Effects of Depression, Stigma and Intimate Partner Violence on Postpartum Women ’s Adherence and Engagement in HIV Care in Kenya

AbstractWe explored the association between HIV-related stigma and experiences of intimate partner violence (IPV) and depression with viral load suppression, and medication and visit adherence in postpartum women receiving lifelong antiretroviral therapy (ART) (N  = 200). We administered a cross-sectional survey to 200 women with HIV at 12 months postpartum who were enrolled in the MOTIVATE trial. The MOTIVATE study is a cluster-randomized trial evaluating the impact of community mentor mothers and text messaging on PMTCT outcomes in southwestern Kenya. Simple and multivariable logistic regression analysis was performed in STATA. Women who experienced stigma or IPV were more likely to miss clinic visits (internalized stigma aOR 1.30 95%CI 1.03–1.64; anticipated stigma aOR 1.20 95%CI 1.04–1.42; IPV aOR 15.71 95%CI 1.47–167.80), report difficu lty taking ART drugs (internalized stigma aOR 1.32 95%CI 1.10–1.58; anticipated stigma aOR 1.14 95%CI 1.01–1.30) and not taking medication as prescribed (IPV aOR 2.00 95%CI 1.05–3.74). Depression was additionally associated with decreased odds of viral load suppression (aOR 0.16 95%CI 0.04–0 .76). There is need to develop tailored psychosocial interventions within PMTCT programs that appropriately address mental health, stigma, and violence.
Source: AIDS and Behavior - Category: Infectious Diseases Source Type: research

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CONCLUSIONS: Food insecurity places low-income African American women at risk of depression. Given widespread poverty among HIV-positive individuals in the Black Belt, access to food should be considered in HIV-related prescriptions and in health disparities research. PMID: 31735727 [PubMed - in process]
Source: Journal of Health Care for the Poor and Underserved - Category: International Medicine & Public Health Authors: Tags: J Health Care Poor Underserved Source Type: research
This study fills that gap by including all mothers in specified areas. A cohort study examines MLH in Cape Town, South Africa recruited in pregnancy and followed repeatedly for 5  years, compared to MWOH. Almost all (98%) pregnant women in 12 neighborhoods (N = 594) were recruited in pregnancy. Mothers and children were reassessed five times over 5 years with high retention rates at each of the six assessments, from 98.7% at 2 weeks to 82.8% at 5 years post-birth. ML H’s uptake and adherence to HIV care was evaluated over time associated with maternal comorbidities of alcohol use, de...
Source: AIDS and Behavior - Category: Infectious Diseases Source Type: research
This study sought to understand how women’s attitudes towards ART changes between the pregnancy and postpartum periods, and the factors associated with these attitudes. The study enrolled 200 pregnant women living with HIV. Structured surveys were administered during pregnancy and at three and 6 months postpartum. Overall, attitudes towards ART were stable over time. More positive attitudes towards ART were associated with HIV acceptance, lower levels of depression, and lower levels of shame. Counselling interve ntions are needed to help HIV-infected women accept their status and reduce shameful emotions. Depres...
Source: AIDS and Behavior - Category: Infectious Diseases Source Type: research
The recently appointed director of NIDCD brings an extensive research background in hearing loss, ear disease, and cochlear implantation—and an enthusiasm for addressing barriers to hearing health care. Interview by Jillian Kornak The National Institutes of Health (NIH) recently named Debara L. Tucci the next director of the National Institute on Deafness and Other Communication Disorders (NIDCD), replacing acting director Judith Cooper. Tucci will leave her position as professor of surgery in the Division of Head and Neck Surgery &Communication Sciences at Duke University Medical Center, where she has served on ...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Academia & Research Audiology Health Care News Private Practice Schools Slider Aging and Hearing Loss audiologist hearing health care public health Source Type: blogs
AbstractThe aim was to identify latent class trajectories of depression symptoms among HIV+ women in Uganda. Depression was assessed at four time points using the Hopkins Symptom Checklist among 288 women caring for a child 2 –5 years old. Mixture modeling was used to estimate the number and nature of classes defined by trajectories of depressive symptoms over time. Maternal and child characteristics were explored as predictors of class. Three trajectories of symptoms of depression were identified; (1) stable-low, (2) moderate-subclinical, and (3) chronic-high. About 8% of women reported moderately or highly ele...
Source: AIDS and Behavior - Category: Infectious Diseases Source Type: research
Conclusion: Probable antenatal depression was not associated with engagement in HIV care through 12 months post-ART initiation. In a population with high HIV care engagement, antenatal depression may not impair HIV-related outcomes.
Source: AIDS - Category: Infectious Diseases Tags: CONCISE COMMUNICATIONS Source Type: research
AbstractIn developing countries, up to 20% of maternal deaths during pregnancy are due to suicide, and being HIV-infected confers additional risk. This manuscript sought to identify perinatal correlates of suicidal ideation among women living with HIV (WLHIV) in rural South Africa. Pregnant WLHIV (N  = 681) were recruited and re-assessed at 12-months postpartum. Mean age was 28.3 (SD = 5.7) years and 68% were below the poverty line. Prenatal suicidal ideation was 39%; suicidal ideation continued for 7% at 12 months, 13% experienced incident suicidal ideation, and for 19% suicidal ideat ion ...
Source: AIDS and Behavior - Category: Infectious Diseases Source Type: research
ConclusionsThis study aids to draw attention on the incorporation of routine screening for basic support and intervention for identified risk factors in postpartum period. Policies can be formulated to encourage postpartum women to obtain adequate rest during pregnancy, support women with poor partner relationship, reduce marital dissatisfaction, help women adjust with stressful life events, and prevent and manage abortion appropriately. These policies may reduce harmful consequences of postpartum depressive symptoms for women, newborn and their family.
Source: International Journal of Nursing Sciences - Category: Nursing Source Type: research
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 009 The diagnosis of HIV is no longer fatal and the term AIDS is becoming less frequent. In many countries, people with HIV are living longer than those with diabetes. This post will hopefully teach the basics of a complex disease and demystify some of the potential diseases you need to consider in those who are severely immunosuppressed. While trying to be comprehensive this post can not be exhaustive (as you can imagine any patient with ...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Clinical Cases Tropical Medicine AIDS art cryptococcoma cryptococcus HIV HIV1 HIV2 PEP PrEP TB toxoplasma tuberculoma Source Type: blogs
ConclusionsThis study aids to draw attention on the incorporation of routine screening for basic support and intervention for identified risk factors in postpartum period. Policies can be formulated to encourage postpartum women to obtain adequate rest during pregnancy, support women with poor partner relationship, reduce marital dissatisfaction, help women adjust with stressful life events, and prevent and manage abortion appropriately. These policies may reduce harmful consequences of postpartum depressive symptoms for women, newborn and their family.
Source: International Journal of Nursing Sciences - Category: Nursing Source Type: research
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