Association between sexual violence and psychiatric morbidity among HIV positive women in South Africa.

This study examined the association between rape and psychiatric morbidity among recently diagnosed HIV-infected women in South-Africa. One hundred and five women attending an out-patient infectious disease clinic of the Department of Internal Medicine, Tygerberg Hospital, Cape Town, South-Africa participated in the study. Full medical as well as socio-demographic histories were obtained for each patient. Psychiatric morbidity was assessed with the MINI International Neuropsychiatric Interview (MINI). Life-time prevalence of rape among the women was 4.8%. A significant relationship was found between rape and (i) drug dependence (X2 = 40.77, P < 0.00), (ii) alcohol dependence (X2 = 14.37, P < 0.01), (iii) post traumatic stress disorder (X2 = 8.91, P < 0.02), and (iv) major depression (X2 = 4.57, P < 0.05). Women who were raped were more likely to be younger (t = 2.86, P < 0.05), Afrikaans-speaking (X2 = 7.39, P < 0.02), and unemployed (X2 = 6.42, P < 0.04). HIV positive women with a history of having been raped may experience a number of psychiatric disorders. As part of the comprehensive medical care of HIV, it is important that health workers assess past sexual abuse and current psychiatric symptoms.