Social determinants of peripartum depressive symptoms among Black peripartum women living with HIV.

HIV infection during pregnancy, may present risk of developing depression during pregnancy and postpartum. This psychiatric mood disorder, and many others such as anxiety and HIV-related post-traumatic stress disorder (PTSD) have been reported prevalent among pregnant and non-pregnant women living with HIV (WLWH). Multiple studies have found associations between social determinants of health and depressive symptoms in this population. However, despite deleterious effects on mother and child which may include suicidal ideations and infant death, only very few studies have examined this phenomenon for peripartum women, particularly Black women- a population prone to living in poor social and economic environments. Therefore, guided by the socio-ecologic model, this study examined predictors of peripartum depressive symptoms among Black peripartum WLWH. The study was a secondary data analysis of 143 Black women seen at special prenatal and women's health clinics in Miami, South Florida, USA. More than half of the women who experienced peripartum depressive symptoms (PDS) (n = 81, 57%) were of low socio-economic status. Low income was associated with increased odds of experiencing PDS. Women who endorsed intimate partner violence/abuse (IPV/A) were 6.5 times more likely to experience PDS; and compared to women with 1 or no childcare burden, women with 2 children-care burden were 4.6 times more likely to experience PDS. These findings demonstrate the negative impact of social factors on the psychological health of Black peripartum WLWH. Burdensome interpersonal relationships may have deleterious effects and trigger PDS among these women. Implications for nursing practice, education and research are also discussed.