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0 -1.2203 TD
[(seling)-338.5(by)-331.3(study)-333(trauma)-334.2(counselors)-338.8(at)-335.1(another)-338.9(time.)-333.2(If)-331.4(a)-334.6(par-)]TJ
T*
[(ticipant)-359.3(had)-353.7(an)-350.7(acute)-354.6(medical)-347.8(illness)-357.9(during)-351.5(the)-351.5(study)-358.3(visit,)]TJ
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[(she)-200.6(was)-192.1(referred)-201.3(to)-192.9(a)-195.5(clinical)-199(provider)-196.1(in)-196.6(the)-199.8(colocated)-193.9(clinic)-195.9(or)]TJ
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[(to)-281.4(her)-282.2(primary)-286(care)-277.6(site.)]TJ
/F10 1 Tf
0 -2.4406 TD
(Measures)Tj
/F5 1 Tf
1.1128 -1.8336 TD
[(Sociodemographic)-515.5(and)-511.7(health)-516(factors)-510.4(assessed)-513.4(included)]TJ
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[(age)-376.9(at)-373(study)-371(visit,)-372.9(marital)-371.6(status,)-380.4(monthly)-369.6(income,)-376.1(employ-)]TJ
0 -1.2203 TD
[(ment,)-288.8(educational)-294.5(attainment,)-289.3(reading)-286.3(ability,)-287.9(healthcare)-287.8(use)]TJ
T*
[(\(care)-290.7(settings)-293(and)-290.4(treatment)-293.2(by)-287(trauma)-290(counselors\),)-297.9(HIV)-289.4(ser-)]TJ
0 -1.2266 TD
[(ostatus,)-225.1(and,)-211.2(for)-218.9(the)-218.7(HIV-positive)-221.3(participants,)-219.7(CD4)-216.1(cell)-221.2(count)]TJ
0 -1.2203 TD
[(and)-334.7(reported)-337.6(use)-337.7(of)-332(ART.)-334(Participants)-336.9(were)-337.2(also)-329.6(questioned)]TJ
T*
[(about)-242.5(postgenocidal)-240.2(physical)-244(and)-239.8(sexual)-235.4(abuse)-240.5(and)-239.8(threats)-239.7(to)]TJ
0 -1.2266 TD
[(their)-286.2(safety.)]TJ
/F10 1 Tf
0 -2.4406 TD
[(Harvard)-336(Trauma)-332.5(Questionnaire)]TJ
/F5 1 Tf
1.1128 -1.8336 TD
[(RWISA)-289.8(trauma)-290(counselors)-294.5(were)-286.7(trained)-288.7(by)-287(the)-294.6(study)-288.8(psy-)]TJ
-1.1128 -1.2203 TD
[(chologist)-242.8(to)-237.2(use)-236.5(the)-244(Harvard)-238.1(Trauma)-235.6(Questionnaire)-244.1(\(HTQ\))-234.6(to)]TJ
0 -1.2266 TD
[(determine)-318.2(events)-321.8(experienced)-316.5(during)-313.6(the)-319.9(1994)-307.9(genocide)-319.7(and)]TJ
0 -1.2203 TD
[(responses)-315.5(to)-306.7(these)-308.5(events.)-305.8(The)-309.8(HTQ)-303.2(is)-308.3(a)-303(cross-culturally)-308.1(val-)]TJ
T*
[(idated)-300.3(instrument)-302.9(measuring)-296.2(trauma)-296.3(and)-296.8(torture)-297.2(events)-302.9(and)]TJ
0 -1.2266 TD
[(symptoms.)-414.4(In)-410.2(accordance)-411.3(with)-413.7(World)-407.4(Health)-411.4(Organization)]TJ
0 -1.2203 TD
[(\(WHO\))-344.4(guidelines)-333.7(for)-339.1(cross-cultural)-344.4(translation)-341.1(and)-334.7(adapta-)]TJ
T*
[(tion,)-234.4(the)-231.4(HTQ)-233.7(was)-230.1(translated)-233.1(into)-231.5(French,)-235.3(then)-228.4(Kinyarwanda,)]TJ
0 -1.2266 TD
[(followed)-321.1(by)-312.3(blind)-315.1(back-translation)-323.9(into)-313.7(French)-320.9(and)-315.7(then)-317(En-)]TJ
0 -1.2203 TD
(glish.)Tj
6.7246 0 0 5.9768 334.2046 379.0487 Tm
(14)Tj
8.9663 0 0 8.9663 344.6361 375.0802 Tm
[(Three)-411.6(focus)-409.9(groups)-416.6(comprising)-409.9(six)-411.7(to)-414.2(eight)-416.4(trauma)]TJ
