Antenatal depressive symptoms in Kenyan women living with HIV: contributions of recent HIV diagnosis, stigma, and partner violence.

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Title: Antenatal depressive symptoms in Kenyan women living with HIV: contributions of recent HIV diagnosis, stigma, and partner violence.
Authors: Osborn, Lusi, Ronen, Keshet, Larsen, Anna M., Richardson, Barbra, Khasimwa, Brian, Chohan, Bhavna, Matemo, Daniel, Unger, Jennifer, Drake, Alison L., Kinuthia, John, John-Stewart, Grace
Source: AIDS Care. Jan 2022, Vol. 34 Issue 1, p69-77. 9p. 1 Diagram, 2 Charts.
Subjects: Diagnosis of mental depression, Maternal health services, Pregnancy & psychology, Attitudes of mothers, Cross-sectional method, Social stigma, Medical screening, Intimate partner violence, Questionnaires, Descriptive statistics, Prenatal care, Women's health, Psychology of HIV-positive persons, Vertical transmission (Communicable diseases), Pregnancy
Geographic Terms: Sub-Saharan Africa, Kenya
Abstract: Depression among pregnant women living with HIV (WLWH) in sub-Saharan Africa leads to poor pregnancy and HIV outcomes. This cross-sectional analysis utilized enrollment data from a randomized trial (Mobile WAChX, NCT02400671) in six Kenyan public maternal and child health clinics. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9), stigma with the Stigma Scale for Chronic Illness, and intimate partner violence (IPV) with the Abuse Assessment Screen. Correlates of moderate-to-severe depressive symptoms ("depression", PHQ-9 score ≥10) were assessed using generalized estimating equation models clustered by facility. Among 824 pregnant WLWH, 9% had depression; these women had more recent HIV diagnosis than those without depression (median 0.4 vs. 2.0 years since diagnosis, p =.008). Depression was associated with HIV-related stigma (adjusted Prevalence Ratio [aPR]:2.36, p =.025), IPV (aPR:2.93, p =.002), and lower social support score (aPR:0.99, p =.023). Using population-attributable risk percent to estimate contributors to maternal depression, 81% were attributable to stigma (27%), recent diagnosis (24%), and IPV (20%). Integrating depression screening and treatment in prevention of mother-to-child HIV transmission programs may be beneficial, particularly in women recently diagnosed or reporting stigma and IPV. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
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Abstract:Depression among pregnant women living with HIV (WLWH) in sub-Saharan Africa leads to poor pregnancy and HIV outcomes. This cross-sectional analysis utilized enrollment data from a randomized trial (Mobile WAChX, NCT02400671) in six Kenyan public maternal and child health clinics. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9), stigma with the Stigma Scale for Chronic Illness, and intimate partner violence (IPV) with the Abuse Assessment Screen. Correlates of moderate-to-severe depressive symptoms ("depression", PHQ-9 score ≥10) were assessed using generalized estimating equation models clustered by facility. Among 824 pregnant WLWH, 9% had depression; these women had more recent HIV diagnosis than those without depression (median 0.4 vs. 2.0 years since diagnosis, p =.008). Depression was associated with HIV-related stigma (adjusted Prevalence Ratio [aPR]:2.36, p =.025), IPV (aPR:2.93, p =.002), and lower social support score (aPR:0.99, p =.023). Using population-attributable risk percent to estimate contributors to maternal depression, 81% were attributable to stigma (27%), recent diagnosis (24%), and IPV (20%). Integrating depression screening and treatment in prevention of mother-to-child HIV transmission programs may be beneficial, particularly in women recently diagnosed or reporting stigma and IPV. [ABSTRACT FROM AUTHOR]
ISSN:09540121
DOI:10.1080/09540121.2021.1981216