Treatment of Perinatal Depression and Correlates of Treatment Response Among Pregnant Women Living with HIV in Uganda.
In: Maternal and child health journal, Jg. 27 (2023-11-01), Heft 11, S. 2017-2025
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Introduction: Perinatal depression is common among women living with HIV, but depression care is limited in low-resource settings. We examined (1) characteristics of women receiving Problem Solving Therapy (PST) versus antidepressant therapy (ADT), (2) treatment response by modality, and (3) correlates of treatment response.
Methods: This analysis used data from 191 Ugandan women in the intervention arm of a cluster randomized controlled trial of task-shifted, stepped-care depression treatment for pregnant women living with HIV (PWLWH). Treatment response was defined as scoring < 5 on the nine-item Patient Health Questionnaire (PHQ-9). Bivariate analysis and multivariable logistic regression were used to examine characteristics of women by treatment group and correlates of treatment response.
Results: Of 134 participants with depression, 129 (96%) were treated: 84 (65%) received PST and 45 (35%) received ADT. Severe depression at treatment initiation was more common in those receiving ADT (28.9% versus 4.8%, Fischer's Exact Test < 0.001). Treatment response was higher for PST (70/84; 83.3%) than ADT (30/45; 66.7%; p = .03). ADT side effects were rare and minor; no infants had serious congenital defects. Of 22 participants (19%) who did not respond to treatment, only five received intensified management. Social support and interpersonal violence were associated with treatment response (adjusted odds ratio, [aOR] = 3.06, 95% CI = 1.08-8.66 and aOR = 0.64, 95% CI = 0.44-0.93).
Discussion: Both depression treatment modalities yielded high response rates in Ugandan PWLWH; ADT was well-tolerated. Our results highlight a need to build capacity to implement the stepped-care protocol for non-responders and screen for social support and interpersonal violence.
(© 2023. The Author(s).)
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Treatment of Perinatal Depression and Correlates of Treatment Response Among Pregnant Women Living with HIV in Uganda.
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Autor/in / Beteiligte Person: | Faherty, LJ ; Gwokyalya, V ; Dickens, A ; McBain, R ; Ngo, V ; Nakigudde, J ; Nakku, J ; Mukasa, B ; Beyeza-Kashesya, J ; Wanyenze, RK ; Wagner, GJ |
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Zeitschrift: | Maternal and child health journal, Jg. 27 (2023-11-01), Heft 11, S. 2017-2025 |
Veröffentlichung: | 1999- : New York, NY : Kluwer Academic/Plenum Publishers ; <i>Original Publication</i>: New York : Plenum Press, c1997-, 2023 |
Medientyp: | academicJournal |
ISSN: | 1573-6628 (electronic) |
DOI: | 10.1007/s10995-023-03741-1 |
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