ArticleAnnals of behavioral medicine : a publication of the Society of Behavioral Medicine2020
PMTCT Adherence in Pregnant South African Women: The Role of Depression, Social Support, Stigma, and Structural Barriers to Care.
Article in Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed.
- Trajectories of perinatal depression among women living with HIV in Uganda.Journal of global health · 2024Trial
- Depression Among Pregnant and Breastfeeding Persons Participating in Two Randomized Trials of the Dapivirine Vaginal Ring and Oral Pre-Exposure Prophylaxis (PrEP) in Malawi, South Africa, Uganda, and Zimbabwe.AIDS and behavior · 2024Trial
- Streamlining Stigma Measurement: Validation and Abridgment of the HIV Stigma Scale for Pregnant Women Living with HIV in South Africa.AIDS and behavior · 2026Article
- Assessing the approach to perinatal mental health screening and treatment in maternal-child health clinics in Western Kenya.PLOS global public health · 2026Article
- Community health intervention through musical engagement (CHIME) in South Africa: A formative exploration of the feasibility and development of a music-based intervention to support perinatal mental health.PLOS global public health · 2026Article
- Barriers and Facilitators to the Elimination of Mother-to-Child Transmission Services Among Pregnant and Breastfeeding Women in Gauteng Province, South Africa.Nursing reports (Pavia, Italy) · 2025Article
- "I'll Continue If I Have a Positive Mind": Identifying the Ways in Which Depression and PTSD Impact PrEP Adherence Among PrEP-Experienced Pregnant and Postpartum Women in Cape Town, South Africa.International journal of environmental research and public health · 2025Article
- Attitudes toward digital pill systems for antiretroviral therapy adherence among pregnant and postpartum women living with HIV in South Africa: a qualitative study.Frontiers in psychiatry · 2025Article
- Framework for determining the optimal course of action when efficiency and affordability measures differ by perspective in cost-effectiveness analysis-with an illustrative case of HIV treatment in Mozambique.Cost effectiveness and resource allocation : C/E · 2023Article
- Intersecting Relationships of Psychosocial and Structural Syndemic Problems Among People with HIV in South Africa: Using Network Analysis to Identify Influential Problems.AIDS and behavior · 2023Article
- "I am scared, I do not want to lie": exploring the impacts of COVID-19 on engagement in care, perceived health, relationship dynamics, and parenting among postpartum women with HIV in South Africa.BMC pregnancy and childbirth · 2023Article
- Perinatal Depressive Symptoms and Viral Non-suppression Among a Prospective Cohort of Pregnant Women Living with HIV in Nigeria, Kenya, Uganda, and Tanzania.AIDS and behavior · 2023Article
- "I am scared, I do not want to lie": Exploring the impacts of COVID-19 on engagement in care, perceived health, relationship dynamics, and parenting among postpartum women with HIV in South Africa.Research square · 2023Article
- Probable perinatal depression and social support among women enrolled in Malawi's Option B+ Program: A longitudinal analysis.Journal of affective disorders · 2022Observational
- Adolescent Motherhood and HIV in South Africa: Examining Prevalence of Common Mental Disorder.AIDS and behavior · 2022Article
- Factors Affecting Antiretroviral Therapy Adherence among HIV-Positive Pregnant Women in Greece: An Exploratory Study.Healthcare (Basel, Switzerland) · 2022Article
- Article
- Perinatal Depressive Symptoms, Human Immunodeficiency Virus (HIV) Suppression, and the Underlying Role of Antiretroviral Therapy Adherence: A Longitudinal Mediation Analysis in the IMPAACT P1025 Cohort.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Adolescent, Pregnant, and HIV-Infected: Risk of Adverse Pregnancy and Perinatal Outcomes in Young Women from Southern Mozambique.Journal of clinical medicine · 2021Article
- Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundDepression is a robust predictor of nonadherence to antiretroviral (ARV) therapy, which is essential to prevention of mother-to-child transmission (PMTCT). Women in resource-limited settings face additional barriers to PMTCT adherence. Although structural barriers may be minimized by social support, depression and stigma may impede access to this support. PURPOSE: To better understand modifiable factors that contribute to PMTCT adherence and inform intervention development.
methodsWe tested an ARV adherence model using data from 200 pregnant women enrolled in PMTCT (median age 28), who completed a third-trimester interview. Adherence scores were created using principal components analysis based on four questions assessing 30-day adherence. We used path analysis to assess (i) depression and stigma as predictors of social support and then (ii) the combined associations of depression, stigma, social support, and structural barriers with adherence.
resultsElevated depressive symptoms were directly associated with significantly lower adherence (est = -8.60, 95% confidence interval [-15.02, -2.18], p < .01). Individuals with increased stigma and depression were significantly less likely to utilize social support (p < .01, for both), and higher social support was associated with increased adherence (est = 7.42, 95% confidence interval [2.29, 12.58], p < .01). Structural barriers, defined by income (p = .55) and time spent traveling to clinic (p = .31), did not predict adherence.
conclusionsDepression and social support may play an important role in adherence to PMTCT care. Pregnant women living with HIV with elevated depressive symptoms and high levels of stigma may suffer from low social support. In PMTCT programs, maximizing adherence may require effective identification and treatment of depression and stigma, as well as enhancing social support.
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