Caught in a web of multiple jeopardy: Post-traumatic stress disorder and HIV-positive asylum seekers in Scotland

Many HIV-positive asylum seekers have experienced multiple traumas and human rights violations—circumstances that engender posttraumatic stress disorder (PTSD). This qualitative study examines the impact of PTSD symptoms among HIV-positive asylum seekers in Scotland. Data were collected from 19 participants, using open-ended interviews, and narrative analysis was used to develop significant themes. All respondents had significant traumatic experiences, such as physical and sexual assault, witnessing the beating and death of a loved one, and being forced to participate in the sex trade. Many experienced multiple symptoms of PTSD, including re-experiencing of intrusive thoughts, flashbacks, avoidance, and arousal. These symptoms met the duration and impairment requirements for DSM-5 diagnosis of PTSD. Their symptoms impacted their ability to tell their stories convincingly when interviewed by immigration officials. Legal processes for asylum seeking require individuals to tell their stories but ignore the impact of trauma on their ability to do so, thus increasing the likelihood of their applications being rejected. The findings indicate the need for asylum seekers to have routine assessment and treatment for PTSD and the provision of appropriate therapeutic and advocacy services.