Abstract
Path Analysis Of Physical Symptoms, Emotional Support, Self-esteem, And Depressive Symptoms In HIV-positive Perinatal Women In Thailand
Highlights
At the end of 2009, the Joint United Nations Programme on HIV/AIDS1 estimated that 33.3 million people were living with HIV, including at least 600,000 Thai adults, 20,000 of whom were pregnant women[2]
The objectives of this study were to examine among HIV-positive perinatal Thai women: 1) both the direct and indirect effects of physical symptoms and emotional support on depressive symptoms; 2) which source of support is more significant, family or friends; and 3) the direct effect of self-esteem on depressive symptoms
We found that about half of our 212 HIV-infected pregnant and postpartum participants reported major depressive symptoms, based on Radloff’s (1977) CES-D cutoff score of ≥ 23.36 This depression rate is comparable to those in previous studies among HIV-positive perinatal women around the world: 47% in pregnant women[17] and 42.2% in postpartum women in South Africa,43 53%, in pregnant US women,33 30.8% in perinatal US women,[44] and 54% in postpartum women in Zimbabwe.[45]
Summary
At the end of 2009, the Joint United Nations Programme on HIV/AIDS1 estimated that 33.3 million people were living with HIV, including at least 600,000 Thai adults (ages 15–49 years), 20,000 of whom were pregnant women[2]. Studies in various countries have found that HIV-positive perinatal women with low self-esteem tend to report more depressive symptoms than those with high self-esteem.[11,12,17,20] Qualitative studies have found that HIV-positive pregnant women in Thailand with low self-esteem are more likely to be depressed than those with high self-esteem, and stigmatization related to the infection seemed to be an antecedent of low self-esteem.[21,22,23] Further, perinatal women with HIV tend to have low self-esteem and negative personal perceptions that lead to depression. Studies have found that HIVpositive pregnant and postpartum Thai women worry constantly about their infant's health, fearing that the fetus/infant has been infected.[22,25,26] Negative perceptions about the infant's health can compound the mother's negative feelings of being incompetent and have been positively linked to depressive symptoms in Thai and U.S postpartum women.[12,27]
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