-3.5219 -1.2203 TD
[(counselors)-547.5(from)-532.6(different)-543(Rwandan)-539.5(womens)-539.6(associations)]TJ
T*
[(reviewed)-319.1(the)-313.6(questionnaire)-321.4(item-by-item,)-319.1(adapting)-312.4(the)-319.9(HTQ)]TJ
0 -1.2266 TD
[(items)-337.9(to)-332(the)-332.5(Rwandan)-330.8(experience)-338.8(and)-334.7(the)-332.6(Kinyarwanda)-331.2(lin-)]TJ
0 -1.2203 TD
[(guistic)-247.9(equivalent.)-241(The)-246.6(instrument)-246(was)-236.4(then)-247.4(piloted)-242.2(to)-237.2(ensure)]TJ
T*
[(that)-535(the)-528.6(words)-534.2(and)-530.7(descriptions)-532.7(of)-534.4(traumatic)-527.2(events)-536.8(and)]TJ
0 -1.2266 TD
[(symptoms)-209.1(were)-210.8(relevant)-210.5(to)-205.6(women)-207.6(who)-203.8(had)-208.2(lived)-206.7(in)-209.2(Rwanda)]TJ
0 -1.2203 TD
[(during)-421.1(the)-421.1(genocide.)-417.5(The)-423.6(instrument)-423.1(was)-413.4(revised)-420.1(to)-420.6(incor-)]TJ
T*
[(porate)-200.7(this)-192.1(input)-193.5(and)-189.3(then)-196.8(administered)-199.2(by)-185.9(the)-199.8(trained)-193.9(trauma)]TJ
0 -1.2266 TD
[(counselors)-288.2(to)-281.4(all)-278.5(RWISA)-283.5(participants.)]TJ
1.1128 -1.2203 TD
[(During)-602.8(the)-598.1(baseline)-597.2(visit,)-600.5(trauma)-593.5(counselors)-604.4(spent)-600.8(45)]TJ
-1.1128 -1.2203 TD
[(minutes)-336.3(administering)-340.4(the)-332.5(HTQ,)-337.7(as)-329.6(well)-337.4(as)-329.6(additional)-338.4(ques-)]TJ
T*
[(tions)-188.5(about)-191.9(reported)-185.8(rape.)-187.7(Participants)-191.5(were)-185.5(asked)-185.2(specically)]TJ
0 -1.2266 TD
[(about)-324.7(their)-317.8(experiences)-327.5(during)-313.6(the)-319.9(genocide,)-322.6(including)-322.6(trau-)]TJ
0 -1.2203 TD
[(ma)-306.9(experiences,)-305.1(head)-303(injury,)-305.8(torture,)-300.1(and)-303.1(rape.)-301.6(Women)-306.2(who)]TJ
T*
[(reported)-242.7(being)-237(raped)-238.4(during)-237.7(the)-237.7(genocide)-243.8(were)-236.1(asked)-235.8(further)]TJ
0 -1.2267 TD
[(detailed)-449.1(questions)-448.4(about)-444.8(the)-446.4(method,)-446.3(number)-449.9(of)-445.8(episodes,)]TJ
0 -1.2203 TD
[(duration,)-574.1(place,)-569.2(and)-568.6(physical)-566.4(sequelae)-572.6(of)-566(the)-572.8(rapes.)-568.4(The)]TJ
T*
[(trauma)-416.4(counselors)-421(and)-416.9(study)-415.2(staff)-419.5(created)-413.7(an)-420.2(environment)]TJ
0 -1.2266 TD
[(where)-372.2(women)-365.7(could)-370.3(disclose)-362.4(their)-368.4(traumatic)-369.1(history)-370.7(by)-362.9(an-)]TJ
0 -1.2203 TD
[(swering)-457.5(yes)-448.2(or)-452.4(no)-455.1(to)-452.2(specic)-450.3(questions)-454.7(or)-452.4(by)-451.4(providing)-453.4(a)]TJ
T*
[(narrative.)-390.8(There)-379.9(was)-381.8(no)-385.5(pressure)-385.9(to)-382.6(disclose)-381.4(more)-386.6(than)-379.8(the)]TJ
0 -1.2266 TD
[(participants)-317.9(desired,)-311.4(allowing)-306.8(them)-311.1(to)-313.1(determine)-311.8(how)-311.3(much)]TJ
0 -1.2203 TD
[(they)-450.8(wanted)-444.2(to)-452.2(share.)-444(The)-448.9(interviewers)-445.7(were)-451(trained)-446.8(by)-445.1(a)]TJ
T*
[(psychologist)-363.7(and)-353.7(responded)-356.8(to)-357.3(emotional)-354.9(distress)-359.3(in)-348.4(cultur-)]TJ
T*
