HIV/AIDS: Research and Palliative Care (Dec 2020)
One-Third of Perinatal Women Living with HIV Had Perinatal Depression in Gondar Town Health Facilities, Northwest Ethiopia
Abstract
Mulualem Mihret Gelaw,1 Ejigu Gebeye Zeleke,2 Mezgebu Silamsaw Asres,3 Mebratu Mitiku Reta3 1Felegehiwot Referral Hospital, Bahirdar, Ethiopia; 2Department of Epidemiology and Biostatistics, Institution of Public Health, University of Gondar, Gondar, Ethiopia; 3Department of Internal Medicine, School of Medicine, University of Gondar, Gondar, EthiopiaCorrespondence: Mebratu Mitiku Reta Email [email protected]: Depression is the most common co-morbidity among perinatal women living with HIV. It affects client’s adherence to care and treatment, which results in increased viral load; further exposing women to opportunistic infections that reduce quality-of-life. A cumulative effect of these may increase mother-to-child transmission of HIV.Methods: An institution-based cross-sectional study was conducted among perinatal women living with HIV in Gondar town health facilities, Northwest Ethiopia from October 1– 30, 2018. A single population proportion formula was used to calculate the sample size. The sample was stratified and proportionally allocated to each health facility. Participants were chosen from each stratum independently using a simple random sampling technique. A total of 422 study participants were selected. The World Health Organization (WHO) 20-item self-reported questionnaire (SRQ-20) was used to measure perinatal depression among women living with HIV. Perceived stigma was measured using HIV stigma scale. Women were interviewed at the PMTCT clinic during follow-up care, and clinical variables were extracted from client chart. Bi-variable and multivariable logistic regression models were used to identify factors associated with perinatal depression. Variables having an odds ratio with 95% confidence interval and a P-value less than 0.05 were taken as significant variables associated with perinatal depression.Results: The prevalence of perinatal depression among women living with HIV was found to be 38.4% (95% CI=34.1– 43.1%). Fair and poor ART drug adherence (AOR=5.44; 95% CI= 2.81– 10.56%), the presence of comorbid illness (AOR=3.24; 95% CI: 1.83– 5.75), being on second line ART (AOR=2.97; 95% CI=1.08– 8.17), perceived stigma (AOR=3.61; 95% CI=2.11– 6.17), and suicidal ideation (AOR=3.89; 95% CI=1.28– 11.81) were factors associated with perinatal depression.Conclusion: The prevalence of perinatal depression among women living with HIV was found to be high. Adherence counseling needs to be strengthened; preventing first line treatment failure has to be encouraged; greater emphasis has to be given for those women on second line ART. Early identification and management of co-morbidity has to be considered. HIV positive perinatal women need counseling to reduce HIV-related perceived stigma.Keywords: perinatal women, HIV/AIDS, depression, Ethiopia
