Abstract
This study aimed to assess the prevalence of depressed symptoms and associated factors in prenatal HIV-positive women in primary care facilities in rural South Africa. In a cross-sectional study, 663 HIV-positive prenatal women in 12 community health centres in Mpumalanga province, South Africa, were recruited by systematic sampling (every consecutive patient after HIV post-test counselling). Results indicate that overall, 48.7% [95% CI: 44.8, 52.6] of women during the prenatal period reported depressed mood (scores of ≥ 13 on the Edinburgh Postnatal Depression Scale 10). In multivariate analysis, not being employed, unplanned pregnancy, not having an HIV-positive child, poor antiretroviral therapy adherence, non-condom use at last sex, and intimate partner violence were associated with depressive symptoms. Potential risk factors among HIV-infected prenatal women were identified which could be utilized in interventions. Routine screening for depression may be integrated into prenatal care settings.
Highlights
Prenatal depression and anxiety have been associated with increased risk of preterm birth and low birth weight, and delayed cognitive and language development, behavioural and emotional problems (Smith, Shao, Howell, Lin & Yonkers 2011; Van den Berg, Mulder, Mennes & Glover 2005)
Several studies have investigated the prevalence of depressive symptoms among HIV-positive pregnant women, 42% in Tanzania (Smith Fawzi, Kaaya, Mbwambo, Msamanga, Antelman, Wei, et al 2007), 39% and 52.9% in Uganda (Kaida, Matthews, Ashaba, Tsai, Kanters, Robak, et al 2014), 78% in Thailand (Ross, Sawatphanit & Zeller 2009), and 85% in Zambia (Kwalombota 2002)
Of the 709 HIV-positive pregnant women invited to participate in the study, eight declined, and 38 had unusable data resulting in a total sample of 663 participants
Summary
Prenatal depression and anxiety have been associated with increased risk of preterm birth and low birth weight, and delayed cognitive and language development, behavioural and emotional problems (Smith, Shao, Howell, Lin & Yonkers 2011; Van den Berg, Mulder, Mennes & Glover 2005). Several studies have investigated the prevalence of depressive symptoms among HIV-positive pregnant women, 42% in Tanzania (Smith Fawzi, Kaaya, Mbwambo, Msamanga, Antelman, Wei, et al 2007), 39% and 52.9% in Uganda (Kaida, Matthews, Ashaba, Tsai, Kanters, Robak, et al 2014), 78% in Thailand (Ross, Sawatphanit & Zeller 2009), and 85% in Zambia (Kwalombota 2002). It was concluded that depression, as well as other psychiatric symptomatology, among women living with HIV can adversely affect psychological health and quality of life, as well as clinical outcomes (Kapetanovic, Dass-Brailsford, Nora & Talisman 2014). Kapetanovic et al (2014) further argue that the increasing number of HIV-infected women reaching reproductive age and greater accessibility to protocols aimed at Preventing Mother-to-Child Transmission of HIV (MTCT), highlight a greater need to explore how mental health-related outcomes may affect women’s quality of life and reproductive health, and increase the risk for vertical transmission of HIV It was concluded that depression, as well as other psychiatric symptomatology, among women living with HIV can adversely affect psychological health and quality of life, as well as clinical outcomes (Kapetanovic, Dass-Brailsford, Nora & Talisman 2014). Kapetanovic et al (2014) further argue that the increasing number of HIV-infected women reaching reproductive age and greater accessibility to protocols aimed at Preventing Mother-to-Child Transmission of HIV (MTCT), highlight a greater need to explore how mental health-related outcomes may affect women’s quality of life and reproductive health, and increase the risk for vertical transmission of HIV
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