Faculty of Applied Sciences, School of Nursing The University of British Columbia, Vancouver Campus, Musqueam Traditional Territory, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.
University of Miami School of Nursing and Health Studies, 5030 Brunson Drive, Coral Gables, Miami 33143, United States of America.
Arch Psychiatr Nurs. 2021 Feb;35(1):102-110. doi: 10.1016/j.apnu.2020.05.004. Epub 2020 May 23.
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.
HIV 感染孕妇，可能增加孕妇和产后抑郁的风险。这种精神情绪障碍，以及焦虑和与 HIV 相关的创伤后应激障碍（PTSD）等许多其他障碍，在感染 HIV 的孕妇和非孕妇中都有报道。多项研究发现，健康的社会决定因素与该人群的抑郁症状之间存在关联。然而，尽管这对母婴都有不良影响，包括自杀意念和婴儿死亡，但只有极少数研究检查了围产期妇女（尤其是黑人妇女）的这种现象，黑人妇女更容易生活在贫穷的社会和经济环境中。因此，本研究以社会生态学模型为指导，检查了围产期黑人 HIV 感染妇女围产期抑郁症状的预测因素。这项研究是对美国佛罗里达州迈阿密的特殊产前和妇女健康诊所的 143 名黑人妇女进行的二次数据分析。经历围产期抑郁症状（PDS）的妇女中，超过一半（n=81，57%）社会经济地位较低。低收入与 PDS 发生几率增加相关。经历过亲密伴侣暴力/虐待（IPV/A）的妇女发生 PDS 的几率增加 6.5 倍；与儿童照顾负担为 1 或没有的妇女相比，儿童照顾负担为 2 的妇女发生 PDS 的几率增加 4.6 倍。这些发现表明，社会因素对围产期黑人 HIV 感染妇女的心理健康有负面影响。负担过重的人际关系可能对这些妇女产生有害影响并引发 PDS。还讨论了护理实践、教育和研究的意义。
