“Pain in My Heart”: Understanding Perinatal Depression and Engagement in HIV Care in Malawi

Angela Bengtson, University of North Carolina at Chapel Hill
Bradley Gaynes, University of North Carolina at Chapel Hill
Mina Hosseinipour, University of North Carolina at Chapel Hill
Kazione Kulisewa, College of Medicine, Malawi
Anna Kutengule, UNC Project Malawi
Katherine LeMasters , University of North Carolina at Chapel Hill
Samantha Meltzer-Brody, University of North Carolina at Chapel Hill
Dalitso Midiani, Ministry of Health - Malawi
Steve Mphonda, UNC Project Malawi
Brian Pence, University of North Carolina at Chapel Hill
M. Udedi, Ministry of Health - Malawi

Perinatal depression (PND) is common among women living with HIV and can interfere with HIV care engagement, antiretroviral medication adherence, and clinical outcomes. We interviewed health providers and perinatal women with HIV and PND at clinics in Lilongwe District, Malawi. Of 73 women screened, 24 had PND. Women discussed a double burden of being newly diagnosed with HIV and feeling depressed. Many received an unexpected HIV diagnosis during antenatal care, which came with stigmatization, worry about transmission, anxiety around disclosure, marital issues, and low medication adherence. All women were open to PND screening and treatment, which providers agreed was necessary. Participants stated that counseling should begin during pregnancy and continue postpartum and that one-on-one counseling with nurses was preferable. These findings highlight the need to address PND among HIV-infected women. This formative research will guide an intervention to address PND and HIV care for HIV-infected women during the perinatal period.

See extended abstract

 Presented in Session 10. Fertility, Family Planning, Sexual Behavior & Reproductive Health 2