[(ally)-257.6(sensitive)-267(and)-258.8(therapeutic)-262.8(ways.)-256.4(Participants)-261(were)-261.4(able)-254(to)]TJ
0 -1.2266 TD
[(return)-284.7(for)-282.2(up)-280.9(to)-281.5(three)-282.6(debrieng)-287.8(sessions.)]TJ
1.1128 -1.2203 TD
[(The)-385.7(total)-392.5(number)-386.7(of)-382.6(genocidal)-392.4(trauma)-384.8(events)-391.4(was)-381.8(calcu-)]TJ
-1.1128 -1.2203 TD
[(lated)-290.9(and)-284.1(presented)-288.1(as)-285.4(a)-277.7(number)-285.5(and)-290.4(in)-278.8(relation)-292(to)-281.5(the)-288.3(mean)]TJ
0 -1.2267 TD
[(number)-209.7(for)-212.6(the)-206.1(cohort.)-208.3(The)-208.6(HTQ)-208.4(also)-209.5(includes)-211.3(a)-208.2(measurement)]TJ
/F3 1 Tf
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(1326)Tj
47.504 0 TD
[(COHEN)-331.9(ET)-338.7(AL.)]TJ
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[(symptoms)-316.6(required)-317(for)-313.8(a)-315.7(DSM)-314.8(IV)-314.8(diagnosis:)-316.6(reexperiencing,)]TJ
0 -1.2266 TD
[(avoidance,)-602.6(and)-600.3(hyperarousal.)-609.4(Each)-599.5(category)-599.5(had)-600.3(several)]TJ
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[(components,)-211.1(all)-208.9(of)-205.6(which)-207.2(were)-204.5(scored.)-205.9(A)-203.7(nal)-211.8(mean)-202.7(score)-206.3(was)]TJ
T*
[(calculated.)-435.9(Mean)-431.5(HTQ)-429.7(scores)]TJ
/F6 1 Tf
13.9167 0 TD
(>)Tj
/F5 1 Tf
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[(2)-429.5(meet)-434.1(DSM-IV)-434(diagnostic)]TJ
-14.6312 -1.2266 TD
[(criteria)-184.7(for)-181(PTSD,)-184.2(and)-182.9(women)-182.3(with)-186.1(mean)-177.4(HTQ)-183.1(scores)]TJ
/F6 1 Tf
23.1166 0 TD
(>)Tj
/F5 1 Tf
.7145 0 TD
[(2)-182.9(were)]TJ
-23.8311 -1.2203 TD
[(categorized)-202.7(as)-190.5(having)-198.3(PTSD)-193.9(in)-196.6(this)-198.4(study.)-190.5(During)-198.2(the)-199.8(6-month)]TJ
T*
[(follow-up)-511.1(study)-503.7(visits,)-500.7(genocidal)-506.2(trauma)-504.9(events)-505.2(were)-507.9(not)]TJ
0 -1.2266 TD
[(discussed,)-307.8(but)-297.1(the)-307.3(participants)-305.3(were)-299.3(again)-301.2(asked)-299(about)-305.7(trau-)]TJ
0 -1.2203 TD
[(ma)-281.6(symptoms.)]TJ
/F10 1 Tf
0 -2.8327 TD
[(Depressive)-334.3(symptoms)]TJ
/F5 1 Tf
1.1128 -1.8336 TD
[(The)-512.1(Center)-516.7(for)-509.8(Epidemiologic)-515.1(Studies)-513.9(Depression)-515.1(Scale)]TJ
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[(\(CES-D\),)-462.6(a)-454.8(widely)-452.3(used)-460.8(validated)-455.8(20-item)-456.2(scale,)-455.4(measured)]TJ
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[(depressive)-321.5(symptoms,)-319.5(with)-318.8(the)-319.9(standard)-314.4(cutoff)-321(of)]TJ
/F6 1 Tf
22.5728 0 TD
()Tj
/F5 1 Tf
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[(16)-315.2(indi-)]TJ
-23.2936 -1.2203 TD
[(cating)-333.1(clinically)-333.4(signicant)-331.7(symptoms)-335.6(of)-332(depression)-333.3(and)-328.4(the)]TJ
T*
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[(27)-264.6(indicating)-277(major)-264.7(depressive)-277.2(disorder)-267.8(\()-82.7(MDD\).)]TJ
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(15)Tj
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[(were)-406.8(missing,)-403.7(using)-399.7(the)-402.1(person-mean)-408.6(approach,)-402.8(which)-403.2(has)]TJ
