The Use of Efavirenz During Pregnancy is Associated with Suicidal Ideation in Postpartum Women in Rural South Africa

Abstract

Efavirenz is used for the management of HIV infection during pregnancy in South Africa (SA), but it is contraindicated in patients with history of depression due to possible suicidal ideation. This study compared suicidal ideation 12-months postpartum among women receiving and not receiving efavirenz in rural SA, where high rates of depression have been identified. Antenatal psychological intimate partner violence (IPV; AOR = 1.04), depression (AOR = 1.06) and detection of efavirenz in dried blood spot at 32weeks predicted suicidal ideation 12-months postnatally (AOR = 2.29), controlling for antenatal stigma and physical IPV. Findings support using alternative agents for the management of HIV during pregnancy.