Prevalence, factors associated, and negative outcomes of “probable PTSD” among HIV infected children and adolescents: CHAKA study 2014–2017

The aim of this study was to determine the prevalence of “probable post-traumatic stress disorder (PTSD),” factors associated with probable PTSD, and its relationship with clinical and behavioral problems among children and adolescents with HIV/AIDS (CA-HIV). A random sample of 1,339 CA-HIV (aged 5–18 years, living with HIV) whose caregivers completed an extensive battery of measures. The caregivers evaluated psychiatric symptom severity using a standardized DSM-5-referenced psychiatric rating scale, the Child and Adolescent Symptom Inventory-5. The prevalence of “probable PTSD” was estimated with 95% confidence intervals (95% CI). Logistic and ordinal regression models were fitted to determine factors associated with probable PTSD, including study site, sex of the child, age of the child, caregiver religion, caregiver psychological distress, any anxiety and any attention-deficit/hyperactivity disorder (ADHD). Logistic and ordinal regression models were fitted to determine factors associated with probable PTSD and to evaluate the relationship between probable PTSD and clinical and behavioral outcomes. The overall prevalence of “probable PTSD” was 19.6%. CA-HIV with “probable PTSD” were more likely to have had their sexual debut (aOR = 2.78; 95% CI 1.12–6.55; P = 0.02). “Probable PTSD” was marginally associated with poor adherence to HIV medication (aOR = 0.13, 95% CI 0.02–0.97; P = 0.05). The study identified a high prevalence of “probable PTSD” among CA-HIV, with significant associations with caregiver psychological distress, anxiety, and ADHD. These findings underscore the need for targeted mental health interventions tailored to the unique needs of CA-HIV in Uganda. Furthermore, integrating mental health services into routine HIV care could address the significant burden of PTSD and its comorbidities in this vulnerable population in Uganda.