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[(been)-254.2(shown)-252.8(to)-249.8(be)-250.9(accurate.)]TJ
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(16)Tj
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[(In)-252.1(this)-249(approach,)-257.4(the)-250.3(full)-249.2(CES-D)]TJ
-12.7786 -1.2203 TD
[(is)-283.1(calculated)-281.3(as:)]TJ
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(20)Tj
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(=)Tj
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[(number)-336.1(of)-357.3(missing)-331.2(items\))]TJ
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[([person)-338.7(mean)-335.5(among)-336.4(nonmissing)-334.4(items])]TJ
/F10 1 Tf
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[(Statistical)-336.1(analysis)]TJ
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1.1128 -1.8336 TD
[(The)-461.5(Cronbach)]TJ
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(a)Tj
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[(,)-458.2(a)-461.1(measure)-461.8(of)-458.5(internal)-463.3(consistency)-468(reli-)]TJ
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[(ability,)-338.5(was)-331.2(estimated)-340.8(to)-332(be)-339.4(0.93)-330.2(for)-339.1(all)-329(40)-334.1(trauma)-334.2(symptom)]TJ
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[(items)-293.6(of)-287.8(the)-294.6(HTQ)-290.6(and)-290.4(was)-293.3(0.89)-286(for)-294.8(the)-288.3(CES-D,)-297.3(indicating)-289.6(ex-)]TJ
0 -1.2203 TD
[(cellent)-351.4(internal)-355.9(consistency.)-357.1(Differences)-351.7(in)-354.7(reported)-350.2(baseline)]TJ
0 -1.2266 TD
[(characteristics,)-483(including)-487(depressive)-485.9(symptoms)-481(and)-480.1(PTSD,)]TJ
0 -1.2203 TD
[(between)-306.8(HIV-infected)-312.5(and)-303.1(uninfected)-311.9(women)-308.7(were)-305.6(assessed)]TJ
T*
[(using)-279.6(chi-square,)-288.7(exact,)-276.1(and)]TJ
/F7 1 Tf
12.4814 0 TD
(t)Tj
/F5 1 Tf
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[(tests)-288(as)-279(appropriate.)]TJ
-11.9693 -1.2266 TD
[(We)-378.3(calculated)-388.8(the)-389.5(change)-382.9(in)-386.3(PTSD)-383.6(from)-387.2(baseline)-388.5(visit)-389(to)]TJ
-1.1128 -1.2203 TD
[(each)-381.5(of)-388.9(the)-383.1(follow-up)-390.9(visits)-384(and)-385.3(used)-384.9(linear)-383.6(regression)-391(and)]TJ
T*
[(analysis)-187.2(of)-186.6(variance)-189.9(\(ANOVA\))-186.6(models)-185.1(to)-186.6(statistically)-191.6(compare)]TJ
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[(these)-314.8(changes)-321(across)-314.7(different)-321.7(characteristics.)-324.9(A)-311.2(multivariate)]TJ
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[(model)-341.9(was)-350.2(then)-342.3(used)-347(to)-344.7(examine)-347.4(independent)-350(predictors)-354.5(of)]TJ
T*
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T*
[(ables)-274.2(from)-273.4(the)-275.6(univariate)-271.9(model)-278.7(that)-275.7(had)-271.5(the)-275.6(most)-274(consistent)]TJ
0 -1.2266 TD
[(associations)-404.4(with)-394.7(PTSD)-402.6(change)-401.9(as)-392.8(well)-400.6(as)-399.2(those)-399.9(with)-401(theo-)]TJ
