Menu Close

“Pain in My Heart”: Understanding Perinatal Depression among Women Living with HIV in Malawi


LeMasters, Katherine; Dussault, Josée; Barrington, Clare; Bengtson, Angela M.; Gaynes, Bradley; Go, Vivian F.; Hosseinipour, Mina C.; Kulisewa, Kazione; Kutengule, Anna; & Meltzer-Brody, Samantha, et al. (2020). "Pain in My Heart": Understanding Perinatal Depression among Women Living with HIV in Malawi. PLOS ONE, 15(6), e0227935. PMCID: PMC7274419


BACKGROUND: Perinatal depression (PND) can interfere with HIV care engagement and outcomes. We examined experiences of PND among women living with HIV (WLWH) in Malawi.
METHODS: We screened 73 WLWH presenting for perinatal care in Lilongwe, Malawi using the Edinburgh Postnatal Depression Scale (EPDS). We conducted qualitative interviews with 24 women experiencing PND and analyzed data using inductive and deductive coding and narrative analysis.
RESULTS: Women experienced a double burden of physical and mental illness, expressed as pain in one's heart. Receiving an HIV diagnosis unexpectedly during antenatal care was a key contributor to developing PND. This development was influenced by stigmatization and social support.
CONCLUSIONS: These findings highlight the need to recognize the mental health implications of routine screening for HIV and to routinely screen and treat PND among WLWH. Culturally appropriate mental health interventions are needed in settings with a high HIV burden.


Reference Type

Journal Article

Article Type


Year Published


Journal Title



LeMasters, Katherine
Dussault, Josée
Barrington, Clare
Bengtson, Angela M.
Gaynes, Bradley
Go, Vivian F.
Hosseinipour, Mina C.
Kulisewa, Kazione
Kutengule, Anna
Meltzer-Brody, Samantha
Midiani, Dalitso
Mphonda, Steve
Udedi, Michael
Pence, Brian W.