Department of Global Health, University of Washington, Seattle, WA, USA.
Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA.
AIDS Behav. 2023 Mar;27(3):783-795. doi: 10.1007/s10461-022-03810-6. Epub 2022 Oct 9.
Depression is common during pregnancy and is associated with reduced adherence to HIV-related care, though little is known about perinatal trajectories of depression and viral suppression among women living with HIV (WLHV) in sub-Saharan Africa. We sought to assess any association between perinatal depressive symptoms and viral non-suppression among WLWH. Depressive symptomatology and viral load data were collected every 6 months from WLWH enrolled in the African Cohort Study (AFRICOS; January 2013-February 2020). Generalized estimating equations modeled associations between depressive symptoms [Center for Epidemiological Studies Depression (CES-D) ≥ 16] and viral non-suppression. Of 1722 WLWH, 248 (14.4%) had at least one pregnancy (291 total) and for 61 pregnancies (21.0%), women reported depressive symptoms (13.4% pre-conception, 7.6% pregnancy, 5.5% one-year postpartum). Depressive symptomatology was associated with increased odds of viral non-suppression (aOR 2.2; 95% CI 1.2-4.0, p = 0.011). Identification and treatment of depression among women with HIV may improve HIV outcomes for mothers.
抑郁症在怀孕期间很常见，与 HIV 相关护理的依从性降低有关，尽管人们对撒哈拉以南非洲地区 HIV 感染者（WLHV）的围产期抑郁和病毒抑制轨迹知之甚少。我们试图评估围产期抑郁症状与 WLWH 病毒抑制不良之间的任何关联。从 2013 年 1 月至 2020 年 2 月，在参加非洲队列研究（AFRICOS）的 WLWH 中每 6 个月收集一次抑郁症状和病毒载量数据。广义估计方程模型分析了抑郁症状[流行病学研究中心抑郁量表（CES-D）≥16]与病毒抑制不良之间的关联。在 1722 名 WLWH 中，有 248 名（14.4%）至少怀孕一次（共 291 次），对于 61 次妊娠，女性报告有抑郁症状（受孕前 13.4%、妊娠时 7.6%、产后一年时 5.5%）。抑郁症状与病毒抑制不良的几率增加相关（调整比值比 2.2；95%CI 1.2-4.0，p=0.011）。识别和治疗 HIV 感染者的抑郁症可能会改善母亲的 HIV 结局。
