PTSD May Increase Morbidity Risk in Veterans With HIV
Posttraumatic stress disorder (PTSD) among veterans living with HIV significantly increased the risk for AIDS and multiple comorbidities, particularly arthritis, cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), and multimorbidity — with the greatest impact seen in the first decade after diagnosis.
METHODOLOGY:
Researchers conducted a prospective cohort study to assess whether PTSD is associated with increased risk for adverse clinical outcomes in veterans with HIV who received care at the Department of Veterans Affairs.
They included 3206 veterans (97.4% men; median age at HIV diagnosis, 31.7 years; 42.1% with PTSD) who were deployed in Iraq and Afghanistan while serving in the military and initiated antiretroviral therapy before December 31, 2020.
Participants were followed-up until December 2022, with censoring at death, the last healthcare visit, or study termination. The association between PTSD with morbidity and mortality, considering the number of deployments and levels of combat exposure were determined.
TAKEAWAY:
PTSD significantly increased the overall risks for AIDS by 11% (adjusted hazard ratio [aHR], 1.11), CKD by 21% (aHR, 1.21), COPD by 46% (aHR, 1.46), multimorbidity by 49% (aHR, 1.49), CVD by 57% (aHR, 1.57), and arthritis by two folds (aHR, 1.95; P <.05 for all).
<.05 for all). Among veterans with a single deployment, those with PTSD had 92%, 87%, 80%, 53%, 44%, 32%, and 27% higher risks for asthma, CVD, arthritis, multimorbidity, COPD, liver disease, and AIDS, respectively, than those without PTSD.
Veterans with PTSD and combat exposure had a lower risk for AIDS but higher risks for multimorbidity, asthma, CVD, and arthritis than those never diagnosed with PTSD and unexposed to combat.
The associations of PTSD with mortality and morbidity appeared most pronounced in the first decade post-diagnosis, followed by a gradual decline in association strength; however, risks remained elevated.
IN PRACTICE:
'It is recommended that providers who work with VWH [veterans with HIV] consider adopting a trauma-informed model of HIV care and that providers screen veterans for PTSD, so that their unique trauma history can help guide medical decisions and treatment,' the authors wrote.
SOURCE:
This study was led by Kartavya J. Vyas, PhD, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta. It was published online on May 22, 2025, in AIDS .
LIMITATIONS:
The data could not capture each individual's true index trauma or the severity of their PTSD. Additionally, the study was limited by considerable loss to follow-up, potential uncontrolled confounding related to homelessness, and a lack of generalizability to veterans with HIV who were not receiving antiretroviral therapy.
DISCLOSURES:
The study did not receive any specific funding. Two authors reported receiving federal research support — one from the Emory Center for AIDS Research and the National Institute of Allergy and Infectious Diseases, and the other from the National Institutes of Health and the CDC — in addition to investigator-initiated grants and consulting fees from various pharmaceutical companies.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
38 minutes ago
- Yahoo
Here's what to know about the twice-yearly preventative HIV shot
The Food and Drug Administration has approved a twice-yearly preventive HIV shot that could protect millions from the virus. People at risk for HIV may choose to take PrEP, a medication that helps prevent HIV infection. PrEp has been prescribed as a daily pill or a shot given every two months. This new twice-yearly drug called lenacapavir is now the longest-lasting type of PrEP. Ian Haddock, a Houston man who participated in a study of the drug, told The Associated Press it 'expands the opportunity for prevention.' 'Now I forget that I'm on PrEP because I don't have to carry around a pill bottle,' he said. The shot, made by Gilead Sciences, is injected under the skin of the abdomen. It leaves a small 'depot' of medication that slowly absorbs into the body. 'This really has the possibility of ending HIV transmission,' Greg Millett, public policy director at amfAR, The Foundation for AIDS Research, told the AP. But the upheaval in U.S. healthcare — including cuts to public health agencies and Medicaid — and slashing of American foreign aid to fight HIV are clouding the prospects. Millett said "gaping holes in the system" in the U.S. and globally "are going to make it difficult for us to make sure we not only get lenacapavir into people's bodies but make sure they come back' even as little as twice a year. Gilead's drug already is sold to treat HIV under the brand name Sunlenca. The prevention dose will be sold under a different name, Yeztugo. Gilead didn't immediately announce its price. The drug only prevents HIV transmission – it doesn't block other sexually transmitted diseases. Global efforts at ending the HIV pandemic by 2030 have stalled. There still are more than 30,000 new infections in the U.S. each year and about 1.3 million worldwide. Only about 400,000 Americans already use some form of PrEP, a fraction of those estimated to benefit. A recent study found states with high use of PrEP saw a decrease in HIV infections, while rates continued rising elsewhere. About half of new infections are in women, who often need protection they can use without a partner's knowledge or consent. One rigorous study in South Africa and Uganda compared more than 5,300 sexually active young women and teen girls given twice-yearly lenacapavir or the daily pills. There were no HIV infections in those receiving the shot while about 2% in the comparison group caught HIV from infected sex partners. A second study found the twice-yearly shot nearly as effective in gay men and gender-nonconforming people in the U.S. and in several other countries hard-hit by HIV. Haddock, who leads the Normal Anomaly Initiative, a nonprofit serving Black LGBTQ+ communities, had tried PrEP off and on since 2015 but he jumped at the chance to participate in the lenacapavir study and continues with the twice-yearly shots as part of the research follow-up. 'Men, women, gay, straight – it really just kinds of expands the opportunity for prevention,' he added. Just remembering a clinic visit every six months 'is a powerful tool versus constantly having to talk about, like, condoms, constantly making sure you're taking your pill every day.' 'Everyone in every country who's at risk of HIV needs access to PrEP,' Dr. Gordon Crofoot of Houston, who helped lead the study in men, told the AP. 'We need to get easier access to PrEP that's highly effective like this is.'