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[(retical)-278.8(evidence)-287.9(for)-282.2(the)-282(association.)]TJ
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0 -2.447 TD
(Results)Tj
/F5 1 Tf
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[(Of)-275.4(the)-282(936)-283.1(participants)-286.3(enrolled)-282.3(in)-278.8(RWISA)-283.5(at)-278.2(baseline,)-284(698)]TJ
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[(\(163)-283.5(HIV-negative)-295.5(and)-290.4(535)-283.1(HIV-positive\))-297.7(subjects)-291.2(completed)]TJ
T*
[(the)-250.3(baseline)-255.8(HTQ)-252.6(and)-246.2(at)-252.9(least)-251.3(one)-252.7(postbaseline)-261.7(HTQ)-246.3(\(visits)-258(2,)]TJ
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[(3,)-268(and)-265.1(4\))-271.9(and)-265.1(were)-267.7(included)-269.9(in)-272.5(this)-267.9(analysis.)-272.4(The)-265.5(238)-270.4(subjects)]TJ
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[(without)-348.7(postbaseline)-350.2(HTQ)-341.1(data)-350.3(were)-343.6(excluded.)-350.2(Participants)]TJ
T*
[(included)-263.6(in)-259.8(the)-256.7(analysis)-263.1(were)-261.4(similar)-256.3(to)-262.5(those)-260.8(not)-265.9(included)-257.3(in)]TJ
T*
[(terms)-360.4(of)-370(age,)-360.8(marital)-365.2(status,)-361.4(income,)-369.8(education,)-363.9(HIV)-365.3(status,)]TJ
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[(experience)-623.3(of)-616.6(genocidal)-620(rape)-621.1(and)-619.2(traumatic)-622(events,)-621.9(and)]TJ
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[(baseline)-255.8(HTQ)-258.9(and)-258.8(CES-D)-256.4(scores.)-261.1(However,)-255.1(those)-260.8(included)-257.3(in)]TJ
T*
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(1.)Tj
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[(Baseline)-334.3(Characteristic)-335.2(of)-336.4(Rwanda)-338.3(Womens)-333.1(Interassociation)-339.5(Study)-331.3(and)-338(Assessment)-339(Participants)]TJ
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(HIV-negative)Tj
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[(visit)-452.2(to)-452.2(visit)-458.5(2,)-445(3,)-451.4(and)-454.8(4)-448.4(i)0(n)-455.8(linear)-453.2(regression)-454.2(models)-450.7(using)]TJ
T*
[(change)-376.6(as)-380.2(the)-376.8(outcome)-377.2(\(Table)-377.6(2\).)-376(For)-374.6(example,)-379.9(the)-376.8(variable)]TJ
0 -1.2266 TD
[(marital)-409.5(status)-409.1(shows)-408.8(change)-408.2(from)-406.2(study)-408.9(entry)-407.2(to)-407.9(visit)-407.9(2)-404.2(o)0(f)]TJ
/F6 1 Tf
.1644 -1.2203 TD
(-)Tj
/F5 1 Tf
.7208 0 TD
[(0.05)-349.2(for)-351.7(widowed,)-347.2(which)-352.7(means)-349.4(that)-351.6(PTSD)-345.7(declined)-357(from)]TJ
-.8852 -1.2203 TD
[(baseline)-356.9(to)-363.6(visit)-357.4(2)-353.6(b)0(y)-356.6(0.05)-355.5(units)-357.8(more)-361.3(for)-358(those)-355.6(who)-361.9(are)-354.2(wi-)]TJ
T*
[(dowed)-377(than)-379.8(it)-377.1(did)-376.3(for)-377(other)-380.3(groups.)-381.6(For)-374.6(the)-383.1(variable)-372.2(of)-382.6(ex-)]TJ
0 -1.2266 TD
[(perienced)-270.2(postgenocidal)-265.5(violence,)-268.9(the)-269.3(coefcient)-271.2(of)-262.5(0.07)-267(from)]TJ
