Kabel Katherine E, Lee Jane H, Githaiga Jennifer N, Gwangqa Linda, Fertig Madison R, Gulbicki Lauren R, Bustamante Maria J, Knight Lucia, O'Cleirigh Conall, Psaros Christina, Stanton Amelia M
Department of Psychological & Brain Sciences, Boston University, MA, USA.
Division of Social and Behavioural Sciences, University of Cape Town, South Africa.
Womens Health (Lond). 2025 Jan-Dec;21:17455057251351417. doi: 10.1177/17455057251351417. Epub 2025 Aug 25.
Pregnant and postpartum persons (PPPs) are at increased risk for HIV acquisition, and depression and posttraumatic stress disorder (PTSD) negatively impact engagement in HIV prevention behaviors like pre-exposure prophylaxis (PrEP) use, thereby increasing risk.
The present study explored changes in mental health symptoms from pregnancy to postpartum to inform future interventions for PPP that address mental health and HIV prevention.
This analysis is part of a larger, mixed-methods study conducted in South Africa that examined antenatal mental health barriers to PrEP use, employing an explanatory sequential design.
Participants recruited from an antenatal clinic were pregnant or postpartum, over 18, not on PrEP, and with no history of PrEP use. Participants first took a survey to assess depression and PTSD symptoms. Those with elevated symptoms during pregnancy completed qualitative interviews during pregnancy and postpartum. Data were analyzed via thematic analysis.
Of 110 survey participants, 23 completed qualitative interviews (10 pregnancy only, 6 postpartum only, 7 both). This analysis includes 13 participants who completed either both interviews or postpartum only. Three themes illustrated processes linked to symptom reduction postpartum: (1) increased feelings of empowerment (e.g., via acceptance of life circumstances), (2) improvements in emotional and tangible support (e.g., via improved communication, increased caretaking and financial support), and (3) conceptualizations of infants and motherhood as sources of joy and motivation (e.g., pride in maternal role, companionship with baby).
These themes highlight processes that may contribute to reductions in depression and PTSD symptoms postpartum, which could be integrated into interventions targeting mental health and HIV prevention during pregnancy. Intervention components may include skills promoting self-efficacy, problem-solving, communication, and identifying sources of joy and meaning. Interventions leveraging these mechanisms of symptom improvement during the postpartum transition may enhance mental health during pregnancy and promote greater engagement in HIV prevention behaviors.
孕妇和产后人群感染艾滋病毒的风险增加，而抑郁症和创伤后应激障碍（PTSD）会对诸如使用暴露前预防（PrEP）等艾滋病毒预防行为的参与度产生负面影响，从而增加风险。
本研究探讨了从孕期到产后心理健康症状的变化，以为未来针对孕妇和产后人群的心理健康及艾滋病毒预防干预措施提供参考。
该分析是在南非进行的一项更大规模的混合方法研究的一部分，该研究采用解释性序列设计，考察了使用PrEP的产前心理健康障碍。
从产前诊所招募的参与者为孕妇或产后女性，年龄超过18岁，未使用PrEP，且无PrEP使用史。参与者首先进行一项调查，以评估抑郁症和PTSD症状。孕期症状严重的参与者在孕期和产后完成定性访谈。通过主题分析对数据进行分析。
在110名参与调查的参与者中，23人完成了定性访谈（10人仅在孕期接受访谈，6人仅在产后接受访谈，7人在孕期和产后均接受访谈）。本分析纳入了13名完成了两次访谈或仅产后访谈的参与者。三个主题阐述了与产后症状减轻相关的过程：（1）增强的赋权感（例如，通过接受生活状况），（2）情感和实际支持的改善（例如，通过改善沟通、增加照顾和经济支持），以及（3）将婴儿和母亲身份视为快乐和动力来源的观念（例如，对母亲角色的自豪感、与婴儿的陪伴）。
这些主题突出了可能有助于减轻产后抑郁症和PTSD症状的过程，这些过程可纳入针对孕期心理健康和艾滋病毒预防的干预措施中。干预内容可能包括促进自我效能感、解决问题、沟通以及识别快乐和意义来源的技能。利用产后过渡期间这些症状改善机制的干预措施可能会增强孕期的心理健康，并促进更多地参与艾滋病毒预防行为。
