Duggal Mona, Sarna Avina, Dahiya Neha, Singh Roopal Jyoti, Jeon Sangchoon, Subramanian Anuradha, Sood Mamta, Singh Pushpendra, Kaur Gurjinder, Reynolds Nancy R
National Institute for Research in Digital Health and Data Science, Indian Council of Medical Research (ICMR), V. Ramalingaswami Bhawan, P.O. Box No. 4911 Ansari Nagar, New Delhi, 110029, India.
Population Council, Zone 5A, Ground Floor, India Habitat Centre, Lodi Road, New Delhi, 110003, India.
Oxf Open Digit Health. 2025 May 21;3:oqaf012. doi: 10.1093/oodh/oqaf012. eCollection 2025.
Pregnant and postpartum women living with Human Immunodeficiency Virus (HIV) are at high risk for perinatal depression, which can significantly undermine HIV care engagement and treatment outcomes. Despite this, depression often remains unidentified and untreated. This pilot study evaluated the feasibility, fidelity, acceptability and preliminary effects of a mobile phone counselling intervention among perinatal women living with HIV and depression in India. Forty women in their third trimester (≥28 weeks of gestation) and screening positive for depressive symptoms (Edinburgh Postnatal Depression Scale ≥13) were recruited from three government-run treatment centres in Delhi. Participants were randomized to: (a) the intervention condition, 'BEST-ma-CARE' mobile phone counselling, or (b) an attention control condition, time- and phone-matched perinatal wellness counselling. All counselling was delivered via basic mobile phones. Data were collected at baseline and follow-up at 36-40 weeks pregnancy, within 7 days of delivery and at 6 and 12 weeks postpartum. Overall, 82% of the participants completed the study, with higher retention in the intervention arm (90%). Engagement was also higher in the intervention group with 78% of antenatal and 95% of postnatal calls attended, compared to 70% and 80% in the control group. The intervention was highly acceptable; 76% reported it 'helped them a lot', compared to 69% in the control group. All participants (100%) appreciated scheduled counsellor calls. Both groups showed reductions in depressive symptoms and perceived illness severity, while internalized stigma increased only in the control group. Improvements in antiretroviral adherence, viral load and CD4 counts were stronger in the intervention group. Results indicate that integration of mobile phone counselling into maternal HIV care shows promise.
感染人类免疫缺陷病毒（HIV）的孕妇和产后妇女患围产期抑郁症的风险很高，这会严重影响她们对HIV治疗的参与度和治疗效果。尽管如此，抑郁症往往仍未得到识别和治疗。这项试点研究评估了针对印度感染HIV且患有抑郁症的围产期妇女的手机咨询干预措施的可行性、保真度、可接受性和初步效果。从德里的三个政府运营的治疗中心招募了40名孕晚期（妊娠≥28周）且抑郁症状筛查呈阳性（爱丁堡产后抑郁量表≥13）的妇女。参与者被随机分为：（a）干预组，即“BEST-ma-CARE”手机咨询，或（b）注意力控制组，即时间和电话匹配的围产期健康咨询。所有咨询均通过基本手机进行。在基线、妊娠36 - 40周、分娩后7天内以及产后6周和12周进行随访时收集数据。总体而言，82%的参与者完成了研究，干预组的保留率更高（90%）。干预组的参与度也更高，产前咨询电话的接听率为78%，产后咨询电话的接听率为95%，而对照组分别为70%和80%。该干预措施非常容易被接受；76%的人表示它“对她们帮助很大”，而对照组为69%。所有参与者（100%）都对安排的咨询师电话表示赞赏。两组的抑郁症状和感知疾病严重程度均有所降低，而内化耻辱感仅在对照组中有所增加。干预组在抗逆转录病毒治疗依从性、病毒载量和CD4细胞计数方面的改善更为明显。结果表明，将手机咨询纳入孕产妇HIV护理显示出前景。
