Comparison of Anxiety and Depression Among HIV-Positive and HIV-Negative Pregnant Women During COVID-19 Pandemic in Ekiti State, Southwest Nigeria

Abstract

Purpose Coronavirus disease 2019 (COVID-19) pandemic is the significant public health crisis of the 21st century that has disrupted personal, local, and international territorial relationships. Earlier studies have shown that people with HIV were at least twice at risk of dying from COVID-19 than the general population. There are also deep concerns about the indirect impact of COVID-19 on women within the reproductive age group in Sub-Saharan Africa who were already struggling to access reproductive healthcare services. In addition, pregnant HIV-positive women have an increased rate of anxiety and depression. This study, therefore, examined depression and anxiety disorders in pregnant HIV-positive women in response to the COVID-19 pandemic. Patients and Methods This cross-sectional study used a structured questionnaire containing sociodemographic information, Patient Health Questionnaire-9 (PHQ-9), and General Anxiety Disorder-7 (GAD-7) assessment tools. Data obtained were analyzed using Statistical Package for Social Science version 26. Results Ninety-nine (99) representing 78% of 127 pregnant HIV-positive women enrolled in the PMTCT program were eligible for this study. This number matched 99 randomly selected pregnant HIV-negative in the study areas as controls. Major depressive disorder (MDD) and severe anxiety disorder were significantly higher among the HIV-positive group than in the HIV-negative group (PHQ-9 Mean ± SD 8.0 ± 5.4 vs 2.3 ± 2.9; p = 0.000) and (GAD-7 Mean ± SD 5.9 ± 4.6 vs 1.2 ± 2.2; p = 0.000). Conclusion Given the high prevalence of major depressive disorder and severe anxiety disorder among pregnant HIV-positive women, mental health care should be incorporated into the prevention with positive interventions and strategies to reduce the indirect consequences of the COVID-19 pandemic.

Prevalence of Perinatal Anxiety and Related Disorders in Low- and Middle-Income Countries

“…Given that generalized anxiety disorder was reported across 184 studies, we were able to further interrogate the prevalence of this disorder across important subgroups (Figure 3). While investigating generalized anxiety by country income status, we found a higher prevalence among studies performed in lower-middle–income countries (27.6%; 95% CI, 21.6%-33.9%; 59 studies; n = 25 109) compared with low-income countries (24.0%; 95% CI, 15.3%-33.8%; 11 studies; n = 4961). Upper-middle–income countries had the lowest prevalence (19.1%; 95% CI, 16.0%-22.4%; 110 studies; n = 138 496).…”

“…Generalized anxiety disorder (including anxiety not specified) was the most commonly reported anxiety disorder, examined by 184 of 203 studies (90.6%) . The pooled point prevalence for generalized anxiety disorder was 22.2% (95% CI, 19.4%-25.0%; n = 173 553).…”

“…Our search identified 10 617 studies; 1231 full texts were reviewed, and of these, 203 studies were included (Figure 1; eTable 2 in Supplement 1). Cumulatively, outcomes were reported for 212 318 perinatal women (from conception to 12 months post birth) from 33 LMICs. The prevalence estimates of 6 anxiety and related disorders were reported: generalized anxiety disorder, social anxiety disorder, posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, and adjustment disorder.…”

“…The majority of studies reported the prevalence of generalized anxiety antenatally (150 [81.5%]). Among these, the pooled point prevalence was 23.9% (95% CI, 20.5%-27.4%; n = 149 485).…”

“…Next, we assessed the prevalence of generalized anxiety by method of assessment. Screening tools were used in 153 studies (17 different questionnaires), and 30 studies used a structured or semistructured diagnostic interview (8 types). One study used both .…”