Symptoms of post-traumatic stress and associations with sexual behaviour and PrEP preferences among young people in South Africa, Uganda and Zimbabwe

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dc.contributor.authorWebb, Emily L
dc.contributor.authorDietrich, Janan J
dc.contributor.authorSsemata, Andrew S
dc.contributor.authorNematadzira, Teacler G
dc.contributor.authorHornschuh, Stefanie
dc.contributor.authorKakande, Ayoub
dc.contributor.authorTshabalala, Gugulethu
dc.contributor.authorMuhumuza, Richard
dc.contributor.authorMutonyi, Gertrude
dc.contributor.authorAtujuna, Millicent
dc.contributor.authorBere, Tarisai
dc.contributor.authorBekker, Linda-Gail
dc.contributor.authorAbas, Melanie A
dc.contributor.authorWeiss, Helen A
dc.contributor.authorSeeley, Janet
dc.contributor.authorStranix-Chibanda, Lynda
dc.contributor.authorFox, Julie
dc.date.accessioned2022-07-13T11:29:01Z
dc.date.available2022-07-13T11:29:01Z
dc.date.issued2022-05-16
dc.date.updated2022-05-22T03:24:53Z
dc.description.abstractBackground It is not known whether post-traumatic stress disorder (PTSD) increases HIV-risk behaviours among young people in sub-Saharan Africa. We assessed associations of PTSD symptoms with sexual behaviour, HIV risk perception, and attitudes towards PrEP among young people taking part in the CHAPS community survey. We hypothesised that PTSD symptoms would increase sexual behaviours associated with HIV risk, hinder PrEP uptake and influence preference for daily versus on-demand PrEP. Methods Young people without HIV, aged 13–24 years, were purposively recruited in Johannesburg and Cape Town in South Africa, Wakiso in Uganda, and Chitungwiza in Zimbabwe, and surveyed on socio-demographic characteristics, PrEP knowledge and attitudes, sexual behaviour, HIV perception and salience, and mental health. PTSD symptoms were measured using the Primary Care PTSD Screen for the Diagnostic and Statistical Manual of Mental Disorders 5 (PC-PTSD-5). Logistic and ordinal logistic regression was used to assess associations between PC-PTSD-5 score and socio-demographic characteristics, sexual behaviour, HIV risk perception, PrEP attitudes, and substance use, adjusting for age, sex, setting, depression and anxiety. Results Of 1330 young people (51% male, median age 19 years), 522 (39%) reported at least one PTSD symptom. There was strong evidence that having a higher PC-PTSD-5 score was associated with reported forced sex (OR 3.18, 95%CI: 2.05–4.93), self-perception as a person who takes risks (OR 1.12, 95%CI: 1.04–1.20), and increased frequency of thinking about risk of HIV acquisition (OR 1.16, 95%CI: 1.08–1.25). PTSD symptoms were not associated with willingness to take PrEP, preference for on-demand versus daily PrEP, or actual HIV risk behaviour such as condomless sex. Conclusions Symptoms consistent with probable PTSD were common among young people in South Africa, Uganda and Zimbabwe but did not impact PrEP attitudes or PrEP preferences. Evaluation for PTSD might form part of a general assessment in sexual and reproductive health services in these countries. More work is needed to understand the impact of PTSD on HIV-risk behaviour, forced sex and response to preventive strategies including PrEP.en_US
dc.identifier.apacitationWebb, E. L., Dietrich, J. J., Ssemata, A. S., Nematadzira, T. G., Hornschuh, S., Kakande, A., ... Fox, J. (2022). Symptoms of post-traumatic stress and associations with sexual behaviour and PrEP preferences among young people in South Africa, Uganda and Zimbabwe. <i>BMC Infectious Diseases</i>, 22(1), 466. http://hdl.handle.net/11427/36646en_ZA
dc.identifier.chicagocitationWebb, Emily L, Janan J Dietrich, Andrew S Ssemata, Teacler G Nematadzira, Stefanie Hornschuh, Ayoub Kakande, Gugulethu Tshabalala, et al "Symptoms of post-traumatic stress and associations with sexual behaviour and PrEP preferences among young people in South Africa, Uganda and Zimbabwe." <i>BMC Infectious Diseases</i> 22, 1. (2022): 466. http://hdl.handle.net/11427/36646en_ZA
dc.identifier.citationWebb, E.L., Dietrich, J.J., Ssemata, A.S., Nematadzira, T.G., Hornschuh, S., Kakande, A., Tshabalala, G. & Muhumuza, R. et al. 2022. Symptoms of post-traumatic stress and associations with sexual behaviour and PrEP preferences among young people in South Africa, Uganda and Zimbabwe. <i>BMC Infectious Diseases.</i> 22(1):466. http://hdl.handle.net/11427/36646en_ZA
