abstract: 'BackgroundPerinatal depression (PND) is prevalent and negatively impacts

  HIV care among women living with HIV (WLHIV), yet PND remains

  under-identified in Malawian WLHIV. Accordingly, this formative study

  explored perceptions of the feasibility and acceptability of an

  integrated, task-shifted approach to PND screening and treatment in

  maternity clinics. MethodsWe completed consecutive PND screenings of

  HIV+ women attending pre- or post-natal appointments at 5 clinics in

  Lilongwe district, Malawi. We conducted in-depth interviews with the

  first 4-5 women presenting with PND per site (n = 24 total) from July to

  August 2018. PND classification was based on a score \& GE; 10 on the

  Edinburgh Postnatal Depression Scale (EPDS). We conducted 10 additional

  in-depth interviews with HIV and mental health providers at the 5

  clinics. ResultsMost participants endorsed the feasibility of integrated

  PND screening, as they believed that PND had potential for significant

  morbidity. Among providers, identified barriers to screening were

  negative staff attitudes toward additional work, inadequate staffing

  numbers and time constraints. Suggested solutions to barriers were

  health worker training, supervision, and a brief screening tool.

  Patient-centered counselling strategies were favored over medication by

  WLHIV as the acceptable treatment of choice, with providers supporting

  the role of medication to be restricted to severe depression. Providers

  identified nurses as the most suitable health workers to deliver

  task-shifted interventions and emphasized further training as a

  requirement to ensure successful task shifting. ConclusionImproving PND

  in a simple, task-shifted intervention is essential for supporting

  mental health among women with PND and HIV. Our results suggest that an

  effective PND intervention for this population should include a brief,

  streamlined PND screening questionnaire and individualized counselling

  for those who have PND, with supplemental support groups and depression

  medication readily available. These study results support the

  development of a PND intervention to address the gap in treatment of PND

  and HIV among WLHIV in Malawi.'
affiliation: 'Dussault, JM (Corresponding Author), Univ N Carolina, Gillings Sch Global
  Publ Hlth, Dept Epidemiol, Chapel Hill, NC 27599 USA.

  Kulisewa, Kazione, Kamuzu Univ Hlth Sci, Fac Med, Dept Psychiat \& Mental Hlth,
  Private Bag 360, Blantyre, Malawi.

  Dussault, Josee M.; Gaynes, Bradley N.; LeMasters, Katherine; Pence, Brian W., Univ
  N Carolina, Gillings Sch Global Publ Hlth, Dept Epidemiol, Chapel Hill, NC 27599
  USA.

  Gaynes, Bradley N.; Meltzer-Brody, Samantha, Univ N Carolina, UNC Sch Med, Dept
  Psychiat, Chapel Hill, NC USA.

  Hosseinipour, Mina C.; Kutengule, Anna; Mphonda, Steven M., UNC Project Malawi,
  Lilongwe, Malawi.

  Hosseinipour, Mina C., Univ N Carolina, UNC Sch Med, Dept Med, Chapel Hill, NC USA.

  Go, Vivian F., Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Hlth Behav,
  Chapel Hill, NC USA.

  Midiani, Dalitso; Udedi, Michael, Minist Hlth, Lilongwe, Malawi.

  Bengtson, Angela M., Brown Univ, Brown Sch Publ Hlth, Dept Epidemiol, Providence,
  RI USA.'
article-number: '833'
author: Kulisewa, Kazione and Dussault, Josee M. and Gaynes, Bradley N. and Hosseinipour,
  Mina C. and Go, Vivian F. and Kutengule, Anna and LeMasters, Katherine and Meltzer-Brody,
  Samantha and Midiani, Dalitso and Mphonda, Steven M. and Udedi, Michael and Pence,
  Brian W. and Bengtson, Angela M.
author-email: josee.dussault@unc.edu
author_list:
- family: Kulisewa
  given: Kazione
- family: Dussault
  given: Josee M.
- family: Gaynes
  given: Bradley N.
- family: Hosseinipour
  given: Mina C.
- family: Go
  given: Vivian F.
- family: Kutengule
  given: Anna
- family: LeMasters
  given: Katherine
- family: Meltzer-Brody
  given: Samantha
- family: Midiani
  given: Dalitso
- family: Mphonda
  given: Steven M.
- family: Udedi
  given: Michael
- family: Pence
  given: Brian W.
- family: Bengtson
  given: Angela M.
da: '2023-09-28'
doi: 10.1186/s12888-022-04476-z
eissn: 1471-244X
files: []
journal: BMC PSYCHIATRY
keywords: Perinatal depression; Mental health; HIV; Malawi; Task-shifting
keywords-plus: 'OPTION B PLUS; MENTAL-HEALTH; POSTNATAL DEPRESSION; PRIMARY-CARE;

  LOW-INCOME; COUNSELING INTERVENTION; ANTIRETROVIRAL THERAPY; ANTENATAL

  DEPRESSION; PRENATAL DEPRESSION; POSTPARTUM'
language: English
month: DEC 29
number: '1'
number-of-cited-references: '54'
orcid-numbers: 'Udedi, Michael/0000-0001-8769-4313

  Dussault, Josee/0000-0001-7434-2159'
papis_id: 4962100467fbe0b6efda38de84949f6e
ref: Kulisewa2022feasibilityacceptabi
researcherid-numbers: 'Udedi, Michael/V-6147-2017

  '
times-cited: '1'
title: 'The feasibility and acceptability of a task-shifted intervention for perinatal
  depression among women living with HIV in Malawi: a qualitative analysis'
type: Article
unique-id: WOS:000905932200001
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '22'
web-of-science-categories: Psychiatry
year: '2022'