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The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa
2024;30 2220.

Childhood trauma, substance use and depressive symptoms in people with HIV during COVID-19.

Nikita Prosad Singh, Vuyokazi Ntlantsana, Andrew Tomita, Saeeda Paruk
Author Information
  1. Nikita Prosad Singh: Department of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. ORCID
  2. Vuyokazi Ntlantsana: Department of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. ORCID
  3. Andrew Tomita: KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. ORCID
  4. Saeeda Paruk: Department of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. ORCID
PMID: 39507827 DOI: 10.4102/sajpsychiatry.v30i0.2220

Abstract

Background: Adverse childhood experiences (ACEs), substance use, depressive symptoms, and HIV outcomes in people living with HIV (PLWHIV) have not been comprehensively investigated within a single study.
Aim: The aim of this study was to investigate the prevalence and association of ACEs, substance use, depressive symptoms and human immunodeficiency virus (HIV) outcomes in PLWHIV accessing HIV care during the coronavirus disease 2019 (COVID-19) pandemic.
Setting: District hospital HIV clinic in South Africa.
Methods: A total of 196 PLWHIV completed a socio-demographic and clinical questionnaire; an adapted World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test; WHO ACEs International Questionnaire, and Patient Health Questionnaire.
Results: The most common ACEs were having one or no parent, parental separation or divorce ( = 131, 66.8%), exposure to collective ( = 57, 29.1%) and community violence ( = 55, 28.1%), with 40.3% ( = 79) experiencing ≥ 3 ACEs. The most commonly used substances were alcohol ( = 34, 17.3%), tobacco ( = 33, 16.8%), and cannabis ( =13, 6.6%). The prevalence of depressive symptoms was 19.4% ( = 38). Linear regression analyses indicated greater alcohol (adj β = 2.84, < 0.01), tobacco (adj β = 3.64, < 0.01) and cannabis use risk scores (adj β = 2.39, < 0.01) were associated with ≥ 3 ACEs. Logistic regression indicated depressive risk (adjusted odds ratio [OR] = 9.39, 95% confidence interval [CI] 4.78-23.51) was associated with ≥ 3 ACEs.
Conclusion: A high prevalence of ACEs, substance use and depressive symptoms exists among PLWHIV, along with an association between cumulative ACEs and both substance use and depressive symptoms.
Contribution: Enhanced screening and management services are recommended to address this triple burden in PLWHIV.

Keywords

COVID-19 HIV South Africa adverse childhood experiences alcohol cannabis depression tobacco

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