dc.identifier.ris TY - Journal Article AU - Webb, Emily L AU - Dietrich, Janan J AU - Ssemata, Andrew S AU - Nematadzira, Teacler G AU - Hornschuh, Stefanie AU - Kakande, Ayoub AU - Tshabalala, Gugulethu AU - Muhumuza, Richard AU - Mutonyi, Gertrude AU - Atujuna, Millicent AU - Bere, Tarisai AU - Bekker, Linda-Gail AU - Abas, Melanie A AU - Weiss, Helen A AU - Seeley, Janet AU - Stranix-Chibanda, Lynda AU - Fox, Julie AB - Background It is not known whether post-traumatic stress disorder (PTSD) increases HIV-risk behaviours among young people in sub-Saharan Africa. We assessed associations of PTSD symptoms with sexual behaviour, HIV risk perception, and attitudes towards PrEP among young people taking part in the CHAPS community survey. We hypothesised that PTSD symptoms would increase sexual behaviours associated with HIV risk, hinder PrEP uptake and influence preference for daily versus on-demand PrEP. Methods Young people without HIV, aged 13–24 years, were purposively recruited in Johannesburg and Cape Town in South Africa, Wakiso in Uganda, and Chitungwiza in Zimbabwe, and surveyed on socio-demographic characteristics, PrEP knowledge and attitudes, sexual behaviour, HIV perception and salience, and mental health. PTSD symptoms were measured using the Primary Care PTSD Screen for the Diagnostic and Statistical Manual of Mental Disorders 5 (PC-PTSD-5). Logistic and ordinal logistic regression was used to assess associations between PC-PTSD-5 score and socio-demographic characteristics, sexual behaviour, HIV risk perception, PrEP attitudes, and substance use, adjusting for age, sex, setting, depression and anxiety. Results Of 1330 young people (51% male, median age 19 years), 522 (39%) reported at least one PTSD symptom. There was strong evidence that having a higher PC-PTSD-5 score was associated with reported forced sex (OR 3.18, 95%CI: 2.05–4.93), self-perception as a person who takes risks (OR 1.12, 95%CI: 1.04–1.20), and increased frequency of thinking about risk of HIV acquisition (OR 1.16, 95%CI: 1.08–1.25). PTSD symptoms were not associated with willingness to take PrEP, preference for on-demand versus daily PrEP, or actual HIV risk behaviour such as condomless sex. Conclusions Symptoms consistent with probable PTSD were common among young people in South Africa, Uganda and Zimbabwe but did not impact PrEP attitudes or PrEP preferences. Evaluation for PTSD might form part of a general assessment in sexual and reproductive health services in these countries. More work is needed to understand the impact of PTSD on HIV-risk behaviour, forced sex and response to preventive strategies including PrEP. DA - 2022-05-16 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Infectious Diseases KW - Post-traumatic stress disorder KW - Young people KW - Mental health KW - HIV KW - PrEP KW - Sub-Saharan Africa LK - https://open.uct.ac.za PY - 2022 T1 - Symptoms of post-traumatic stress and associations with sexual behaviour and PrEP preferences among young people in South Africa, Uganda and Zimbabwe TI - Symptoms of post-traumatic stress and associations with sexual behaviour and PrEP preferences among young people in South Africa, Uganda and Zimbabwe UR - http://hdl.handle.net/11427/36646 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12879-022-07430-2
dc.identifier.urihttp://hdl.handle.net/11427/36646
dc.identifier.vancouvercitationWebb EL, Dietrich JJ, Ssemata AS, Nematadzira TG, Hornschuh S, Kakande A, et al. Symptoms of post-traumatic stress and associations with sexual behaviour and PrEP preferences among young people in South Africa, Uganda and Zimbabwe. BMC Infectious Diseases. 2022;22(1):466. http://hdl.handle.net/11427/36646.en_ZA
dc.language.rfc3066en
dc.publisher.departmentDesmond Tutu HIV Centreen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Infectious Diseasesen_US
dc.source.journalissue1en_US
dc.source.journalvolume22en_US
dc.source.pagination466en_US
dc.source.urihttps://bmcinfectdis.biomedcentral.com/
dc.subjectPost-traumatic stress disorderen_US
dc.subjectYoung peopleen_US
dc.subjectMental healthen_US
dc.subjectHIVen_US
dc.subjectPrEPen_US
dc.subjectSub-Saharan Africaen_US
dc.titleSymptoms of post-traumatic stress and associations with sexual behaviour and PrEP preferences among young people in South Africa, Uganda and Zimbabween_US
dc.typeJournal Articleen_US
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