Prevalence of PTSD and depression, and associated sexual risk factors, among male Rwanda Defense Forces military personnel.
OBJECTIVES
To assess depression and PTSD prevalence among the Rwanda Defense Forces (RDF) and evaluate whether sexual risk behaviour, STIs, HIV and alcohol use were significantly higher among those who screened positive.


METHODS
Consenting active-duty male RDF personnel, aged ≥21 years, completed an anonymous sexual risk survey linked to HIV rapid testing that included standardised assessments for PTSD (PCL-M), depression (CES-D) and alcohol use (AUDIT). PTSD and depression prevalence were calculated (data available for 1238 and 1120 participants, respectively), and multivariable regression analyses were conducted.


RESULTS
22.5% screened positive for depression, 4.2% for PTSD and 3.4% for both. In adjusted analyses, odds of either depression or PTSD were significantly higher in participants reporting STI symptoms (OR = 2.27, 2.78, respectively) and harmful alcohol use (OR = 3.13, 3.21, respectively). Sex with a high-risk sex partner, lower rank and never deploying were also significantly associated with depression in adjusted analyses.


CONCLUSIONS
Nearly one-fourth of RDF participants screened positive for PTSD or depression, which impacts sexual risk behaviour, HIV acquisition risk and military readiness. Findings may extend to other deploying militaries and provide additional evidence of an association between mental health status and sexual risk behaviour. Effective mental health treatment interventions that also include alcohol use assessments, STI identification/treatment and sexual risk behaviour reduction are needed.
['Harbertson|Judith|J|', 'Grillo|Michael|M|', 'Zimulinda|Eugene|E|', 'Murego|Charles|C|', 'Cronan|Terry|T|', 'May|Susanne|S|', 'Brodine|Stephanie|S|', 'Sebagabo|Marcellin|M|', 'Araneta|Maria Rosario G|MR|', 'Shaffer|Richard|R|']
D000328:Adult D000428:Alcohol Drinking D003430:Cross-Sectional Studies D003866:Depressive Disorder D015658:HIV Infections D006801:Humans D008297:Male D008889:Military Personnel D015995:Prevalence D012044:Regression Analysis D012307:Risk Factors D012432:Rwanda D012749:Sexually Transmitted Diseases D013313:Stress Disorders, Post-Traumatic D047568:Unsafe Sex D055815:Young Adult
PTSD Depression and sexual risk in the Rwanda Defense Forces