Research Article

The impact of trauma on South African women with HIV: The role of anxiety and physical symptomology


Rates of trauma and HIV are high in South Africa, and those who experience more trauma have higher levels of psychological distress. This cross-sectional study examined trauma, physical, and mental health among black South African women living with HIV (WLH). We hypothesised that WLH would have higher rates of trauma than women not living with HIV (WNLH). We also hypothesised that there would be a relationship between trauma, anxiety, and physical symptoms, such that anxiety would mediate the relationship between trauma and physical symptoms for WLH. This study enrolled 242 women, 99 WLH. Women were individually interviewed, completing the Life Stressor Checklist (trauma history), the Physical Symptom Inventory, and the IPAT Anxiety Scale. WLH reported significantly more traumatic life events (M = 3.69, SD = 2.32) than WNLH (M = 3.06, SD = 2.42), t = −2.07, p = 0.04. Additionally, traumatic life events were positively associated with physical symptoms. Further, there was an indirect effect of trauma history on physical symptoms through anxiety, b = 0.97, 95% BC CI [0.29, 1.89], such that the direct effect of trauma on physical symptoms was no longer significant, b = 0.87, 95% BC CI [−0.83, 2.56] when anxiety was added to the model. This pattern of findings suggests that anxiety is a key mechanism through which trauma history is associated with more physical symptoms in WLH. Future research should focus on the effect of interventions alleviating the impact that trauma may have on the mental and physical health of WLH.

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