2023-09-28 14:46:10 +00:00
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abstract: 'BackgroundPerinatal depression (PND) is prevalent and negatively impacts
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HIV care among women living with HIV (WLHIV), yet PND remains
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under-identified in Malawian WLHIV. Accordingly, this formative study
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explored perceptions of the feasibility and acceptability of an
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integrated, task-shifted approach to PND screening and treatment in
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maternity clinics. MethodsWe completed consecutive PND screenings of
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HIV+ women attending pre- or post-natal appointments at 5 clinics in
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Lilongwe district, Malawi. We conducted in-depth interviews with the
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first 4-5 women presenting with PND per site (n = 24 total) from July to
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August 2018. PND classification was based on a score \& GE; 10 on the
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Edinburgh Postnatal Depression Scale (EPDS). We conducted 10 additional
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in-depth interviews with HIV and mental health providers at the 5
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clinics. ResultsMost participants endorsed the feasibility of integrated
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PND screening, as they believed that PND had potential for significant
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morbidity. Among providers, identified barriers to screening were
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negative staff attitudes toward additional work, inadequate staffing
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numbers and time constraints. Suggested solutions to barriers were
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health worker training, supervision, and a brief screening tool.
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Patient-centered counselling strategies were favored over medication by
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WLHIV as the acceptable treatment of choice, with providers supporting
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the role of medication to be restricted to severe depression. Providers
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identified nurses as the most suitable health workers to deliver
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task-shifted interventions and emphasized further training as a
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requirement to ensure successful task shifting. ConclusionImproving PND
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in a simple, task-shifted intervention is essential for supporting
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mental health among women with PND and HIV. Our results suggest that an
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effective PND intervention for this population should include a brief,
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streamlined PND screening questionnaire and individualized counselling
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for those who have PND, with supplemental support groups and depression
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medication readily available. These study results support the
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development of a PND intervention to address the gap in treatment of PND
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and HIV among WLHIV in Malawi.'
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affiliation: 'Dussault, JM (Corresponding Author), Univ N Carolina, Gillings Sch Global
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Publ Hlth, Dept Epidemiol, Chapel Hill, NC 27599 USA.
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Kulisewa, Kazione, Kamuzu Univ Hlth Sci, Fac Med, Dept Psychiat \& Mental Hlth,
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Private Bag 360, Blantyre, Malawi.
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Dussault, Josee M.; Gaynes, Bradley N.; LeMasters, Katherine; Pence, Brian W., Univ
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N Carolina, Gillings Sch Global Publ Hlth, Dept Epidemiol, Chapel Hill, NC 27599
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USA.
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Gaynes, Bradley N.; Meltzer-Brody, Samantha, Univ N Carolina, UNC Sch Med, Dept
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Psychiat, Chapel Hill, NC USA.
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Hosseinipour, Mina C.; Kutengule, Anna; Mphonda, Steven M., UNC Project Malawi,
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Lilongwe, Malawi.
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Hosseinipour, Mina C., Univ N Carolina, UNC Sch Med, Dept Med, Chapel Hill, NC USA.
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Go, Vivian F., Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Hlth Behav,
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Chapel Hill, NC USA.
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Midiani, Dalitso; Udedi, Michael, Minist Hlth, Lilongwe, Malawi.
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Bengtson, Angela M., Brown Univ, Brown Sch Publ Hlth, Dept Epidemiol, Providence,
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RI USA.'
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article-number: '833'
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author: Kulisewa, Kazione and Dussault, Josee M. and Gaynes, Bradley N. and Hosseinipour,
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Mina C. and Go, Vivian F. and Kutengule, Anna and LeMasters, Katherine and Meltzer-Brody,
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Samantha and Midiani, Dalitso and Mphonda, Steven M. and Udedi, Michael and Pence,
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Brian W. and Bengtson, Angela M.
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author-email: josee.dussault@unc.edu
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author_list:
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- family: Kulisewa
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given: Kazione
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- family: Dussault
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given: Josee M.
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- family: Gaynes
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given: Bradley N.
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- family: Hosseinipour
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given: Mina C.
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- family: Go
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given: Vivian F.
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- family: Kutengule
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given: Anna
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- family: LeMasters
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given: Katherine
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- family: Meltzer-Brody
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given: Samantha
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- family: Midiani
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given: Dalitso
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- family: Mphonda
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given: Steven M.
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- family: Udedi
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given: Michael
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- family: Pence
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given: Brian W.
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- family: Bengtson
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given: Angela M.
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da: '2023-09-28'
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doi: 10.1186/s12888-022-04476-z
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eissn: 1471-244X
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files: []
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journal: BMC PSYCHIATRY
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keywords: Perinatal depression; Mental health; HIV; Malawi; Task-shifting
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keywords-plus: 'OPTION B PLUS; MENTAL-HEALTH; POSTNATAL DEPRESSION; PRIMARY-CARE;
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LOW-INCOME; COUNSELING INTERVENTION; ANTIRETROVIRAL THERAPY; ANTENATAL
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DEPRESSION; PRENATAL DEPRESSION; POSTPARTUM'
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language: English
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month: DEC 29
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number: '1'
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number-of-cited-references: '54'
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orcid-numbers: 'Udedi, Michael/0000-0001-8769-4313
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Dussault, Josee/0000-0001-7434-2159'
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papis_id: 4962100467fbe0b6efda38de84949f6e
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ref: Kulisewa2022feasibilityacceptabi
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researcherid-numbers: 'Udedi, Michael/V-6147-2017
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'
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times-cited: '1'
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title: 'The feasibility and acceptability of a task-shifted intervention for perinatal
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depression among women living with HIV in Malawi: a qualitative analysis'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000905932200001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '0'
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volume: '22'
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web-of-science-categories: Psychiatry
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year: '2022'
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