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.
In a prospective observational study, Dr. Janet M. Turan, associate professor in the department of health care organization and policy at the University of Alabama at Birmingham — along with Dr. Bulent Turan, assistant professor in UAB’s department of psychology, and Ms. Kristi L. Stringer, graduate student trainee in the department of sociology — 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 the East African country of Kenya. Data were gathered from eight antenatal clinics in rural Nyanza Province regarding 135 HIV-positive women at their first antenatal visit (prior to testing HIV-positive for the first time) and then subsequently at six weeks after giving birth.
The researchers found that at this six-week point 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 with women who had linked to care and that 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.
“Linkage to HIV Care, Postpartum Depression, and HIV-related Stigma in Newly Diagnosed Pregnant Women Living with HIV in Kenya: A Longitudinal Observational Study” was published in December in the journal BMC Pregnancy & Childbirth.
Journal article: http://www.biomedcentral.com/1471-2393/14/400/abstract