Common mental disorders and intimate partner violence against pregnant women living with HIV in Cameroon: a cross-sectional analysis

Angela M Parcesepe,John A Gallis,Claudian Soffo,Evette Cordoba,Berenger Tchatchou,Joy Noel Baumgartner,Jennifer Headley,John Hembling

doi:10.1186/s12884-021-03673-0

Abstract

BackgroundWomen living with HIV are at increased risk of poor mental health and intimate partner violence (IPV). Mental health disorders have been consistently associated with suboptimal HIV-related outcomes. Little is known about the prevalence or correlates of mental health disorders among pregnant women living with HIV in sub-Saharan Africa.MethodsThis study assessed the prevalence of probable common mental disorders (CMD), i.e., depressive or anxiety disorders, and the relationship between probable CMD and recent IPV among pregnant women living with HIV in Cameroon. The sample included 230 pregnant women living with HIV aged > 18 enrolled in care at 10 HIV clinics in Cameroon. Probable CMD was assessed with the WHO Self Reporting Questionnaire (SRQ-20). Multivariable logistic regression was conducted to assess the relationship between IPV and probable CMD.ResultsAlmost half (42%) of participants had probable CMD using a 7/8 cut-off of the SRQ-20. Emotional, physical, and sexual IPV were reported by 44, 37, and 31% of respondents, respectively. In multivariable regression analyses, all forms of IPV assessed were significantly associated with greater odds of probable CMD.ConclusionsPregnant women living with HIV in Cameroon had a high prevalence of probable CMD and IPV. Screening and services to address IPV and mental health are urgently needed for this population. Integrated interventions to both prevent and screen and address IPV and probable CMD should be developed, implemented, and evaluated.

Highlights

Women living with Human immunodeficiency virus (HIV) are at increased risk of poor mental health and intimate partner violence (IPV)
Among women living with HIV, IPV has been associated with suboptimal HIV treatment outcomes, including lower antiretroviral therapy (ART) use, low CD4 count, poor ART adherence, and lack of viral suppression [3, 4]
Among the 230 women surveyed, one-quarter (26.7%) of participants had probable common mental disorders (CMD) using the 9/10 cut-off of the World Health Organization (WHO) Self Reporting Questionnaire (SRQ-20) while 42.2% screened positive for CMD using the less conservative 7/8 cut-off score

Summary

Introduction

Women living with HIV are at increased risk of poor mental health and intimate partner violence (IPV). Mental health disorders have been consistently associated with suboptimal HIV-related outcomes. Intimate partner violence (IPV) is common and associated with a cascade of negative physical and mental health outcomes for women including an increased risk of HIV acquisition [1]. IPV can lead directly to HIV acquisition through forced sex with an individual living with HIV. IPV can indirectly lead to HIV acquisition through increased sexual risk behaviors and limited ability to negotiate behaviors that prevent HIV. Among women living with HIV, IPV has been associated with suboptimal HIV treatment outcomes, including lower antiretroviral therapy (ART) use, low CD4 count, poor ART adherence, and lack of viral suppression [3, 4]

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