The importance of identifying and treating depression in HIV infected, pregnant women: a review

Abstract

Women make up approximately half of all HIV infections worldwide. A substantial number of women living with HIV in the United States are of childbearing age and many of these women will become pregnant each year. These women must navigate the complexities of two health concerns (HIV infection and pregnancy) and the complexities of two health care provision systems (obstetrics and infectious disease). The goal of HIV treatment during pregnancy is to optimize health of the mother and minimize risk of vertical transmission. To realize these goals, high levels of adherence to antiretroviral therapy (ART) and periodic contact with medical professionals are required. Depression is not uncommon in pregnant women and has been identified as a robust predictor of non-adherence to ART and implicated in difficulty utilizing prenatal care. The purpose of the current article is to review evidence in support of diagnosis and treatment, when appropriate, of unipolar depression in HIV positive, pregnant women in developed nations. The article begins by defining the scope of the problem. Assessment and treatment options are discussed, followed by suggestions for future research.

Rates and predictors of prenatal depression in women living with and without HIV

“…If providers are aware that these variables may predict depression, they can identify women at risk and intervene earlier in the pregnancy through targeted or more frequent screening. Identifying and treating depression in pregnant women with HIV is critical in increasing ART adherence and prenatal care utilization, while improving the mother's health and reducing the risk of perinatal transmission (Psaros et al, 2009). Providers can accomplish this through the implementation of more frequent depression screenings, the provision of mental health referrals, and increased ART adherence counseling during pregnancy.…”

“…Because fertility desires are not impacted by HIV serostatus (Chen, Phillips, Kanouse, Collins, & Miu, 2001;Finocchario-Kessler et al, 2012;Loutfy et al, 2009), a growing number of women face pregnancy complicated by HIV infection, and will confront the concomitant demands of these two conditions. Moreover, prenatal depression affects women's physical and mental well-being in multiple ways, making it important to investigate the impact of prenatal depression, especially among women with HIV (Psaros, Geller, & Aaron, 2009).…”

Levels of self-reported depression and anxiety among HIV-positive patients in Albania: a cross-sectional study

“…The number of HIV-positive patients with self-reported histories of mental health diagnoses in Albania is high, so addressing these issues for patients in the future may be vital in combating a local epidemic. Early recognition of these diseases and proper intervention could aid in maintaining the low HIV prevalence in Albania (52,53). …”

Coping Strategies Among Brazilian Pregnant Women Living With HIV

“…A noteworthy finding of the present study is that being diagnosed with HIV during pregnancy can impose difficulties to gather social support to cope with the infection. Literature has well documented the great emotional burden involved in receiving a HIV diagnosis, especially for the initial phase of adjustment to HIV and due to the HIV-related stigma (Psaros, Geller, & Aaron, 2009). Our findings alert us to the need to address this particular group of women who received their diagnosis concurrently with confirmation of their pregnancy.…”