CBS News
an hour ago
- CBS News
Pandemic-era puppies, kittens now filling San Francisco shelters beyond capacity
The COVID-19 pandemic is still having a deadly effect on the pet population. The number of unwanted animals is straining San Francisco's shelter capacity to the breaking point, sometimes with tragic results. Just about every animal shelter in the state is jammed these days and it all points back to the pandemic when shelters were empty and it was hard to find any animal to adopt, as people tried to cope with COVID isolation. But also at that time, spaying and neutering were suspended or drastically reduced. And now those generations of puppies and kittens are filling the shelters. "So, not just in San Francisco, but in California and nationwide, we are like two million spay/neuters behind. So, that just leads to more and more accidental breeding," said Virginia Donohue, Executive Director of San Francisco's Animal Care and Control. "Pre-pandemic, we were full a couple times a year. Now we're full a couple times a month. It is a constant problem. It's no longer an occasional problem." And it can have heartbreaking consequences. SF Animal Care and Control works to find unwanted pets a home, but when none is available, they must turn to euthanasia to make room. "We try very hard to euthanize just for medical and behavior issues," said Donohue. "But there are points when an animal is here too long and nobody is coming for it, we don't have a place for it to go and its behavior is deteriorating. Then we're going to euthanasia." One of the reasons the city's public animal shelter is so full is because its major adoption partner, the San Francisco SPCA, is taking a lot fewer dogs and cats than it used to. The SF SPCA, which is a private entity, has joined forces with the Stockton SPCA and is now rescuing a lot more unwanted pets from the Central Valley. "Historically, they've taken as many as 600 dogs," said SF's Donohue. "Currently, it's under 200. So, obviously, that's a pain point." It's also a reason why Animal Care and Control is having to turn to euthanasia. Another is that the shelter has a "custody" program that holds dogs up to two weeks for people who go to jail or the hospital or who die. That all takes space from those pets looking to be adopted. On Saturday, a dog owner named Ethan said he sometimes wonders where they're all coming from. "To see the amount of people out there that have dogs that aren't taking care of them, like, I don't really understand how they got these dogs in the first place," he said. The dogs are out there, many in desperate need of a caring home. But there is only so much space in the shelters and reducing the population is now more than just a humane thing to do. It's becoming a matter of life and death. "I mean, don't get a dog if you weren't intending to get a dog," Donohue said. "But if you want a dog, just look at your local shelter first. Even if you don't find the dog of your dreams there, just look and see what's available."
