Psychological pathways to HIV-related posttraumatic stress disorder symptoms among people living with HIV in China: the mediating role of rumination

The occurrence of HIV-related posttraumatic stress disorder (PTSD) compromises the physical and mental health of people living with HIV (PLWH). This study examined the psychological pathways of HIV-related PTSD symptoms considering the influence of rumination in PLWH of China. A cross-sectional survey was conducted in Changsha, China. The data were collected using the PTSD Checklist-Civilian Version, the Ruminative Response Scale, the Multidimensional Scale of Perceived Social Support, and measures of sociodemographic and HIV-related clinic characteristics. A total of 602 PLWH were surveyed. The average score of HIV-related PTSD symptoms was (34.54 +/- 13.58). The mediation model showed that perceived social stigma and physical health exhibited direct associations with PTSD symptoms (beta = 0.093, -0.145, respectively), while the direct relations of family support, friend support and significant others support to PTSD symptoms were not significant. Rumination mediated the effect of perceived social stigma (beta = 0.077), physical health (beta = -0.150), family support (beta = -0.144) and friend support (beta = -0.105) on PTSD symptoms. The study findings underscore the importance of routinely assessing PTSD for PLWH, and developing trauma-focused interventions that alleviate HIV-related PTSD symptoms and reduce rumination while improving social support and physical health and reducing social stigma.