0 -1.2203 TD
[(study)-333(entry)-337.7(to)-332(visit)-332.1(2)-334.6(means)-330.5(that)-332.6(for)-339.1(those)-330.3(who)-336.6(experienced)]TJ
T*
[(genocidal)-190.1(violence,)-186.7(the)-187.1(decline)-189.6(in)-184(PTSD)-187.6(from)-184.9(baseline)-192.5(to)-180.3(visit)-193(2)]TJ
0 -1.2267 TD
[(was)-280.7(0.07)-279.7(units)-281.9(less)-284.3(than)-285(for)-275.8(those)-286(who)-279.7(did)-281.4(not.)]TJ
29.1107 58.6703 TD
[(For)-273.5(reduction)-273.6(in)-266.2(HTQ)-271.6(score)-275.9(between)-268.8(the)-275.6(baseline)-268.4(visit)-275.1(and)]TJ
-1.1128 -1.2203 TD
[(visit)-407.9(2)-404.2(\(where)-404.3(the)-402.1(largest)-408.2(reduction)-406.4(between)-401.6(visits)-409.2(was)-400.8(ob-)]TJ
0 -1.2266 TD
[(served\),)-331.4(only)-323.9(high)-324.6(baseline)-325.3(PTSD)-326.7(was)-324.9(associated)-326.8(with)-325.2(a)-322(sig-)]TJ
0 -1.2203 TD
[(nicantly)-203.9(reduced)-196.8(HTQ)-195.7(score.)-202.9(This)-194.6(pattern)-201.8(of)-192.9(improvement)-203.9(in)]TJ
T*
[(PTSD)-440.5(in)-436.9(those)-437.8(participants)-444.4(with)-432.6(the)-440(highest)-440(baseline)-439.1(HTQ)]TJ
0 -1.2266 TD
[(scores)-308.8(continued)-301.6(from)-305(baseline)-300(to)-306.7(visits)-301.8(3)-296.7(and)-303.1(4.)-299.6(In)-302.7(addition,)]TJ
0 -1.2203 TD
[(the)-326.2(likelihood)-321.2(of)-319.4(a)-322(reduced)-323.3(HTQ)-315.9(score)-326.4(in)-316.7(visit)-325.7(3)-315.7(was)-324.9(signi-)]TJ
T*
[(cantly)-212.9(increased)-219.2(if)-212.7(the)-212.4(participant)-215.4(reported)-211.1(experiencing)-217.5(more)]TJ
0 -1.2266 TD
[(traumatic)-198.4(events.)-192(In)-188.9(changes)-194.6(from)-191.2(baseline)-198.9(to)-186.6(visit)-193(4,)-192.1(reporting)]TJ
0 -1.2203 TD
[(a)-284(higher)-287.2(number)-285.5(of)-287.8(traumatic)-280.6(events)-290.2(and)-284.1(experiencing)-287(geno-)]TJ
T*
[(cidal)-407.2(rape)-406.1(were)-400.5(signicantly)-409.2(associated)-402.6(with)-407.4(reduced)-405.5(HTQ)]TJ
T*
[(scores.)-299.1(Importantly,)-291.1(those)-298.7(participants)-292.6(with)-293.5(more)-291.8(depressive)]TJ
0 -1.2266 TD
[(symptoms)-322.9(\(CES-D)]TJ
/F6 1 Tf
8.6434 0 TD
()Tj
/F5 1 Tf
.7208 0 TD
[(16\))-315.6(were)-318.3(less)-322.2(likely)-316.5(to)-319.4(show)-312.6(declines)-323.7(in)]TJ
-9.3642 -1.2203 TD
[(their)-191.3(HTQ)-183.1(scores)-182.3(at)-183.3(each)-185.4(visit.)-183.2(Eighty)-183.6(percent)-188.4(of)-180.3(the)-187.1(cohort)-186.4(had)]TJ
T*
[(PTSD)-200.2(symptoms)-190.1(decrease)-199.5(from)-191.2(visit)-199.3(1)-189.2(t)0(o)-192.9(visit)-199.3(4.)-192.1(In)-195.2(general,)-191.3(the)]TJ
0 -1.2266 TD
[(same)-244.9(factors)-244.8(that)-244.1(were)-242.4(associated)-244.6(with)-243(linear)-244.5(change)-243.8(in)-240.9(PTSD)]TJ
0 -1.2203 TD
[(from)-184.9(visit)-186.6(1)-182.9(t)0(o)-180.3(visit)-186.6(4)-182.9(\(Table)-181.5(2\))-183.3(were)-185.5(also)-184.2(associated)-187.7(with)-179.7(lack)-183.8(of)]TJ
T*
[(improvement)-229.2(in)-228.2(PTSD)-225.5(from)-222.8(visit)-230.9(1)-220.8(t)0(o)-224.5(visit)-230.9(4)-220.8(\(data)-224.3(not)-227.9(shown\).)]TJ
1.1128 -1.2266 TD
