HIV-status disclosure and depression in the context of unintended pregnancy among South African women.
Depressive symptoms are common among pregnant women living with HIV, and an unintended pregnancy may heighten vulnerability. HIV-status disclosure is thought to improve psychological well-being, but few quantitative studies have explored the relationships among disclosure, pregnancy intention and depression. Using multivariable linear regression models, we examined the impact of disclosure on depressive symptoms (Edinburgh Postnatal Depression Scale; EPDS) during pregnancy and postpartum among women who tested HIV-positive during the pregnancy in South Africa; and explored the role of pregnancy intention in this relationship. Among 350 women (median age: 27 years; 70% reporting that their current pregnancy was unintended), neither disclosure to a male partner nor disclosure to ≥1 family/community member had a consistent effect on depressive symptoms. However, pregnancy intention modified the association between disclosure to a male partner and depression during pregnancy: disclosure was associated with higher depression scores among women who reported that their current pregnancy was unintended but was associated with lower depression scores among women who reported that their pregnancy was intended. During the early postpartum period, disclosure to ≥1 family/community member was associated with higher depression scores. Counselling around disclosure in pregnancy should consider the heightened vulnerability that women face when experiencing an unintended pregnancy.
['Brittain|Kirsty|K|', 'Mellins|Claude A|CA|', 'Remien|Robert H|RH|', 'Phillips|Tamsin|T|', 'Zerbe|Allison|A|', 'Abrams|Elaine J|EJ|', 'Myer|Landon|L|']
D000328:Adult D019052:Depression, Postpartum D005260:Female D015658:HIV Infections D006304:Health Status D006801:Humans D011247:Pregnancy D011275:Pregnancy, Unwanted D057566:Self Report D013019:South Africa D014342:Truth Disclosure
disclosure depression HIV pregnancy intention South Africa