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

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

SUB-Saharan Africa; KENYA

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]

Copyright of AIDS Care is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)