[(Compared)-428.6(to)-426.9(uninfected)-432(women,)-425.5(women)-428.9(with)-426.3(HIV)-428.5(had)]TJ
-1.1128 -1.2203 TD
[(similar)-300.5(changes)-302.1(in)-304.1(HTQ)-296.9(scores)-302.5(in)-304.1(visits)-301.8(2)-296.7(and)-296.8(3)-303(but)-297.1(a)-303(signi-)]TJ
T*
[(cantly)-548.1(smaller)-537.2(reduction)-545.5(in)-538(HTQ)-543.5(scores)-542.7(in)-544.4(visit)-540.7(4.)-539.9(These)]TJ
T*
[(changes)-264.1(were)-255(not)-259.5(related)-259.9(to)-262.5(their)-254.6(CD4)-260.3(cell)-259.2(counts.)-258.1(As)-261.9(women)]TJ
0 -1.2266 TD
[(with)-382.1(HIV)-378(initiated)-384.1(indicated)-382.3(ART,)-378.3(we)-380.9(also)-380.2(investigated)-380.6(the)]TJ
0 -1.2203 TD
[(effect)-285(of)-281.4(its)-283.5(use)-280.8(on)-284.4(reducing)-281.1(HTQ)-277.9(scores.)-286.4(By)-279.3(the)-282(fourth)-281(study)]TJ
T*
[(visit,)-322.3(two)-314.7(thirds)-322.2(of)-313.1(the)-319.9(HIV-infected)-325.1(women)-315.1(reported)-318.6(taking)]TJ
0 -1.2266 TD
[(ARTs.)-196.2(As)-198.7(shown)-195.9(in)-196.6(Table)-193.7(2,)-198.4(however,)-195.3(there)-194(was)-198.5(no)-195.8(correlation)]TJ
0 -1.2203 TD
[(between)-572.3(antiretroviral)-569.6(medication)-563.1(use)-565.3(and)-562.3(reduced)-569.9(HTQ)]TJ
T*
(scores.)Tj
1.1128 -1.2266 TD
[(We)-302.4(then)-310.6(used)-302.7(a)-303(multivariate)-308(model)-304(to)-306.7(evaluate)-302.1(predictors)]TJ
-1.1128 -1.2203 TD
[(for)-326.4(the)-326.2(sustained)-329.9(reduction)-324.2(in)-329.4(HTQ)-322.2(scores)-327.7(from)-324(the)-326.2(baseline)]TJ
T*
[(visit)-256.2(to)-256.2(visit)-256.2(4)-252.4(\(Table)-257.4(3\).)-255.8(We)-251.8(included)-257.3(baseline)-255.8(HTQ)-252.6(score)-256.9(and)]TJ
0 -1.2266 TD
(CES-D)Tj
/F6 1 Tf
3.3638 0 TD
()Tj
/F5 1 Tf
.7145 0 TD
[(16,)-267.5(which)-264.1(had)-265.1(the)-269.3(most)-267.7(consistent)-268.7(associations)-271.6(with)]TJ
-4.0783 -1.2203 TD
[(PTSD)-320.4(change)-326(in)-316.7(the)-319.9(univariate)-322.5(models,)-320.8(along)-317.1(with)-325.2(variables)]TJ
T*
[(for)-206.3(which)-207.2(there)-213(is)-200.9(theoretical)-209.5(evidence)-212(for)-206.3(association.)-203.7(We)-207.6(also)]TJ
T*
[(included)-194(HIV)-188.3(status,)-184.4(as)-190.5(we)-184.9(had)-182.9(hypothesized)-193.7(that)-187.2(PTSD)-187.6(could)]TJ
0 -1.2266 TD
[(be)-421.6(part)-419.3(of)-420.6(the)-421.1(psychologic)-424.4(response)-421.6(to)-420.6(being)-420.3(infected)-420.9(with)]TJ
0 -1.2203 TD
[(HIV.)-267.1(After)-262.2(adjusting)-262.2(for)-263.2(HIV)-257.8(status,)-266.6(CD4)]TJ
/F6 1 Tf
18.3807 0 TD
(<)Tj
/F5 1 Tf
.7208 0 TD
[(200)-257.8(vs.)]TJ
/F6 1 Tf
3.4144 0 TD
(>)Tj
/F5 1 Tf
.7208 0 TD
[(200)-257.8(had)]TJ
-23.2367 -1.2203 TD
[(no)-202.2(association)-207.1(in)-202.9(univariate)-202.3(models)-204.1(and)-201.9(was)-204.8(not)-202.6(included.)-203.3(We)]TJ
0 -1.2266 TD
[(used)-296.4(the)-300.9(number)-298.2(of)-294.1(genocidal)-297.6(traumatic)-299.6(events)-296.6(in)-291.5(the)-300.9(model)]TJ
0 -1.2203 TD
[(instead)-226.1(of)-218.2(reported)-223.8(experience)-225(of)-224.5(genocidal)-221.7(rape,)-219.4(as)-222.1(genocidal)]TJ
T*
[(traumatic)-615.7(events)-612.7(and)-606.6(genocidal)-607.4(rape)-614.8(were)-609.1(collinear,)-607.1(the)]TJ
