TY  - JOUR
PY  - 2022//
TI  - Stressors and maladaptive coping mechanisms associated with elevated perinatal depressive symptoms and suicidality among women living with HIV in Uganda
JO  - International journal of behavioral medicine
A1  - Wagner, Glenn J.
A1  - Gwokyalya, Violet
A1  - Akena, Dickens Howard
A1  - Nakigudde, Janet
A1  - McBain, Ryan
A1  - Faherty, Laura
A1  - Ngo, Victoria
A1  - Nakku, Juliet
A1  - Kyohangirwe, Leticia
A1  - Banegura, Anchilla
A1  - Beyeza-Kashesya, Jolly
A1  - Wanyenze, Rhoda K.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Perinatal depression is highly prevalent among women living with HIV and contributes to nonadherence to the PMTCT (prevention of mother-to-child transmission) care continuum. We examined correlates of elevated depressive symptoms and suicidality in this population. <br><br>METHOD: Baseline data from 391 Ugandan women enrolled in a cluster randomized controlled trial of a depression care intervention were analyzed. Adult women with confirmed sero-positive HIV status were eligible if their gestation period was ≤ 32 weeks, and they had a Patient Health Questionnaire (PHQ-9) score ≥ 5. Correlates of elevated depressive symptoms (PHQ-9 > 9) and moderate-to-severe suicidal ideation (more than half of the days in the prior 2 weeks) were assessed using bivariate and multivariate logistic regression models, controlling for clustering within study sites by using a random effects specification (with study site as the random effect), as well as age and education. <br><br>RESULTS: The mean PHQ-9 score was 12.7 (SD = 5.1); 267 (68.3%) participants had elevated depressive symptoms, and 51 (13.0%) reported moderate-to-severe suicidality. In multiple logistic regression analysis, perceived provider stigma of childbearing [OR (95% CI) = 1.81 (1.16, 2.84)], greater use of negative problem-solving [OR (95% CI) = 1.09 (1.04, 1.15)], and lower general social support [OR (95% CI) = 0.50 (0.30, 0.82)] were correlated with elevated depression symptoms, while moderate-to-severe suicidal ideation was correlated with greater experience of physical interpersonal violence (IPV) and greater use of negative problem-solving. <br><br>CONCLUSIONS: Programs aimed at improving provider support for the childbearing needs of persons living with HIV, supporting women who are experiencing IPV, and helping women to develop effective problem-solving skills and social supports may reduce symptoms of perinatal depression and help optimize PMTCT care outcomes. TRIAL REGISTRATION: Clinicaltrials.gov NCT03892915 (registered March 21, 2019).<p />  <p>Language: en</p>
LA  - en
SN  - 1070-5503
UR  - http://dx.doi.org/10.1007/s12529-022-10124-3
ID  - ref1
ER  -