The Effect of Telephone Support on Depressive Symptoms Among HIV-Infected Pregnant Women in Thailand: An Embedded Mixed Methods Study

Abstract

Depressive symptoms negatively impact the lives of HIV-infected individuals and are correlated with faster progression to AIDS. Our embedded mixed methods study examined and described the effects of telephone support on depressive symptoms in a sample of HIV-infected pregnant Thai women. HIV-infected pregnant Thai women (n = 40) were randomly assigned to either the control or the intervention group. A registered nurse provided telephone support to the intervention group. Depressive symptoms were measured at three points in both groups. In-depth interviews were conducted at Time 2 and Time 3. Results show that depressive symptoms in the intervention group decreased over time. Qualitative results describe how telephone support can work, but also reveal that telephone support did not work for everyone. We recommend that a larger mixed methods study be conducted to examine the effects of telephone support on depressive symptoms among HIV-infected women, including the costs and benefits of such support.

Mental Health of HIV-Seropositive Women During Pregnancy and Postpartum Period: A Comprehensive Literature Review

“…The efficacy of multivitamin supplementation [30] and problem-solving group therapy [31] in Tanzanian RCTs; telephone supportive intervention in the Thailand RCT [37]; and promising results of culturally adapted psycho-educational interventions in two South African trials [25, 26] are encouraging. Future RCTs could build on this evidence and evaluate interventions aimed at not only improving mental health outcomes, but also evaluating the impact on salient clinical outcomes, such as ART adherence, HIV disease severity, obstetric outcomes or MTCT rates.…”

“…Of these five studies, four were descriptive, cross-sectional studies [34–36, 38], and one was a mixed-methods study combining a clinical trial with a qualitative study [37]. All five studies used the CES-D to quantify the depressive symptoms.…”

“…[37] The intervention, which included scheduled weekly telephone sessions of emotional and educational support provided by a registered nurse, as well as additional sessions initiated by the participants on an as-needed basis, showed greater improvement of CES-D scores from baseline to 1-month and 2-month follow-up relative to the control condition (i.e., regular prenatal care, including routinely provided standard information regarding pregnancy and HIV self-care). Additionally, in-depth interviews were conducted only with the women who had participated in the active treatment arm ( N = 20).…”

“…The narratives highlighted the following three factors as key ingredients of the intervention that helped decrease depressive symptoms: (1) putting things into perspective, (2) knowing that someone was always there and (3) practical guidance. [37]…”

Women, Motherhood and Living with HIV/AIDS

“…As mentioned earlier, telephone support by an RN was found to be helpful in lessening depressive symptoms among HIV-positive pregnant women in Thailand (Ross et al 2012b ) . Thus, emotional and informational telephone support could be expanded to more effectively care for HIV-positive perinatal Thai women.…”