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Exploring patterns and predictors of suicidal ideation among pregnant and postpartum women living with HIV in Kilimanjaro, Tanzania.

Publication ,  Journal Article
Knettel, BA; Mwamba, RN; Minja, L; Goldston, DB; Boshe, J; Watt, MH; KCMC Option B+ study team,
Published in: AIDS
September 1, 2020

OBJECTIVE: Pregnant and postpartum women living with HIV face disproportionate risk of depression and suicide, particularly in low-income and middle-income countries. This study examined patterns and predictors of suicidal ideation among women living with HIV in antenatal care in Kilimanjaro, Tanzania. DESIGN: We conducted a longitudinal cohort study of 200 pregnant women living with HIV, with surveys conducted during pregnancy and 6 months postpartum. METHODS: Pregnant women were recruited during HIV and antenatal care visits at nine clinics. A structured questionnaire was verbally administered in Kiswahili by a trained study nurse. We used simple frequencies and t-tests to measure patterns of suicidal ideation and logistic regression to assess factors associated with suicidal ideation. RESULTS: Suicidal ideation was endorsed by 12.8% of women during pregnancy and decreased significantly to 3.9% by 6 months postpartum. Ideation was not significantly greater among participants newly diagnosed with HIV. In univariable analyses, suicidal ideation was associated with depression, anxiety, HIV stigma, single relationship status, unknown HIV status of the father of the baby, negative attitudes about antiretroviral medication, and low social support. In the multivariable model, women experiencing anxiety and HIV stigma were significantly more likely to endorse suicidal ideation during pregnancy. CONCLUSION: Suicidal ideation and associated feelings of hopelessness are a critical challenge in antenatal care among women living with HIV, with important implications for quality of life, care engagement, and survival. To better support patients, targeted approaches to address anxiety, depression, stigma, and hopelessness must be prioritized, including crisis support for suicide prevention.

Duke Scholars

Published In

AIDS

DOI

EISSN

1473-5571

Publication Date

September 1, 2020

Volume

34

Issue

11

Start / End Page

1657 / 1664

Location

England

Related Subject Headings

  • Virology
  • Tanzania
  • Suicidal Ideation
  • Social Stigma
  • Risk Factors
  • Quality of Life
  • Pregnant Women
  • Pregnancy Complications, Infectious
  • Pregnancy
  • Postpartum Period
 

Citation

APA
Chicago
ICMJE
MLA
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Knettel, B. A., Mwamba, R. N., Minja, L., Goldston, D. B., Boshe, J., Watt, M. H., & KCMC Option B+ study team, . (2020). Exploring patterns and predictors of suicidal ideation among pregnant and postpartum women living with HIV in Kilimanjaro, Tanzania. AIDS, 34(11), 1657–1664. https://doi.org/10.1097/QAD.0000000000002594
Knettel, Brandon A., Rimel N. Mwamba, Linda Minja, David B. Goldston, Judith Boshe, Melissa H. Watt, and Melissa H. KCMC Option B+ study team. “Exploring patterns and predictors of suicidal ideation among pregnant and postpartum women living with HIV in Kilimanjaro, Tanzania.AIDS 34, no. 11 (September 1, 2020): 1657–64. https://doi.org/10.1097/QAD.0000000000002594.
Knettel BA, Mwamba RN, Minja L, Goldston DB, Boshe J, Watt MH, et al. Exploring patterns and predictors of suicidal ideation among pregnant and postpartum women living with HIV in Kilimanjaro, Tanzania. AIDS. 2020 Sep 1;34(11):1657–64.
Knettel, Brandon A., et al. “Exploring patterns and predictors of suicidal ideation among pregnant and postpartum women living with HIV in Kilimanjaro, Tanzania.AIDS, vol. 34, no. 11, Sept. 2020, pp. 1657–64. Pubmed, doi:10.1097/QAD.0000000000002594.
Knettel BA, Mwamba RN, Minja L, Goldston DB, Boshe J, Watt MH, KCMC Option B+ study team. Exploring patterns and predictors of suicidal ideation among pregnant and postpartum women living with HIV in Kilimanjaro, Tanzania. AIDS. 2020 Sep 1;34(11):1657–1664.

Published In

AIDS

DOI

EISSN

1473-5571

Publication Date

September 1, 2020

Volume

34

Issue

11

Start / End Page

1657 / 1664

Location

England

Related Subject Headings

  • Virology
  • Tanzania
  • Suicidal Ideation
  • Social Stigma
  • Risk Factors
  • Quality of Life
  • Pregnant Women
  • Pregnancy Complications, Infectious
  • Pregnancy
  • Postpartum Period