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Open Access Research

Mental health outcomes in HIV and childhood maltreatment: a systematic review

Georgina Spies1, Tracie O Afifi4, Sarah L Archibald56, Christine Fennema-Notestine56, Jitender Sareen3 and Soraya Seedat12*

Author Affiliations

1 South African Research Chairs Initiative (SARChI), PTSD program, Francie van Zijl drive, Department of Psychiatry, University of Stellenbosch, Cape Town, 7505, South Africa

2 MRC Unit on Anxiety and Stress Disorders, Francie van Zijl drive, Department of Psychiatry, University of Stellenbosch, Cape Town, 7505, South Africa

3 Departments of Psychiatry, Psychology, and Community Health Sciences, Bannatyne Avenue, University of Manitoba, Winnipeg, R3E 0W5, Canada

4 Department of Community Health Sciences, Bannatyne Avenue, University of Manitoba, Winnipeg, R3E 0W5, Canada

5 Department of Psychiatry, Gilman drive, University of California San Diego, La Jolla, CA, 92093, USA

6 Department of Radiology, Gilman Drive, University of California San Diego, La Jolla, CA, 92093, USA

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Systematic Reviews 2012, 1:30  doi:10.1186/2046-4053-1-30

Published: 28 June 2012

Abstract

Background

High rates of childhood maltreatment have been documented in HIV-positive men and women. In addition, mental disorders are highly prevalent in both HIV-infected individuals and victims of childhood maltreatment. However, there is a paucity of research investigating the mental health outcomes associated with childhood maltreatment in the context of HIV infection. The present systematic review assessed mental health outcomes in HIV-positive individuals who were victims of childhood maltreatment.

Methods

A systematic search of all retrospective, prospective, or clinical trial studies assessing mental health outcomes associated with HIV and childhood maltreatment. The following online databases were searched on 25–31 August 2010: PubMed, Social Science Citation Index, and the Cochrane Library (the Cochrane Central Register of Controlled Trials and the Cochrane Developmental, Psychosocial and Learning Problems, HIV/AIDS, and Depression, Anxiety and Neurosis registers).

Results

We identified 34 studies suitable for inclusion. A total of 14,935 participants were included in these studies. A variety of mixed mental health outcomes were reported. The most commonly reported psychiatric disorders among HIV-positive individuals with a history of childhood maltreatment included: substance abuse, major depressive disorder, and posttraumatic stress disorder. An association between childhood maltreatment and poor adherence to antiretroviral regimens was also reported in some studies.

Conclusion

A broad range of adult psychopathology has been reported in studies of HIV-infected individuals with a history of childhood maltreatment. However, a direct causal link cannot be well established. Longer term assessment will better delineate the nature, severity, and temporal relationship of childhood maltreatment to mental health outcomes.

Keywords:
AIDS; Anxiety; Childhood maltreatment; Depression; HIV; Psychiatric morbidity; Substance abuse