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How trauma, recent stressful events, and PTSD affect functional health status and health utilization in HIV-infected patients in the south.

Publication ,  Journal Article
Leserman, J; Whetten, K; Lowe, K; Stangl, D; Swartz, MS; Thielman, NM
Published in: Psychosom Med
2005

OBJECTIVE: In addition to biological markers of human immunodeficiency virus (HIV) disease progression, physical functioning, and utilization of health care may also be important indicators of health status in HIV-infected patients. There is insufficient understanding of the psychosocial predictors of health-related physical functioning and use of health services among those with this chronic disease. Therefore, the current study examines how trauma, severe stressful events, posttraumatic stress disorder (PTSD), and depressive symptoms are related to physical functioning and health utilization in HIV-infected men and women living in rural areas of the South. METHODS: We consecutively sampled patients from 8 rural HIV clinics in 5 southern states, obtaining 611 completed interviews. RESULTS: We found that patients with more lifetime trauma, stressful events, and PTSD symptoms reported more bodily pain, and poorer physical, role, and cognitive functioning. Trauma, recent stressful events, and PTSD explained from 12% to 27% of the variance in health-related functioning, over and above that explained by demographic variables. In addition, patients with more trauma, including sexual and physical abuse, and PTSD symptoms were at greater risk for having bed disability, an overnight hospitalization, an emergency room visit, and four or more HIV outpatient clinic visits in the previous 9 months. Patients with a history of abuse had about twice the risk of spending 5 or more days in bed, having an overnight hospital stay, and visiting the emergency room, compared with those without abuse. The effects of trauma and stress were not explained by CD4 lymphocyte count or HIV viral load; however, these effects appear to be largely accounted for by increases in current PTSD symptoms. CONCLUSION: These findings highlight the importance of addressing past trauma, stress, and current PTSD within clinical HIV care.

Duke Scholars

Published In

Psychosom Med

DOI

EISSN

1534-7796

Publication Date

2005

Volume

67

Issue

3

Start / End Page

500 / 507

Location

United States

Related Subject Headings

  • Stress, Psychological
  • Stress Disorders, Post-Traumatic
  • Southeastern United States
  • Rural Population
  • Psychiatry
  • Patient Care
  • Middle Aged
  • Male
  • Life Change Events
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Leserman, J., Whetten, K., Lowe, K., Stangl, D., Swartz, M. S., & Thielman, N. M. (2005). How trauma, recent stressful events, and PTSD affect functional health status and health utilization in HIV-infected patients in the south. Psychosom Med, 67(3), 500–507. https://doi.org/10.1097/01.psy.0000160459.78182.d9
Leserman, Jane, Kathryn Whetten, Kristin Lowe, Dalene Stangl, Marvin S. Swartz, and Nathan M. Thielman. “How trauma, recent stressful events, and PTSD affect functional health status and health utilization in HIV-infected patients in the south.Psychosom Med 67, no. 3 (2005): 500–507. https://doi.org/10.1097/01.psy.0000160459.78182.d9.
Leserman J, Whetten K, Lowe K, Stangl D, Swartz MS, Thielman NM. How trauma, recent stressful events, and PTSD affect functional health status and health utilization in HIV-infected patients in the south. Psychosom Med. 2005;67(3):500–7.
Leserman, Jane, et al. “How trauma, recent stressful events, and PTSD affect functional health status and health utilization in HIV-infected patients in the south.Psychosom Med, vol. 67, no. 3, 2005, pp. 500–07. Pubmed, doi:10.1097/01.psy.0000160459.78182.d9.
Leserman J, Whetten K, Lowe K, Stangl D, Swartz MS, Thielman NM. How trauma, recent stressful events, and PTSD affect functional health status and health utilization in HIV-infected patients in the south. Psychosom Med. 2005;67(3):500–507.

Published In

Psychosom Med

DOI

EISSN

1534-7796

Publication Date

2005

Volume

67

Issue

3

Start / End Page

500 / 507

Location

United States

Related Subject Headings

  • Stress, Psychological
  • Stress Disorders, Post-Traumatic
  • Southeastern United States
  • Rural Population
  • Psychiatry
  • Patient Care
  • Middle Aged
  • Male
  • Life Change Events
  • Humans