0 -1.2266 TD
[(number)-412(of)-414.2(traumatic)-413.4(events)-410.4(had)-410.6(better)-416.9(associations)-410.7(in)-411.6(uni-)]TJ
0 -1.2203 TD
[(variate)-244.6(models,)-238.6(and)-239.9(genocidal)-240.6(rape)-241.7(is)-238.8(included)-244.6(as)-241.1(a)-239.8(genocidal)]TJ
T*
[(traumatic)-204.7(event.)-197(Previous)-201.4(studies)-200.6(have)-193.2(also)-196.8(found)-200.7(the)-199.8(number)]TJ
T*
[(of)-426.9(traumatic)-432.4(events)-429.3(to)-426.9(be)-421.6(associated)-427.9(with)-432.7(persistent)-429.7(PTSD.)]TJ
0 -1.2266 TD
[(Other)-273.1(variables)-272.4(in)-272.5(Table)-275.9(2)-265.1(were)-274(not)-272.2(included)-276.2(because)-271.2(of)-268.8(both)]TJ
0 -1.2203 TD
[(lack)-209.1(of)-199.3(statistical)-209(association)-207.1(in)-209.3(unadjusted)-201.6(models)-210.4(and)]TJ
/F7 1 Tf
23.7805 0 TD
[(a)-201.6(priori)]TJ
/F5 1 Tf
-23.7805 -1.2203 TD
[(theoretical)-310.6(evidence)-300.5(for)-301.1(association.)-304.9(In)-302.7(the)-300.9(nal)-300.3(model,)-306.9(base-)]TJ
0 -1.2267 TD
[(line)-200(PTSD)-193.9(continued)-194.1(to)-199.2(be)-187.7(the)-199.8(strongest)-198.1(predictor)-195.1(of)-192.9(improved)]TJ
0 -1.2203 TD
[(HTQ)-480.2(score.)-481.1(Reporting)-482.3(depressive)-479.5(symptoms)-481(\(CES-D)]TJ
/F6 1 Tf
24.6277 0 TD
()Tj
/F5 1 Tf
.7208 0 TD
(16\))Tj
-25.3486 -1.2203 TD
[(was)-280.7(again)-282.2(a)-284(major)-277.4(factor)-281.4(preventing)-289.7(improved)-281.5(HTQ)-277.9(score.)]TJ
/F3 1 Tf
0 -3.0603 TD
(Discussion)Tj
/F5 1 Tf
1.1128 -1.8336 TD
[(RWISA)-213.9(participants)-216.8(demonstrated)-220.6(high)-217.1(levels)-211.2(of)-218.2(PTSD)-212.9(and)]TJ
-1.1128 -1.2203 TD
[(depressive)-315.2(symptoms)-310.3(at)-309.8(the)-313.6(start)-312.3(of)-306.7(this)-312.2(study)-314.1(more)-310.8(than)-310.3(10)]TJ
T*
[(years)-315.7(after)-317.2(the)-313.6(Rwandan)-311.8(genocide.)-316.3(Encouragingly,)-314.8(the)-313.6(prev-)]TJ
T*
[(alence)-378.6(of)-376.3(PTSD)-371(changed)-379.6(signicantly)-377.5(over)-370.8(18)-372.1(months,)-378.6(with)]TJ
0 -1.2266 TD
[(61%)-342.1(of)-332(the)-338.9(cohort)-338.2(having)-343.8(PTSD)-333(at)-341.4(baseline)-338(and)-334.7(24%)-335.8(having)]TJ
0 -1.2203 TD
[(PTSD)-282.4(at)-284.5(the)-282(fourth)-281(study)-282.4(visit.)]TJ
1.1128 -1.2203 TD
[(All)-223.4(the)-218.7(participants)-223.1(in)-221.9(RWISA)-220.2(were)-217.1(administered)-224.5(the)-218.7(HTQ.)]TJ
-1.1128 -1.2267 TD
[(Those)-680.6(reporting)-681.1(more)-671.2(traumatic)-679(experiences)-681.5(during)-674(the)]TJ
ET
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1 i
62.362 184.309 m
301.153 184.309 l
301.153 83.962 l
62.362 83.962 l
W n
q
238.992 0 0 100.346 62.362 83.962 cm
/Im1 Do
Q
Q
BT
/F8 1 Tf
8.9663 0 0 8.9663 62.1921 67.2378 Tm
[(FIG.)-286.2(1.)]TJ
/F5 1 Tf
4.0467 0 TD
[(Change)-282.7(in)-285.1(posttraumatic)-292.8(stress)-283.2(disorder)-286.8(\(PTSD\),)-286.3(by)]TJ
-4.0467 -1.1128 TD
[(visit)-338.4(\(with)-338.3(standard)-333.4(error\).)]TJ
/F3 1 Tf
-.019 77.2217 TD
(1328)Tj
47.504 0 TD
[(COHEN)-331.9(ET)-338.7(AL.)]TJ
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