Improvement in Post-Traumatic Stress Disorder in Post-Conflict Rwandan Women


Cohen, Mardge H., Qiuhu Shi, Mary Fabri, Henriette Mukanyonga, Xiaoto Cai, Donald R. Hoover, and Kathryn Anastos. 2011. "Improvement in Post-Traumatic Stress Disorder in Post-Conflict Rwandan Women." Journal of Women's Health 20 (9): 1325-1332.

Authors: Mardge H. Cohen, Qiuhu Shi, Mary Fabri, Henriette Mukanyonga, Xiaoto Cai, Donald R. Hoover, Kathryn Anastos


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.

Keywords: posttraumatic stress disorder, mental health, HIV/AIDS, genocide, war rape

Topics: Armed Conflict, Gender, Women, Genocide, Health, HIV/AIDS, Mental Health, PTSD, Trauma, Post-Conflict, Sexual Violence, Rape Regions: Africa, Central Africa, East Africa Countries: Rwanda

Year: 2011

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