Prevalence of prenatal and postpartum depression and associated factors among HIV-infected women in public primary care in rural South Africa: a longitudinal study

ABSTRACT

This study aimed to assess the longitudinal prevalence of prenatal and postnatal depression and associated factors among HIV-infected women in rural South Africa. In a longitudinal, cluster-randomized, prevention of mother to child transmission (PMTCT) intervention trial, 681 HIV-infected prenatal women in 12 community health centres in Mpumalanga province, South Africa, were recruited in 2015 by consecutive sampling at 8–24 weeks pregnancy and followed up at 32 weeks prenatally, and 6 and 12 months postpartum (retention rate = 59.2%). Results indicate that at baseline, 48.7% of the women screened positive for depression (scores of ≥13 on the “Edinburgh Postnatal Depression Scale 10”), while postnatally (at 12 months) the prevalence was 35.6%. Mothers who did not have depression before or after were 205 (50.1%), those who had depression before and after were 58 (14.4%), those who had depression only before were 81 (20.1%), and those who had depression only after were 59 (14.6%). In multinominal logistic regression analyses, less education and physical and psychological intimate partner violence were associated with sustained perinatal depression. Participation in the PMTCT intervention was associated with remitting depression while alcohol use was associated with the onset of postnatal depression. Using generalized linear mixed models in longitudinal analyses, psychological partner violence, lack of male involvement during pregnancy and non-adherence to antiretroviral treatment were associated with depression. In conclusion, a high pre- and postnatal prevalence of depression was found highlighting the utility of interventions to address prevention and treatment of perinatal depression.

KEYWORDS:

• Antenatal care
• postnatal care
• HIV
• depression
• longitudinal study
• South Africa

Acknowledgements

This study was funded by a grant from the National Institute of Child Health and Human Development, R01HD078187, United States National Institutes of Health, and with the support from the Miami CFAR, NIH grant numberP30 AI073961.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Karl Peltzer http://orcid.org/0000-0002-5980-0876

Deborah Jones http://orcid.org/0000-0002-4106-8891

Additional information

Funding

This study was funded by a grant from the National Institute of Child Health and Human Development, R01HD078187, United States National Institutes of Health, and with the support from the Miami CFAR, NIH grant numbers P30 AI073961 and K23HD074489.