Journal Article

Depression and anxiety among pregnant women living with HIV in Kilimanjaro region, Tanzania

Knettel, Brandon A., Minja, Linda, Mmbaga, Blandina T., Ngocho, James Samwel, Sorsdahl, Katherine, Williams, Petal P., Watt, Melissa H.

2019

Overview

Mental health disorders in pregnant women living with HIV are associated with poor maternal and child outcomes, and undermine the global goals of prevention of mother-to-child transmission of HIV (PMTCT). This study aimed to determine prevalence of depression and anxiety and identify factors associated with these common mental health disorders among HIV-infeced pregnant women in Tanzania. We enrolled 200 pregnant women living with HIV from antenatal care clinics in the Kilimanjaro region. Women were eligible if they were in the second or third trimester of pregnancy and had been in PMTCT care for a minimum of one month. Data were collected via interviewer administered surveys. Participants self reported depression symptoms (Edinburgh Postnatal Depression Scale, EPDS) and anxiety symptoms (Brief Symptom Index, BSI). Multivariate logistic regression models examined factors associated with depression, anxiety, and comorbid depression and anxiety. 25.0% of women met screening criteria for depression (EPDS ≥10). Depression was significantly associated with being single (aOR = 4.2, 95% CI = 1.1-15.5), food insecurity (aOR = 2.4, 95% CI = 1.0-6.4), and HIV shame (aOR = 1.2, 95% CI = 1.1-1.3). 23.5% of participants met screening criteria for anxiety (BSI ≥1.01). Anxiety was associated with being single (aOR = 3.6, 95%CI = 1.1-11.1), HIV shame (aOR = 1.1, 95% CI = 1.1-1.2) and lifetime experience of violence (aOR = 2.3, 95% CI = 1.0-5.1). 17.8% of the sample met screening criteria for both depression and anxiety. Comorbid depression and anxiety was associated with being single (aOR = 4.5, 95%CI = 1.0-19.1), HIV shame (aOR = 1.2, 95%CI = 1.1-1.3) and lifetime experience of violence (aOR = 3.4, 95% CI = 1.2-9.6). Depression and anxiety symptomatology was common in this sample of pregnant women living with HIV, with a sizable number screening positive for comorbid depression and anxiety. In order to successfully engage women in PMTCT care and support their well-being, strategies to screen for mental health disorders and support women with mental illnesses are needed.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acquired immune deficiency syndrome / Adult / Aggression / AIDS / Anxieties / Anxiety / Anxiety - psychology / Anxiety - virology / Anxiety Disorders - epidemiology / Anxiety Disorders - psychology / Anxiety Disorders - virology / Biology and Life Sciences / Children / Comorbidity / Criteria / Cross-Sectional Studies / Depression (Mood disorder) / Depression - psychology / Depression - virology / Depressive Disorder - epidemiology / Depressive Disorder - psychology / Depressive Disorder - virology / Diagnosis / Disease transmission / Disorders / Female / Food security / Health / Health aspects / Health screening / HIV / HIV - pathogenicity / HIV Infections - epidemiology / HIV Infections - psychology / HIV patients / Human immunodeficiency virus / Humans / Illnesses / Medical diagnosis / Medicine and Health Sciences / Mental depression / Mental disorders / Mental health / Mentally ill persons / People and Places / Postpartum depression / Pregnancy / Pregnancy Complications, Infectious - epidemiology / Pregnant women / Pregnant Women - psychology / Prevalence / Psychological aspects / Regression analysis / Regression models / Risk factors / Screening / Self Report / Signs and symptoms / Surveys and Questionnaires / Tanzania - epidemiology / Violence / Well being / Women's health / Womens health