Yahoo
an hour ago
- Yahoo
Colorectal cancer isn't an 'old person's disease,' advocates warn. A stage 4 cancer survivor shares 5 things you should never do if you want to avoid the disease
Colorectal cancer is a serious health risk for many Canadians — including people under age 50. More than 25,200 people were diagnosed with colorectal cancer in 2024, making it the fourth most commonly diagnosed cancer in Canada last year. Now, advocates want all provinces and territories to lower the screening age for the disease to 45. "Our objective is to ensure that young Canadians do not ignore the signs and symptoms just because of their age and that they are aware of their family medical history and risk level, as we call on our provincial and territorial health ministries to lower the screening age for colorectal cancer throughout the country to 45," Barry Stein, president and CEO of Colorectal Cancer Canada, explains in a press release on Tuesday. This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle. The non-profit adds that colorectal cancer might be perceived as an "old person's disease," but shares that early-onset colorectal cancer is on the rise and that cancer doesn't care about your age. Most new cases still occur in people age 50 and above, but Canadians born after 1980 are two to two-and-a-half times more likely to be diagnosed with colorectal cancer before age 50 compared to earlier generations. According Colorectal Cancer Canada, 26 people die from the illness everyday on average, with around 69 people receiving a diagnosis daily. For 2024, it was estimated that 9,400 Canadians died from colorectal cancer, making up 11 per cent of all cancer deaths last year. View this post on Instagram A post shared by Colorectal Cancer Canada (@coloncanada) Colorectal cancer cancer grows more slowly than some other cancer and can stay in the colon or rectum for months or even years. If left untreated, it can spread to other parts of the body, but if found early, colorectal cancer can often be cured. This is why Stein points out that colorectal cancer can be preventable through lifestyle choices, awareness of symptoms and early screening. In 1995, while juggling the demands of his legal career, Stein began noticing various concerning symptoms. Those included blood in his stool, migraines, abdominal pain and nausea, which he dismissed as related to stress. "I was turning 41 at the time and had no idea what cancer even was," Stein recalls in a previous interview with Yahoo Canada. "People didn't say that word so much in 1995, let alone colorectal cancer. These were symptoms that came and went, so I ignored them." It wasn't until he finally had a fecal occult blood test and colonoscopies that the diagnosis hit: Stage IV colorectal cancer, which had spread to his liver and lungs. Still, Stein stresses a person's health doesn't have to get to this point; he shares five things Canadians should and shouldn't do to help prevent colorectal cancer. Unexplained changes in bowel habits, blood in the stool, persistent abdominal pain, unexplained weight loss or fatigue should never be symptoms you ignore. These signs might also be linked to other gastrointestinal conditions, including ulcers, Crohn's disease or hemorrhoids, according to the Colorectal Cancer Canada website. That means "just because you have these symptoms doesn't mean you have colon cancer," Stein adds. "But they are a reason to be checked out." Regular screenings are important because colorectal cancer often develops from precancerous polyps, or growths in the colon or rectum. Catching and removing these polyps early can prevent them from becoming cancerous. Starting at age 50, you should undergo routine fecal occult blood tests and colonoscopies. Even though everybody has the right to get screened starting at age 50, the Canadian Partnership Against Cancer states the "screening participation rate across the country is still below the national target of 60 per cent." Despite this, Colorectal Cancer Canada highlights that the screening guidelines have effectively reduced cancer rates in those over age 50, demonstrating their life-saving potential. However, there is a rise in cases among younger adults, particularly those with a family history of colorectal cancer, Stein notes. These individuals are often diagnosed at a later stage because they are not getting screened and health-care professionals may not suspect cancer at a young age. If you're under 50 and experiencing related symptoms, or have a family history of colorectal cancer or polyps, you may need to start screening early. "Speak to your doctor about your personal testing plan," the organization advises. The Foods That Fight Cancer program by Colorectal Cancer Canada recommends eating a diet rich in whole grains, fruits and vegetables. These foods are high in fibre, which helps keep the digestive system healthy and can lower the risk of colorectal cancer. In addition to these foods, the program advises limiting the intake of processed meats and red meat, which are associated with a higher risk of colorectal cancer. It also recommends reducing the amount of alcohol and sugary beverages you drink. Highly processed foods should be minimized as well. By making these dietary changes, the risk of developing colorectal cancer can be minimized, Stein points out. Incorporate regular exercise into your routine, as physical inactivity is a significant risk factor for colorectal cancer. Stein highlights, "Having a sedentary lifestyle, in other words, being a couch potato, is a risk factor." Staying active not only helps maintain a healthy weight but also reduces the risk of colorectal cancer. According to Colorectal Cancer Canada, regular physical activity can lower the risk by improving bowel function and reducing inflammation. Discuss your family history of colorectal cancer with a health-care provider so you understand the risk. If you have a first-degree relative — such as a parent, sibling or child — who's had colorectal cancer, your risk is higher. Shared genetics and lifestyle factors contribute to this increased risk, according to Colorectal Cancer Canada. Moreover, genetic syndromes like Lynch syndrome (hereditary nonpolyposis colorectal cancer) can elevate your risk further. People with Lynch syndrome are more likely to develop colorectal cancer, often at a younger age. Other inherited conditions, like familial adenomatous polyposis (FAP), which causes numerous polyps in the colon and rectum, also heighten the risk. "Your age and generic history of your family are risk factors that you can't control," Stein says, adding the goal is to focus on what can be controlled, like eating healthier foods and exercising. Prevention is often more straightforward than treatment, which can be invasive and challenging. As Stein states, "it's so much easier to prevent something (than to treat it)." "All you have to do is get a kit, poop in your toilet, send it to the lab with a little stick and you find out if it's positive," Stein explains. If it does turn out positive, you would then go for a colonoscopy so that the polyp can be located. "If there is a polyp, they remove it and you catch the cancer early. Otherwise, you go through what I went through, which is quite challenging, to say the least. And at worst, people die." By focusing on early screening and prevention, potential issues can be caught early before developing into cancer, ultimately saving lives and reducing the burden of treatment.
