This study assessed the ability of the Posttraumatic Stress Disorder (PTSD) Checklist for the DSM-5 (PCL-5) to distinguish between caseness and noncaseness for PTSD among South Africans receiving care for HIV. The PCL-5 and the Structured Clinical Interview for DSM-5–Research Version (SCID-RV) module for PTSD were administered to 688 patients receiving antiretroviral therapy (ART) at two HIV care clinics in the greater Cape Town (South Africa) area. In total, nearly half of the sample (n = 324, 47.1%) reported experiencing an index traumatic event, and 101 participants (14.74%, 95% CI [12.17%, 17.62%]) met the diagnostic criteria for PTSD as measured using the SCID-RV. An ROC curve analysis suggested that a PCL-5 cutoff score of 32 yielded optimal sensitivity (0.88) and specificity (0.88), indicating that the measure was successful in determining caseness for PTSD 88% of the time and noncaseness 88% of the time. The AUC was 94.3%, 95% CI [92.6% to 96.1%], indicating high accuracy. The positive predictive value and negative predictive values were 56.3% and 97.7%, respectively, which suggests that the PCL-5 is an effective screening instrument to determine the presence of PTSD among South African ART users. Undetected and, thus, untreated PTSD may reduce quality of life, impede optimal adherence to ART, and increase the likelihood of risk behaviors among individuals living with HIV, contributing to further infections. The PCL-5 may be used for detection, referral, and treatment of PTSD as a way to enhance its management among individuals receiving HIV care.

中文翻译：

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在接受 HIV 治疗的患者中使用 DSM-5 的 PTSD 检查表预测创伤后应激障碍病例数

本研究评估了DSM-5 (PCL-5) 的创伤后应激障碍 (PTSD) 清单区分接受 HIV 护理的南非人中 PTSD 的病例和非病例的能力。在大开普敦（南非）地区的两家 HIV 护理诊所，对 688 名接受抗逆转录病毒治疗 (ART) 的患者进行了 PCL-5 和DSM-5的结构化临床访谈- 研究版 (SCID-RV) 模块. 总共有近一半的样本（n= 324, 47.1%) 报告经历过指数创伤事件，101 名参与者 (14.74%, 95% CI [12.17%, 17.62%]) 符合使用 SCID-RV 测量的 PTSD 诊断标准。ROC 曲线分析表明，32 分的 PCL-5 截止分数产生最佳敏感性 (0.88) 和特异性 (0.88)，表明该措施成功地确定了 88% 的时间的 PTSD 病例和 88% 的时间的非病例。AUC 为 94.3%，95% CI [92.6% 至 96.1%]，表明准确度很高。阳性预测值和阴性预测值分别为 56.3% 和 97.7%，这表明 PCL-5 是确定南非 ART 使用者中是否存在 PTSD 的有效筛查工具。未发现并因此未治疗的 PTSD 可能会降低生活质量，阻碍对 ART 的最佳依从性，并增加 HIV 感染者发生危险行为的可能性，从而导致进一步感染。PCL-5 可用于检测、转诊和治疗 PTSD，以加强对接受 HIV 护理的个人的管理。