The effect of post-traumatic stress disorder on HIV disease progression following hurricane Katrina

Abstract

Post-traumatic stress disorder (PTSD) is a common psychological outcome of any disaster. The purpose of this study was to examine the effects of PTSD on disease progression among HIV-infected persons in metropolitan New Orleans post-hurricane Katrina. One-year post-storm, a convenience sample of 145 HIV-infected patients who returned to care at the HIV Outpatient Program clinic in New Orleans were interviewed. Clinical factors pre and one and two years post-disaster were abstracted from medical records and compared by PTSD status. Of the 145 participants, 37.2% had PTSD. Those with PTSD were more likely than those without PTSD to have detectable plasma viral loads at both follow-up time points post-disaster and more likely to have CD4 cell counts <200/mm³ two years post-disaster. They were also more likely to have had medication interruptions immediately post-disaster. Our findings corroborate the findings of others that PTSD accelerates HIV disease progression. Disaster planners should consider the special counseling and medication safeguards needs of HIV-infected persons.

Keywords:

• natural disasters
• HIV
• disease progression
• post-traumatic stress disorders

Acknowledgements

We wish to thank the patients of the HIV outpatient program for participating, the providers of the HIV outpatient program for referring their patients and field staff: Cheryl Sanders, Sawyer Pouliot, Liljana Johnson, Chism Conwunyi, Mariam Nasir, and Jessica Robinson for their participation in data collection. We also thank“NIAID U19 AI61972” and “Tulane University Research Enhancement Phase I” for theirfunding.