Prevalence and associated factors of postpartum depression among women living with human immunodeficiency virus in three high volume health facilities in Wakiso District, Uganda

Abstract

Introduction: Mothers living with Human Immunodeficiency virus face a range of psychological problems including postpartum depression which result into disease progression and long-lasting effects on the health of their children. This study aimed to determine the prevalence of postpartum depression and its associated factors among women living with HIV in three high volume health facilities in Wakiso district in central Uganda. Methods: This was a health facility based cross-sectional study that utilized quantitative methods to collect data from Wakiso district. The health facilities were purposively selected, and proportionate stratified consecutive sampling depending on target population served in each hospital was utilized to reach the sample size. Mothers living with HIV were then selected consecutively as they arrived from the Prevention/elimination of Mother Transmission clinic in each of the study sites until a sample of 440 participants was obtained. The outcome of the study was post-partum depression that was be assessed by the Edinburgh Postnatal Depression Scale with a cut-off point of ≥10. Data was collected using Kobo collect, a mobile data collection software. It was then downloaded into Microsoft Excel format for cleaning and later imported into STATA version 15 for analysis using percentages and frequencies for categorical variables, mean and standard deviation and multivariate analysis using modified Poisson to establish associations with P-values of ≤0.05as statistically significant. Results: The mean age of the study participants was 28.4 ±6.2 years, with 54.6% (222/407) aged 20-24 years, 59.2% (241/407) married/cohabiting status, and 50.1% (204/407) possessing a secondary level of education. Notably, the prevalence of post-partum depression stood at 28% (114/407). Factors that were significantly associated with post-partum depression were; being aged less than 20 years (APR=1.93, 95% CI: 1.14-3.26) and 20-29 years (APR=1.65, 95% CI: 1.09-2.51), receiving their HIV diagnosis at least one year ago (APR=0.44, 95% CI: 0.31-0.63), family being aware of the woman’s HIV status (APR=0.42, 95% CI: 0.27-0.64), delivering from home (APR=1.91, 95% CI: 1.14-3.18), having their babies were hospitalized for longer than 24 hours (APR=1.43, 95% CI: 1.01-2.05), having an HIV-negative partner (APR=1.75, 95% CI: 1.06-2.88) and experiencing intimate partner violence (APR=2.43, 95% CI: 1.73-3.40). Conclusion: The prevalence of PPD among women living with HIV in three high volume health facilities in Wakiso district was 28%. Being aged less than 20 years, and between 20-29 years, delivering from home, having an HIV negative partner, hospitalization of baby in the first 24 hours after birth and experiencing intimate partner violence increased the risk of postpartum depression. On the other hand, family being aware of the woman’s HIV status and being at least a year since HIV diagnosis reduced the risk of postpartum depression. There is need for targeted interventions taking into consideration age, disclosure of HIV status, and violence exposure to effectively manage postpartum depression among women living with HIV.