Demystifying Traumatic Experiences and Complex Effects in People with HIV and Post-Traumatic Stress Disorder in Tennessee

Background: Compared with the general public, people with HIV (PWH) experience more psychological trauma and higher rates of post-traumatic stress disorder (PTSD), yet limited research explores how PWH may uniquely experience trauma. The primary goal of this study was to investigate trauma exposure...

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Main Authors: L. Lauren Brown, Almariana J. Acuña, Amna Osman, Lloyda B. Williamson, Carolyn M. Audet, Megan L. Wilkins, Jessica M. Sales, Samantha V. Hill, Jill Foster, April C. Pettit, Latrice C. Pichon
Format: Article
Language:English
Published: Mary Ann Liebert 2025-02-01
Series:Health Equity
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Online Access:https://www.liebertpub.com/doi/10.1089/heq.2023.0251
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author L. Lauren Brown
Almariana J. Acuña
Amna Osman
Lloyda B. Williamson
Carolyn M. Audet
Megan L. Wilkins
Jessica M. Sales
Samantha V. Hill
Jill Foster
April C. Pettit
Latrice C. Pichon
author_facet L. Lauren Brown
Almariana J. Acuña
Amna Osman
Lloyda B. Williamson
Carolyn M. Audet
Megan L. Wilkins
Jessica M. Sales
Samantha V. Hill
Jill Foster
April C. Pettit
Latrice C. Pichon
author_sort L. Lauren Brown
collection DOAJ
description Background: Compared with the general public, people with HIV (PWH) experience more psychological trauma and higher rates of post-traumatic stress disorder (PTSD), yet limited research explores how PWH may uniquely experience trauma. The primary goal of this study was to investigate trauma exposure typologies and sequelae among PWH to inform trauma screening and interventions. Methods: Qualitative interviews were conducted with a convenience sample of 20 PWH with PTSD, receiving services from an urban, Tennessee-based HIV Service Organization. Interview guides were conducted to gain a rich understanding of exposure types from the Life Events Checklist-5 (LEC-5), explore potential social determinants of trauma, and uncover effects of chronic trauma or traumata. Thematic content analysis was used to examine typologies and effects. Results: Exposure typologies appeared as social determinants of trauma, including molestation as the most common followed by racial trauma, community violence, incarceration, addiction, interpersonal violence, poverty cycles, and stigma. Standard PTSD symptoms were reported in addition to emerging effects of complexity, synergism, and resilience. Complex effects spanned socioecological contexts and included sequelae of affective dysregulation, negative self-concept/self-organization, and disturbances in relationships. Conclusion: Many typologies were not well accounted for in the LEC-5, underscoring the potential to miss exposure types and thus treatment indication. Similarly, effects expanded beyond standard PTSD symptoms, suggesting that nuanced treatment needs may also be overlooked. Findings are consistent with literature indicating the need for updated trauma screening and assessment measures to most comprehensively and accurately direct treatment needs.
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spelling doaj-art-9b290525ef6f4556b8a1b41bae78e6f12025-08-20T02:58:58ZengMary Ann LiebertHealth Equity2473-12422025-02-019113114110.1089/heq.2023.0251Demystifying Traumatic Experiences and Complex Effects in People with HIV and Post-Traumatic Stress Disorder in TennesseeL. Lauren Brown0Almariana J. Acuña1Amna Osman2Lloyda B. Williamson3Carolyn M. Audet4Megan L. Wilkins5Jessica M. Sales6Samantha V. Hill7Jill Foster8April C. Pettit9Latrice C. Pichon10School of Medicine, Meharry Medical College, Nashville, Tennessee, USA.School of Medicine, Meharry Medical College, Nashville, Tennessee, USA.Nashville CARES, Nashville, Tennessee, USA.School of Medicine, Meharry Medical College, Nashville, Tennessee, USA.Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA.St. Jude Children’s Research Hospital, Infectious Diseases, Memphis, Tennessee, USA.School of Public Health, Emory University, Atlanta, Georgia USA.Department of Pediatrics, Emory University, Georgia, USA.University of Minnesota, Minneapolis, Minnesota, USA.School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.School of Public Health, Division of Social and Behavioral Sciences, University of Memphis, Memphis, Tennessee, USA.Background: Compared with the general public, people with HIV (PWH) experience more psychological trauma and higher rates of post-traumatic stress disorder (PTSD), yet limited research explores how PWH may uniquely experience trauma. The primary goal of this study was to investigate trauma exposure typologies and sequelae among PWH to inform trauma screening and interventions. Methods: Qualitative interviews were conducted with a convenience sample of 20 PWH with PTSD, receiving services from an urban, Tennessee-based HIV Service Organization. Interview guides were conducted to gain a rich understanding of exposure types from the Life Events Checklist-5 (LEC-5), explore potential social determinants of trauma, and uncover effects of chronic trauma or traumata. Thematic content analysis was used to examine typologies and effects. Results: Exposure typologies appeared as social determinants of trauma, including molestation as the most common followed by racial trauma, community violence, incarceration, addiction, interpersonal violence, poverty cycles, and stigma. Standard PTSD symptoms were reported in addition to emerging effects of complexity, synergism, and resilience. Complex effects spanned socioecological contexts and included sequelae of affective dysregulation, negative self-concept/self-organization, and disturbances in relationships. Conclusion: Many typologies were not well accounted for in the LEC-5, underscoring the potential to miss exposure types and thus treatment indication. Similarly, effects expanded beyond standard PTSD symptoms, suggesting that nuanced treatment needs may also be overlooked. Findings are consistent with literature indicating the need for updated trauma screening and assessment measures to most comprehensively and accurately direct treatment needs.https://www.liebertpub.com/doi/10.1089/heq.2023.0251PTSDHIVcomplex traumalife eventsadverse childhood experiences
spellingShingle L. Lauren Brown
Almariana J. Acuña
Amna Osman
Lloyda B. Williamson
Carolyn M. Audet
Megan L. Wilkins
Jessica M. Sales
Samantha V. Hill
Jill Foster
April C. Pettit
Latrice C. Pichon
Demystifying Traumatic Experiences and Complex Effects in People with HIV and Post-Traumatic Stress Disorder in Tennessee
Health Equity
PTSD
HIV
complex trauma
life events
adverse childhood experiences
title Demystifying Traumatic Experiences and Complex Effects in People with HIV and Post-Traumatic Stress Disorder in Tennessee
title_full Demystifying Traumatic Experiences and Complex Effects in People with HIV and Post-Traumatic Stress Disorder in Tennessee
title_fullStr Demystifying Traumatic Experiences and Complex Effects in People with HIV and Post-Traumatic Stress Disorder in Tennessee
title_full_unstemmed Demystifying Traumatic Experiences and Complex Effects in People with HIV and Post-Traumatic Stress Disorder in Tennessee
title_short Demystifying Traumatic Experiences and Complex Effects in People with HIV and Post-Traumatic Stress Disorder in Tennessee
title_sort demystifying traumatic experiences and complex effects in people with hiv and post traumatic stress disorder in tennessee
topic PTSD
HIV
complex trauma
life events
adverse childhood experiences
url https://www.liebertpub.com/doi/10.1089/heq.2023.0251
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