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Correlates of Suicidal Ideation During Pregnancy and Postpartum Among Women Living with HIV in Rural South Africa

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Abstract

In developing countries, up to 20% of maternal deaths during pregnancy are due to suicide, and being HIV-infected confers additional risk. This manuscript sought to identify perinatal correlates of suicidal ideation among women living with HIV (WLHIV) in rural South Africa. Pregnant WLHIV (N = 681) were recruited and re-assessed at 12-months postpartum. Mean age was 28.3 (SD = 5.7) years and 68% were below the poverty line. Prenatal suicidal ideation was 39%; suicidal ideation continued for 7% at 12 months, 13% experienced incident suicidal ideation, and for 19% suicidal ideation had stopped postnatally. Intimate partner violence (AOR = 1.17) and depression (AOR = 1.14) predicted sustained suicidal ideation. Increased income (AOR = 2.25) and greater stigma (AOR = 1.33) predicted incident suicidal ideation. Younger age (AOR = 0.94), disclosure of HIV status to partner (AOR = 0.60), and greater stigma (AOR = 1.24) predicted postnatal cessation of suicidal ideation. Perinatal care may provide windows of opportunity for identification and treatment of suicidal ideation.

Resumen

En los países en desarrollo, hasta el 20% de las muertes maternas durante el embarazo se deben al suicidio, y estar infectado por el VIH conlleva un riesgo adicional. Esta investigación buscó identificar los correlatos perinatales de la ideación suicida en mujeres embarazadas con VIH en zonas rurales de Sudáfrica. Mujeres con VIH (N = 681) durante el embarazo fueron reclutadas y reevaluadas a los 12 meses después del parto. La edad promedio fue de 28.3 (DE = 5.7) años y el 68% de las mujeres estaban por debajo de la línea de pobreza. Aproximadamente 39% de las mujeres estaban experimentando ideación suicida prenatalmente, la cual continuo a los 12 meses para el 7%. El 13% experimentó ideación suicida incidental por primera vez a los 12 meses, y el 19% paro de experimentar ideación suicida después del nacimiento. Violencia de parte de la pareja (AOR = 1.17) y depresión (AOR = 1.14) predijeron la ideación suicida continua. El aumento de los ingresos (AOR = 2.25) y estigma de VIH internalizado (AOR = 1.33) predijeron ideación suicida por primera vez en el embarazo. La edad más joven (AOR = 0.94), revelación del estado de VIH a la pareja (AOR = 0.60) y estigma (AOR = 1.24) predijeron que la ideación suicida cesara después del embarazo a los 12 meses. La atención perinatal puede brindar oportunidades para identificar y tratar la ideación suicida durante el embarazo y postnatalmente.

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Funding

This study was funded by NICHD/NIH Grant No. R01HD078187 and with support from P30AI073961. Part of the manuscript was carried out under a Ford Foundation Fellowship to Violeta J. Rodriguez.

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Authors and Affiliations

  1. Department of Psychology, University of Georgia, 125 Baldwin Street, Athens, GA, 30605, USA

    Violeta J. Rodriguez

  2. Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Avenue, Dominion Tower 404A, Miami, FL, 33136, USA

    Violeta J. Rodriguez, Lissa N. Mandell, Suat Babayigit, Rhea R. Manohar, Stephen M. Weiss & Deborah L. Jones

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  1. Violeta J. Rodriguez
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  2. Lissa N. Mandell
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Correspondence to Deborah L. Jones.

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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 from all individual participants included in the study.

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Rodriguez, V.J., Mandell, L.N., Babayigit, S. et al. Correlates of Suicidal Ideation During Pregnancy and Postpartum Among Women Living with HIV in Rural South Africa. AIDS Behav 22, 3188–3197 (2018). https://doi.org/10.1007/s10461-018-2153-y

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