Introduction
Women living with HIV
experience a disproportionate burden of mental health issues. To date, global
guidelines contain insufficient guidance on mental health support, particularly
regarding perinatal care. The aim of this article is to describe the extent and
impact of mental health issues as experienced by women living with HIV on their
sexual and reproductive health and human rights (SRH&HR).
Methods
A global, mixed-methods,
user-led and designed survey on SRH&HR of women living with HIV was
conducted using snowball sampling, containing an optional section exploring
mental health issues. Statistical quantitative data analysis included
descriptive statistics, correlation and multiple linear regression analysis for
the mental health responses. Thematic analysis of open free-text responses was
performed for qualitative data.
Results
A total of 832
respondents from 94 countries participated in the online survey with 489
responses to the optional mental health section. Of the respondents, 82%
reported depression symptoms and 78% rejection. One-fifth reported mental health
issues before HIV diagnosis. Respondents reported experiencing a 3.5-fold
higher number of mental health issues after diagnosis (8.71 vs 2.48, t[488]=23.00, p<0.001).
Nearly half (n=224; 45.8%) had multiple socially
disadvantaged identities (SDIs). The number of SDIs was positively correlated
with experiencing mental health issues (p<0.05). Women
described how mental health issues affected their ability to enjoy their right
to sexual and reproductive health and to access services. These included
depression, rejection and social exclusion, sleep problems, intersectional
stigma, challenges with sexual and intimate relationships, substance use and
sexual risk, reproductive health barriers and human rights (HR) violations.
Respondents recommended that policymakers and clinicians provide psychological
support and counselling, funding for peer support and interventions to
challenge gender-based violence and to promote HR.
Conclusions
Interventions addressing
intersecting stigmas and any especial impacts of diagnosis during pregnancy are
required to ensure women's SRH&HR. Global policy guidelines regarding women
living with HIV must incorporate mental health considerations.
Full article at: http://goo.gl/ZPpG4N
By: Luisa Orza,*,1,2 Susan Bewley,*,3 Carmen H Logie,*,4 Elizabeth Tyler Crone,5 Svetlana Moroz,6 Sophie Strachan,7Marijo Vazquez,1,2 and Alice Welbourn§*,2
1ATHENA Network, London, UK
2Salamander Trust, London, UK
3Women's Health Academic Centre, King's
College London, London, UK
4Factor-Inwentash Faculty of Social Work,
University of Toronto, Toronto, ON, Canada
5ATHENA Network, Seattle, WA, USA
6Eurasian Women's Network on AIDS, Kiev,
Ukraine
7UNAIDS Dialogue Platform, London, UK
§Corresponding author: Alice Welbourn, Salamander Trust, c/o
Positively UK, 345 City Road, London EC1V 1LR, UK. Tel: +44 203 289 7398. (Email: ten.tsurtrednamalas@ecila)
More at: https://twitter.com/hiv_insight
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