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A Dyadic Investigation of Relationship Dynamics and Depressive Symptoms in HIV-Affected Couples in Malawi

Abstract

Depression is the leading cause of disability worldwide with health implications for people living with HIV. Primary partnerships like marriage could be protective against depression but may worsen depression depending on the relationship quality. We examined depression and its association with relationship dynamics in a cross-sectional sample of 211 HIV-affected married couples in Malawi. We fit multivariable multilevel linear regression models for depressive symptoms. Men and women reported similar levels of depressive symptoms; 28% had a score indicative of probable depression. Almost half of couples had at least one partner with probable depression. In the adjusted models, equality (B = − 0.22; p < 0.01) and unity (B = − 0.94; p < 0.05) were associated with fewer depressive symptoms while individuals with more experiences of physical (B = 0.81; p < 0.01), sexual (B = 0.87; p < 0.01), and emotional violence (B = 1.52; p < 0.001) had higher levels of depressive symptoms. Couples-based interventions aiming to improve relationships may address depression, especially in settings with inadequate mental health services.

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Acknowledgements

The authors would like to thank the tireless efforts of the research staff at Invest in Knowledge in Malawi for data collection.

Funding

This research was funded by the National Institutes of Health under Grants K01MH107331 (AAC), K23MH116807 (ELT), K01MH106416 (JYT) and K24DA037034 (MOJ).

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Correspondence to Emily L. Tuthill.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained for all individual participants included in the study.

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Tuthill, E.L., Neilands, T.B., Johnson, M.O. et al. A Dyadic Investigation of Relationship Dynamics and Depressive Symptoms in HIV-Affected Couples in Malawi. AIDS Behav 23, 3435–3443 (2019). https://doi.org/10.1007/s10461-019-02583-9

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Keywords

  • Heterosexual couples
  • Relationship dynamics
  • HIV
  • Depression
  • Sub-Saharan Africa