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


Autoři: James Samwel Ngocho aff001;  Melissa H. Watt aff003;  Linda Minja aff004;  Brandon A. Knettel aff003;  Blandina T. Mmbaga aff001;  Petal P. Williams aff002;  Katherine Sorsdahl aff002
Působiště autorů: Kilimanjaro Christian Medical University College, Moshi, Tanzania aff001;  Alan J Flisher Centre for Public Mental Health University of Cape Town, Cape Town, South Africa aff002;  Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America aff003;  Kilimanjaro Clinical Research Institute, Moshi, Tanzania aff004;  Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224515

Souhrn

Introduction

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.

Methods

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.

Results

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).

Conclusion

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.

Klíčová slova:

Depression – HIV – HIV clinical manifestations – HIV diagnosis and management – HIV epidemiology – Mental health and psychiatry – Pregnancy – Tanzania


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 10