One-Third of Perinatal Women Living with HIV Had Perinatal Depression in Gondar Town Health Facilities, Northwest Ethiopia.

Background: Depression is the most common co-morbidity among perinatal women living with HIV. It affects client's adherence to care and treatment, which results in increased viral load; further exposing women to opportunistic infections that reduce quality-of-life. A cumulative effect of these may increase mother-to-child transmission of HIV.

Methods: An institution-based cross-sectional study was conducted among perinatal women living with HIV in Gondar town health facilities, Northwest Ethiopia from October 1-30, 2018. A single population proportion formula was used to calculate the sample size. The sample was stratified and proportionally allocated to each health facility. Participants were chosen from each stratum independently using a simple random sampling technique. A total of 422 study participants were selected. The World Health Organization (WHO) 20-item self-reported questionnaire (SRQ-20) was used to measure perinatal depression among women living with HIV. Perceived stigma was measured using HIV stigma scale. Women were interviewed at the PMTCT clinic during follow-up care, and clinical variables were extracted from client chart. Bi-variable and multivariable logistic regression models were used to identify factors associated with perinatal depression. Variables having an odds ratio with 95% confidence interval and a -value less than 0.05 were taken as significant variables associated with perinatal depression.

Results: The prevalence of perinatal depression among women living with HIV was found to be 38.4% (95% CI=34.1-43.1%). Fair and poor ART drug adherence (AOR=5.44; 95% CI= 2.81-10.56%), the presence of comorbid illness (AOR=3.24; 95% CI: 1.83-5.75), being on second line ART (AOR=2.97; 95% CI=1.08-8.17), perceived stigma (AOR=3.61; 95% CI=2.11-6.17), and suicidal ideation (AOR=3.89; 95% CI=1.28-11.81) were factors associated with perinatal depression.

Conclusion: The prevalence of perinatal depression among women living with HIV was found to be high. Adherence counseling needs to be strengthened; preventing first line treatment failure has to be encouraged; greater emphasis has to be given for those women on second line ART. Early identification and management of co-morbidity has to be considered. HIV positive perinatal women need counseling to reduce HIV-related perceived stigma.