title: Social Support, Stigma and Antenatal Depression Among HIV-Infected Pregnant Women in South Africa.
abstract: Depression, HIV-related stigma and low levels of social support may be particularly prevalent and adversely affect health and treatment outcomes among HIV-infected pregnant women. We examined factors associated with social support and stigma among pregnant women initiating antiretroviral therapy in the Western Cape, South Africa; and explored associations with depressive symptoms (Edinburgh Postnatal Depression Scale; EPDS) in linear regression models. Among 623 participants, 11 and 19 % had elevated EPDS scores using thresholds described in the original development of the scale (scores ≥13 and ≥10, respectively). Social support and stigma were highly interrelated and were associated with depressive symptoms. Stigma was observed to moderate the association between social support and depression scores; when levels of stigma were high, no association between social support and depression scores was observed. Elevated depression scores are prevalent in this setting, and interventions to reduce stigma and to address risk factors for depressive symptoms are needed.
authors.affiliation: Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa. kirstybrittain@gmail.com.
authors.forename: Kirsty
authors.initials: K
authors.lastname: Brittain
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA.
authors.forename: Claude A
authors.initials: CA
authors.lastname: Mellins
authors.affiliation: Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Tamsin
authors.initials: T
authors.lastname: Phillips
authors.affiliation: ICAP, Columbia University, Mailman School of Public Health, New York, NY, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Zerbe
authors.affiliation: ICAP, Columbia University, Mailman School of Public Health, New York, NY, USA.|College of Physicians & Surgeons, Columbia University, New York, NY, USA.
authors.forename: Elaine J
authors.initials: EJ
authors.lastname: Abrams
authors.affiliation: Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Landon
authors.initials: L
authors.lastname: Myer
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Remien
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D016014:Linear Models; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D037841:Pregnant People / Q000523:psychology*; D015995:Prevalence; D012307:Risk Factors; D057545:Social Stigma; D012944:Social Support; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
keywords: Antenatal depression; Pregnancy; Social support; South Africa; Stigma