Risk factors for postpartum depression in women living with HIV attending prevention of mother-to-child transmission clinic at Kenyatta National Hospital, Nairobi

ABSTRACT

Mothers with HIV are at high risk of a range of psychosocial issues that may impact HIV disease progression for themselves and their children. Stigma has also become a substantial barrier to accessing HIV/AIDS care and prevention services. The study objective was to determine the prevalence and severity of postpartum depression (PPD) among women living with HIV and to further understand the impact of stigma and other psychosocial factors in 123 women living with HIV attending prevention of mother-to-child transmission (PMTCT) clinic at Kenyatta National Hospital located in Nairobi, Kenya. We used the Edinburgh Postnatal Depression Scale and HIV/AIDS Stigma Instrument – PLWHA (HASI – P). Forty-eight percent (N = 59) of women screened positive for elevated depressive symptoms. Eleven (9%) of the participants reported high levels of stigma. Multivariate analyses showed that lower education (OR = 0.14, 95% CI [0.04–0.46], p = .001) and lack of family support (OR = 2.49, 95% CI [1.14–5.42], p = .02) were associated with the presence of elevated depressive symptoms. The presence of stigma implied more than ninefold risk of development of PPD (OR = 9.44, 95% CI [1.132–78.79], p = .04). Stigma was positively correlated with an increase in PPD. PMTCT is an ideal context to reach out to women to address mental health problems especially depression screening and offering psychosocial treatments bolstering quality of life of the mother–baby dyad.

KEYWORDS:

• Postpartum
• depression
• HIV
• stigma
• prevention of mother-to-child transmission

Acknowledgements

Thanks to staff at KNH-PMTCT clinic staff and participants. We also thank Francis Njiri, University of Nairobi for his data analytic support.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This project was supported by National Institutes of Health/National Institute of Mental Health [grant number R25-MH099132].