Evidence map›Paper›PMID 41007494›Full record

ArticleInternational journal of environmental research and public health2025

"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.

Amelia M Stanton, Madison R Fertig, Jennifer Nyawira Githaiga, Devisi A Ashar, Linda Gwangqa, Melinda Onverwacht, Lucia Knight, Landon Myer, Jessica E Haberer, John Joska and 2 more

Abstract read
In one paragraph

Article in International journal of environmental research and public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. A pilot randomized controlled trial ofWomen's health (London, England)
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Amelia M StantonDepartment of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA.ORCID 0000-0001-5918-6645
Madison R FertigDepartment of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA.ORCID 0009-0003-7002-5254
Jennifer Nyawira GithaigaDivision of Social and Behavioural Sciences, School of Public Health, University of Cape Town, Cape Town 7925, South Africa.ORCID 0000-0002-4511-9393
Devisi A AsharDepartment of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA.ORCID 0009-0007-3731-9583
Linda GwangqaDivision of Social and Behavioural Sciences, School of Public Health, University of Cape Town, Cape Town 7925, South Africa.
Melinda OnverwachtDivision of Social and Behavioural Sciences, School of Public Health, University of Cape Town, Cape Town 7925, South Africa.
Lucia KnightDivision of Social and Behavioural Sciences, School of Public Health, University of Cape Town, Cape Town 7925, South Africa.ORCID 0000-0001-9938-6887
Landon MyerDivision of Epidemiology and Biostatistics, University of Cape Town, Cape Town 7701, South Africa.
Jessica E HabererDepartment of Internal Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.
John JoskaFaculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa.ORCID 0000-0003-4260-1181
Conall O'CleirighDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA.
Christina PsarosDepartment of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA.

Funding

Reducing psychological barriers to PrEP persistence among pregnant and postpartum women in Cape Town, South AfricaK23MH131438 · NIMH · BOSTON UNIVERSITY (CHARLES RIVER CAMPUS) · PI Amelia M. Stanton · 2022 to 2026
$933k
NIMH NIH HHS K23 MH131438NIMH NIH HHS K23MH131438
6 · The paper itself

Abstract

Pregnant and postpartum people (PPPs) face heightened risk for HIV acquisition, yet depression and trauma-related symptoms can undermine adherence to pre-exposure prophylaxis (PrEP). To inform the development of a brief mental health-focused adherence intervention, we explored the impacts of depression and posttraumatic stress disorder (PTSD) symptoms on PrEP use among PPPs in Cape Town, South Africa. Twenty-eight PPPs with elevated symptoms of depression and/or PTSD and recent PrEP adherence challenges completed qualitative interviews. Six antenatal providers were also interviewed. Thematic analysis revealed three key findings with subthemes that deepen exploration of each theme: (1) depression and PTSD symptoms contributed to missed PrEP doses or late pickups by increasing doubt about PrEP efficacy, amplifying pill burden, intensifying avoidance and withdrawal (e.g., hypersomnia and disengagement from providers), and disrupting memory through rumination and emotional overload; (2) most PPPs preferred support from professional counselors, while a minority preferred informal support; and (3) intervention design considerations included aligning patient and provider goals, selecting between individual or group formats, and addressing integration barriers such as staffing and space constraints. Providers affirmed the need for embedded mental health support. Intervention strategies that increase PrEP knowledge and motivation while targeting emotional withdrawal, fatigue, and cognitive overload may improve adherence and reduce HIV risk in this population.

Indexed as

Anti-HIV AgentsDepressionHIV InfectionsMedication AdherencePre-Exposure ProphylaxisStress Disorders, Post-TraumaticAdultFemaleHumansPostpartum PeriodPregnancySouth AfricaYoung AdultAnti-HIV AgentsdepressionHIVposttraumatic stresspre-exposure prophylaxispregnancySouth Africa

Identifiers

PMID41007494
PMCPMC12469639

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.