIV-infected women had depressive symptoms, with highest rates among women with CD4 cell counts <200. In addition to treatment with antiretroviral therapy, economic empowerment and identification and treatment of depression and PTSD may reduce morbidity and mortality among women in postconflict countries.

AB - Objective: During the 1994 Rwandan genocide, rape was used as a weapon of war to transmit HIV. This study measures trauma experiences of Rwandan women and identifies predictors associated with posttraumatic stress disorder (PTSD) and depressive symptoms. Methods: The Rwandan Women's Interassociation Study and Assessment (RWISA) is a prospective observational cohort study designed to assess effectiveness and toxicity of antiretroviral therapy in HIV-infected Rwandan women. In 2005, a Rwandan-adapted Harvard Trauma Questionnaire (HTQ) and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess genocide trauma events and prevalence of PTSD (HTQ mean >2) and depressive symptoms (CES-D≥16) for 850 women (658 HIV-positive and 192 HIV-negative). Results: PTSD was common in HIV-positive (58%) and HIV-negative women (66%) (p=0.05). Women with HIV had a higher prevalence of depressive symptoms than HIV-negative women (81% vs. 65%, p<0.0001). Independent predictors for increased PTSD were experiencing more genocide-related trauma events and having more depressive symptoms. Independent predictors for increased depressive symptoms were making <$18 a month, HIV infection (and, among HIV-positive women, having lower CD4 cell counts), a history of genocidal rape, and having more PTSD symptoms. Conclusions: The prevalence of PTSD and depressive symptoms is high in women in the RWISA cohort. Four of five HIV-infected women had depressive symptoms, with highest rates among women with CD4 cell counts <200. In addition to treatment with antiretroviral therapy, economic empowerment and identification and treatment of depression and PTSD may reduce morbidity and mortality among women in postconflict countries.

UR - http://www.scopus.com/inward/record.url?scp=71449101010&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=71449101010&partnerID=8YFLogxK

U2 - 10.1089/jwh.2009.1367

DO - 10.1089/jwh.2009.1367

M3 - Article

C2 - 19951212

AN - SCOPUS:71449101010

VL - 18

SP - 1783

EP - 1791

JO - Journal of Women's Health

JF - Journal of Women's Health

SN - 1540-9996

IS - 11

ER -