Prevalence of Depressive Symptoms in Pregnant & Postnatal HIV-Positive Women in Ukraine
BACKGROUND:
Perinatal
depression among HIV-positive women has negative implications for HIV-related
and other maternal and infant outcomes. The aim of this study was to
investigate the burden and correlates of perinatal depression among
HIV-positive women in Ukraine, a lower middle income country with one of the
largest HIV-positive populations in Europe.
METHODS:
Cross-sectional
surveys nested within the Ukraine European Collaborative Study were conducted
of HIV-positive women at delivery and between 1 and 12 months postpartum.
Depressive symptoms in the previous month were assessed using a self-report
screening tool. Other data collected included demographics, antiretroviral
therapy (ART)-related self-efficacy, and perceptions of risks/benefits of
interventions to prevent mother-to-child transmission (PMTCT). Characteristics
of women with and without a positive depression screening test result were
compared using Fisher's exact test and χ(2) test for categorical variables.
RESULTS:
A quarter
(27 % (49/180) antenatally and 25 % (57/228) postnatally) of participants
screened positive for depressive symptoms. Antenatal risk factors were living
alone (58 % (7/12) vs 25 % (42/167), being somewhat/terribly bothered
by ART side effects (40 % (17/43) vs 23 % (30/129) not /only slightly bothered,
p = 0.05) and having lower ART-related self-efficacy (43 % (12/28) vs 23 %
(25/110) with higher self-efficacy, p = 0.05).
Postnatally, single mothers were
more likely to screen positive (44 % (20/45) vs 21 % (18/84) of cohabiting and
19 % (19/99) of married women, p < 0.01) as were those unsure of the
effectiveness of neonatal prophylaxis (40 % (20/45) vs 18 % (28/154) sure of
effectiveness, p < 0.01), those worried that neonatal prophylaxis could harm
the baby (30 % (44/146) vs 14 % (10/73) not worried p < 0.01) and those not
confident to ask for help with taking ART (48 % (11/23) vs 27 % (10/37) fairly
confident and 15 % (4/26) confident that they could do this).
Of women who reported
wanting help for their depressive symptoms, 82 % (37/45) postnatally but only
31 % (12/39) antenatally were already accessing peer counselling, treatment
adherence programmes, support groups or social services.
CONCLUSIONS:
A
quarter of women screened positive for depression. Results highlight the need
for proactive strategies to identify depressive symptoms, and an unmet need for
provision of mental health support in the perinatal period for HIV-positive
women in Ukraine.
Below: Responses to three depression screening questions
By: Bailey H1, Malyuta R2, Semenenko I2, Townsend CL3, Cortina-Borja M3, Thorne C3; Ukraine European Collaborative Study in EuroCoord.
- 1Population, Policy and Practice Programme, UCL Institute of Child Health, University College London, London, UK. heather.bailey@ucl.ac.uk.
- 2Perinatal Prevention of AIDS Initiative, Odessa, Ukraine.
- 3UCL Institute of Child Health, University College London, London, UK.
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