Depression and associated factors among human immunodeficiency virus-positive pregnant women in sub-Saharan Africa: systematic review and meta-analysis

Abstract

Background

Despite its severe impact on both maternal and fetal health, antenatal depression has not received as much attention in the healthcare community as postnatal depression. Comprehensive evidence is very important to suggest informed decisions and strategies to the Ministry of Health. Therefore, this study aims to estimate the pooled prevalence of depression and to identify associated factors among pregnant women living with human immunodeficiency virus (HIV)/AIDS in sub-Saharan Africa.

Method

Between May 15, 2024, and June 21, 2024, a systematic and thorough literature search was conducted using reputable electronic databases (PubMed, Cochrane Library) and web sources (Science Direct, African Journals Online, Google Scholar). The quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies, which includes 9 criteria. Heterogeneity among the studies was examined using Cochrane's Q and I² statistics. A random-effects model was employed to compute the pooled estimate of depression among pregnant women living with HIV/AIDS.

Result

The initial database search yielded 39,000 articles. The pooled prevalence of depression among pregnant women living with HIV/AIDS in sub-Saharan Africa was estimated to be 39.86% (95% confidence interval [CI]: 34.89–44.83, P=.000). Factors associated with depression included experiencing intimate partner violence (pooled odd ratio [POR]=1.98; 95% CI: 1.56, 32.51), poor adherence to antiretroviral therapy (POR=2.16; 95% CI: 1.70, 2.74), and household food insecurity (POR=2.40; 95% CI: 1.69, 3.42).

Conclusion

Over one-third of pregnant women with HIV/AIDS experience depression, linked to factors like intimate partner violence, food insecurity, and poor adherence to antiretroviral therapy. Prioritize tailored mental health services and peer support groups. Increase education on intimate partner violence and implement nutritional support programs. Promote community initiatives and simplify ART regimens for improved health outcomes.