Preferences for enhanced treatment options to address HIV care engagement among women living with HIV and perinatal depression in Malawi

BMC Public Health

Research

Angela Bengtson¹  Brian Pence²  Josée Dussault²  Vivian Go³  Kazione Kulisewa⁴  Michael Udedi⁵  Bradley N. Gaynes⁶  Samantha Meltzer-Brody⁶  Steve Mphonda⁷  Anna Kutengule⁷  Mina C. Hosseinipour⁸ 

[1] Department of Epidemiology, Brown School of Public Health, Brown University, Providence, RI, USA;Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;Department of Psychiatry and Mental health, Kamuzu University of Health Sciences, Blantyre, Malawi;Department of Psychiatry and Mental health, Kamuzu University of Health Sciences, Blantyre, Malawi;Ministry of Health, Lilongwe, Malawi;Department of Psychiatry, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;UNC-Project Malawi, Private Bag A-104, Lilongwe, Malawi;UNC-Project Malawi, Private Bag A-104, Lilongwe, Malawi;Department of Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;

关键词: Perinatal depression;    HIV;    Mental health;    Malawi;   

DOI  :  10.1186/s12889-023-16835-w

 received in 2022-11-03, accepted in 2023-09-25,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundOption B + offers lifelong ART to pregnant or breastfeeding mothers, but postpartum loss to HIV care, partially driven by perinatal depression (PND), threatens the impact of this policy. This study aims to understand women’s and providers’ preferences for developing a feasible intervention to address PND and support engagement in HIV care among women living with PND and HIV.MethodsWe conducted a total of 6 focus group discussions (FGDs) involving 4 clinics in Lilongwe District from December 2018 through February 2019. We conducted 2 FGDs each among 3 stakeholder groups: clinical staff, prenatal women, and postnatal women. Perinatal participants were living with HIV and screened positively for PND using the validated Edinburgh Postnatal Depression Scale (EPDS). Clinical staff were nurses who were trained antiretroviral therapy (ART) providers. Interviewers led FGDs in Chichewa using a semi-structured guide. Data were analyzed using deductive and inductive coding in NVivo 12 software.ResultsWomen favored ART linkage services, but providers said they already offered such services, with mixed results. Individual counselling was universally supported. A perceived benefit of group counselling was peer support, but there were concerns among women regarding confidentiality and stigma. Women liked mobile appointment reminders but identified low phone ownership as a barrier. Participants recommended home visits as an additional care engagement strategy. Women consistently discussed the need for social support from family members and friends to address PND and support engagement in HIV care.ConclusionThis study highlights the importance of peer encouragement to support perinatal HIV care engagement among women with HIV and PND. The results from this study can be used to support intervention development to increase HIV care engagement and improve long-term HIV outcomes in women with PND.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023