Probable Antenatal Depression at Antiretroviral Initiation and Postpartum Viral Suppression and Engagement in Option B

Citation

Harrington, Bryna J.; Pence, Brian W.; Maliwichi, Madalitso; Jumbe, Allan N.; Gondwe, Ntchindi A.; Wallie, Shaphil D.; Gaynes, Bradley N.; Maselko, Joanna; Miller, William C.; & Hosseinipour, Mina C., and the S4 Study Team (2018). Probable Antenatal Depression at Antiretroviral Initiation and Postpartum Viral Suppression and Engagement in Option B. AIDS, 32(18), 2827-2833. PMCID: PMC6528829

Abstract

OBJECTIVE: To estimate the association of probable antenatal depression with postpartum HIV care engagement among pregnant women in Malawi. DESIGN: We conducted a prospective cohort study of 299 women who were initiating antiretroviral therapy (ART) through Option B+ at a government antenatal clinic in Malawi.
METHODS: Probable antenatal depression was assessed on the day of ART initiation with the validated Chichewa version of the Edinburgh Postnatal Depression Scale (EPDS). We estimated crude and adjusted risk differences (RD, aRD) of visit attendance and prevalence differences (PD, aPD) of viral suppression through 12 months post-ART initiation comparing women with versus without probable antenatal depression.
RESULTS: One in ten women had probable antenatal depression. Most women were engaged in care through 12 months post-ART initiation: 85% attended all scheduled ART visits, and 81% were in care and virally suppressed. Women with and without probable antenatal depression had a comparable probability of attending all scheduled visits (RD: -0.02; 95%CI -0.16-0.12; aRD: -0.04; 95%CI -0.18-0.10), and of viral suppression (PD: -0.02; 95%CI -0.17-0.13; aPD: -0.01; 95%CI -0.17-0.15) in crude and adjusted analyses.
CONCLUSION: Probable antenatal depression was not associated with engagement in HIV care through 12 months post-ART initiation. In a population with high HIV care engagement, antenatal depression may not impair HIV-related outcomes.

URL

http://dx.doi.org/10.1097/qad.0000000000002025

Reference Type

Journal Article

Year Published

2018

Journal Title

AIDS

Author(s)

Harrington, Bryna J.
Pence, Brian W.
Maliwichi, Madalitso
Jumbe, Allan N.
Gondwe, Ntchindi A.
Wallie, Shaphil D.
Gaynes, Bradley N.
Maselko, Joanna
Miller, William C.
Hosseinipour, Mina C., and the S4 Study Team

PMCID

PMC6528829

ORCiD

Maselko - 0000-0002-6270-8237