"Pain in my heart": Understanding perinatal depression among women living with HIV in Malawi.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
01
01
2020
accepted:
23
05
2020
entrez:
6
6
2020
pubmed:
6
6
2020
medline:
22
8
2020
Statut:
epublish
Résumé
Perinatal depression (PND) can interfere with HIV care engagement and outcomes. We examined experiences of PND among women living with HIV (WLWH) in Malawi. We screened 73 WLWH presenting for perinatal care in Lilongwe, Malawi using the Edinburgh Postnatal Depression Scale (EPDS). We conducted qualitative interviews with 24 women experiencing PND and analyzed data using inductive and deductive coding and narrative analysis. Women experienced a double burden of physical and mental illness, expressed as pain in one's heart. Receiving an HIV diagnosis unexpectedly during antenatal care was a key contributor to developing PND. This development was influenced by stigmatization and social support. These findings highlight the need to recognize the mental health implications of routine screening for HIV and to routinely screen and treat PND among WLWH. Culturally appropriate mental health interventions are needed in settings with a high HIV burden.
Sections du résumé
BACKGROUND
Perinatal depression (PND) can interfere with HIV care engagement and outcomes. We examined experiences of PND among women living with HIV (WLWH) in Malawi.
METHODS
We screened 73 WLWH presenting for perinatal care in Lilongwe, Malawi using the Edinburgh Postnatal Depression Scale (EPDS). We conducted qualitative interviews with 24 women experiencing PND and analyzed data using inductive and deductive coding and narrative analysis.
RESULTS
Women experienced a double burden of physical and mental illness, expressed as pain in one's heart. Receiving an HIV diagnosis unexpectedly during antenatal care was a key contributor to developing PND. This development was influenced by stigmatization and social support.
CONCLUSIONS
These findings highlight the need to recognize the mental health implications of routine screening for HIV and to routinely screen and treat PND among WLWH. Culturally appropriate mental health interventions are needed in settings with a high HIV burden.
Identifiants
pubmed: 32502150
doi: 10.1371/journal.pone.0227935
pii: PONE-D-20-00046
pmc: PMC7274419
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0227935Subventions
Organisme : NIMH NIH HHS
ID : R00 MH112413
Pays : United States
Organisme : NICHD NIH HHS
ID : T32 HD007168
Pays : United States
Organisme : NICHD NIH HHS
ID : P2C HD050924
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI050410
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW010060
Pays : United States
Organisme : NIMH NIH HHS
ID : R34 MH116806
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
N Engl J Med. 2016 Feb 25;374(8):761-70
pubmed: 26933850
JAMA. 2001 Mar 21;285(11):1466-74
pubmed: 11255423
J Int AIDS Soc. 2015 Dec 01;18(Suppl 5):20289
pubmed: 26643460
BMC Public Health. 2011 Oct 26;11:828
pubmed: 22029430
Lancet Psychiatry. 2014 Jul;1(2):159-62
pubmed: 26360580
AIDS Care. 2010 Feb;22(2):159-65
pubmed: 20390494
AIDS Behav. 2011 Aug;15(6):1161-70
pubmed: 20711651
PLoS Med. 2012;9(5):e1001222
pubmed: 22666181
Int J Ment Health Syst. 2016 Mar 15;10:24
pubmed: 26985235
An Bras Dermatol. 2016 May-Jun;91(3):326-30
pubmed: 27438200
Obstet Gynecol. 2005 Nov;106(5 Pt 1):1071-83
pubmed: 16260528
Matern Child Health J. 2015 Jun;19(6):1306-37
pubmed: 25452215
J Acquir Immune Defic Syndr. 2007 Apr 1;44(4):470-7
pubmed: 17179766
J Community Health. 2016 Oct;41(5):946-52
pubmed: 26942766
J Affect Disord. 2013 Sep 25;150(3):1041-7
pubmed: 23769290
AIDS. 2014 Feb 20;28(4):589-598
pubmed: 24468999
AIDS Care. 2010 Nov;22(11):1418-27
pubmed: 20640955
Best Pract Res Clin Obstet Gynaecol. 2014 Jan;28(1):3-12
pubmed: 24140480
J Transcult Nurs. 2010 Apr;21(2):151-8
pubmed: 20220035
J Clin Psychiatry. 2015 Oct;76(10):1385-96
pubmed: 26528645
J Ment Health. 2019 Apr;28(2):198-205
pubmed: 30270683
Transcult Psychiatry. 2016 Jun;53(3):286-312
pubmed: 26905932
Int J Gynaecol Obstet. 2014 Jul;126(1):74-7
pubmed: 24786139
AIDS. 2018 Nov 28;32(18):2827-2833
pubmed: 30234603
Br J Psychiatry. 1987 Jun;150:782-6
pubmed: 3651732
Afr J AIDS Res. 2015;14(1):67-73
pubmed: 25920985
J Affect Disord. 2017 Sep;219:86-92
pubmed: 28531848
J Acquir Immune Defic Syndr. 2014 Mar 1;65(3):359-65
pubmed: 24189149
Trop Med Int Health. 2015 Jul;20(7):903-13
pubmed: 25754063
Res Nurs Health. 1995 Aug;18(4):371-5
pubmed: 7624531
AIDS Behav. 2014 Jun;18(6):1152-73
pubmed: 24584458
AIDS Behav. 2017 Jan;21(1):274-282
pubmed: 27052843