Abstract
This study investigated perinatal depressive symptoms among HIV-infected women enrolled in a cluster-randomized, controlled trial in South Africa. Women (n = 1370) attending 12 community health centers were consecutively enrolled in a two-phase (phase 1 = without a male partner, phase 2 = with a male partner) and two-condition (experimental or control) prevention of mother-to-child transmission (PMTCT) intervention. Women were enrolled at 8–24 weeks pregnant and followed postpartum at 6 weeks and 6 and 12 months (retention rate = 69.8%). Antenatally, 45.4% of women were above the 12-point Edinburgh Postnatal Depression Scale (EPDS) cutoff, 30.2% were above the cutoff at 6 weeks, and 34.2% and 36.9% at 6 months and 12 months postpartum, respectively. In multilevel regression analyses, depressive symptoms decreased over time among women in phase 2 participating in the intervention condition, but neither condition nor phase alone was associated with a decrease in depression. Greater HIV stigma, increased psychological intimate partner violence, less male involvement, lower education, and non-adherence during pregnancy were associated with increased depressive symptoms over the perinatal period. Results indicated that women participating had high levels of depressive symptoms (> 40% prenatally and > 30% postnatally), and the combination of the multi-session PMTCT intervention plus male partner participation contributed to a reduction in depressive symptoms. Results suggest that interventions targeting the reduction of depressive symptoms in perinatal HIV-positive women by increasing male involvement and decreasing HIV stigma and intimate partner violence are needed to reduce depression in this vulnerable population.
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Funding
This study was funded by a grant from the National Institute of Child Health and Human Development, R01HD078187, United States National Institutes of Health, and with the support from the Miami CFAR, NIH grant numberP30 AI073961.
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Prior to study onset, Institutional Review Board and Research Ethics Committee approval was obtained from the University of Miami Miller School of Medicine, the Human Sciences Research Council, and the Mpumalanga Provincial Government. All procedures performed were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained prior to study procedures.
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Peltzer, K., Abbamonte, J.M., Mandell, L.N. et al. The effect of male involvement and a prevention of mother-to-child transmission (PMTCT) intervention on depressive symptoms in perinatal HIV-infected rural South African women. Arch Womens Ment Health 23, 101–111 (2020). https://doi.org/10.1007/s00737-019-00955-7
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DOI: https://doi.org/10.1007/s00737-019-00955-7