Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study.

Journal: BMC pregnancy and childbirth

Volume: 14

Issue: 

Year of Publication: 2015

Affiliated Institutions:  Department of Psychology, University of Alabama at Birmingham, CH , rd Avenue South, Birmingham, AL, -, USA. bturanb@gmail.com. Department of Sociology, University of Alabama at Birmingham, HHB , nd Ave South, Birmingham, AL, -, USA. Klsn@uab.edu. Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya. maricianah@yahoo.com. Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya. ebukusi@rctp.or.ke. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA. Sheri.Weiser@ucsf.edu. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA. CCohen@globalhealth.ucsf.edu. Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA. jmturan@uab.edu.

Abstract summary 

While studies have suggested that depression and HIV-related stigma may impede access to care, a growing body of literature also suggests that access to HIV care itself may help to decrease internalized HIV-related stigma and symptoms of depression in the general population of persons living with HIV. However, this has not been investigated in postpartum women living with HIV. Furthermore, linkage to care itself may have additional impacts on postpartum depression beyond the effects of antiretroviral therapy. We examined associations between linkage to HIV care, postpartum depression, and internalized stigma in a population with a high risk of depression: newly diagnosed HIV-positive pregnant women.In this prospective observational study, data were obtained from 135 HIV-positive women from eight antenatal clinics in the rural Nyanza Province of Kenya at their first antenatal visit (prior to testing HIV-positive for the first time) and subsequently at 6 weeks after giving birth.At 6 weeks postpartum, women who had not linked to HIV care after testing positive at their first antenatal visit had higher levels of depression and internalized stigma, compared to women who had linked to care. Internalized stigma mediated the effect of linkage to care on depression. Furthermore, participants who had both linked to HIV care and initiated antiretroviral therapy reported the lowest levels of depressive symptoms.These results provide further support for current efforts to ensure that women who are newly diagnosed with HIV during pregnancy become linked to HIV care as early as possible, with important benefits for both physical and mental health.

Authors & Co-authors:  Turan Stringer Onono Bukusi Weiser Cohen Turan

Study Outcome 

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Citations :  Leahy-Warren P, McCarthy G. Postnatal depression: prevalence, mothers’ perspectives, and treatments. Arch Psychiatr Nurs. 2007;21(2):91–100. doi: 10.1016/j.apnu.2006.10.006.
Authors :  7
Identifiers
Doi : 400
SSN : 1471-2393
Study Population
Women
Mesh Terms
Adolescent
Other Terms
Study Design
Study Approach
Country of Study
Kenya
Publication Country
England