Psychological distress experienced by pregnant women undergoing antiretroviral treatment: A qualitative study
Abstract
Background: The psychological condition of pregnant women with HIV is often a significant barrier to initiating and adhering to antiretroviral therapy (ART). Psychological distress in these women, if left unaddressed, can lead to poor treatment adherence, increasing the risk of mother-to-child transmission of HIV. Managing psychological distress caused by HIV early is crucial for optimizing maternal health outcomes and reducing transmission risks.
Objectives: This study aims to explore the psychological distress experienced by pregnant women with HIV undergoing ART and to identify ways to improve treatment adherence and reduce the risk of HIV transmission to their children.
Methods: A qualitative research design with a descriptive phenomenological approach was used. Participants were selected through purposive sampling based on specific inclusion and exclusion criteria. Data were collected from five participants through semi-structured, in-depth interviews. Data analysis was performed using ATLAS.ti software.
Results: Four main themes emerged from the data: psychological factors, sociocultural influences, stressors, and life pressures. The study revealed that pregnant women undergoing ART experience significant anxiety, particularly concerning lifelong medication use and the potential transmission of HIV to their babies.
Conclusions: Pregnant women undergoing ART are highly vulnerable to anxiety, driven by concerns about their health and the possibility of transmitting HIV to their children. Family support plays a crucial role in helping mothers manage their anxiety, improve ART adherence, and cope with their psychological distress. Additionally, the legal and religious status of marriage was identified as a key factor contributing to stress, further increasing the risk of anxiety and depression among participants.
Keywords
References
Brito MO, Hodge D, Donastorg Y, Khosla S, Lerebours L, Pope Z. Risk behaviours and prevalence of sexually transmitted infections and HIV in a group of Dominican gay men, other men who have sex with men and transgender women. BMJ Open. 2015;5(4):e007747.
Nguyen LH, Tran BX, Nguyen HLT, Nguyen CT, Hoang CD, Le HQ, et al. Psychological Distress Among Methadone Maintenance Patients in Vietnamese Mountainous Areas. AIDS and Behavior. 2017;21(11):3228–37.
Bailey H, Zash R, Rasi V, Thorne C. HIV treatment in pregnancy. Lancet HIV [Internet]. 2018;5(8):e457–67. Available from: http://dx.doi.org/10.1016/S2352-3018(18)30059-6
Kako PM, Wendorf AR, Stevens PE, Ngui E, Otto-Salaj LL. Contending with Psychological Distress in Contexts with Limited Mental Health Resources: HIV-Positive Kenyan Women’s Experiences. Issues in Mental Health Nursing. 2016;37(1):2–9. doi : https://doi.org/10.3109/01612840.2015.1058446
WHO. World Health Organization. 2022 [cited 2022 Nov 7]. HIV. Available from: https://www.who.int/news-room/fact-sheets/detail/hiv-aids
UNAIDS. UNAIDS Global AIDS 2022. 2022.
Ogueji IA. Experiences and predictors of psychological distress in pregnant women living with HIV. British Journal of Health Psychology 2021;26(3):882–901.
Ditjen P2P. Laporan Perkembangan HIV AIDS & Penyakit lnfeksi Menular Seksual (PIMS) Triwulan I Tahun 2021 [Internet]. 2021 [cited 2021 Jun 9]. Available from: https://www.kemkes.go.id/article/view/20042500001/waspadai-malaria-di-tengah-pandemi-covid-19.html
Woldesenbet S, Cheyip M, Lombard C, Manda S, Ayalew K, Kufa T, et al. Progress towards the UNAIDS 95-95-95 targets among pregnant women in South Africa: Results from the 2017 and 2019 national Antenatal HIV Sentinel Surveys. PLoS One [Internet]. 2022;17(7 July):1–16. Available from: http://dx.doi.org/10.1371/journal.pone.0271564
Moseholm E, Fetters MD, Aho I, Mellgren A, Johansen IS, Storgaard M, et al. Study protocol: Becoming and being a mother living with HIV - A multicentre longitudinal mixed methods study among pregnant women living with HIV, non-pregnant women living with HIV and pregnant women not living with HIV in a high-income setting (the 2B M. BMJ Open. 2019;9(10):1–10. doi : https://doi.org/10.1136/bmjopen-2018-027761
Ashaba S, Kaida A, Coleman JN, Burns BF, Dunkley E, O’Neil K, et al. Psychosocial challenges facing women living with HIV during the perinatal period in rural Uganda. PLoS One. 2017;12(5):1–15.
Aaron E, Bonacquisti A, Geller PA, Polansky M. Perinatal Depression and Anxiety in Women with and without Human Immunodeficiency Virus Infection. Women's Health Issues [Internet]. 2015;25(5):579–85. Available from: http://dx.doi.org/10.1016/j.whi.2015.04.003
Yousuf A, Musa R, Isa MLM, Arifin SRM. Anxiety and Depression Among Women Living with HIV: Prevalence and Correlations. Clinical Practice and Epidemiology in Mental Health. 2020;16(1):59–66. doi : https://doi.org/10.2174%2F1745017902016010059
Sahimi HMS. Health Anxiety and Its Correlations with Self-Perceived Risk and Attitude on COVID-19 among Malaysian Healthcare Workers during the Pandemic. International Journal of Environmental Research and Public Health. 2021; doi : https://doi.org/10.3390/ijerph18094879
Silva RTS, da Silva RAR, Rodrigues IDCV, de Souza Neto VL, da Silva BCO, Souza FM de LC. Coping strategies of people living with aids in face of the disease. Revista Latino-Americana de Enfermagem. 2018;26. doi : https://doi.org/10.1590%2F1518-8345.2284.2985
Krisdayanti E, Hutasoit JI. Pengaruh Coping Strategies terhadap Kesehatan Mental dan Kualitas Hidup Penderita HIV/AIDS positif. Jurnal Ilmu Keperawatan Jiwa. 2019;2(3):179.
Luciano La, editor. Mental Illnesses: Understanding, Prediction and Control [Internet]. BoD; 2012. 105 p. Available from: https://books.google.co.id/books?hl=id&lr=&id=MyyaDwAAQBAJ&oi=fnd&pg=PA105&dq=Psychological+distress&ots=g-UhlIzHF1&sig=kszTe-ivPFD2NTW0unPyJuyfFlI&redir_esc=y#v=onepage&q=Psychological distress&f=false
Rodriguez-Garcia R, Bonnel R, N’Jie N, Olivier J, Pascual FB, Wodon Q. Analyzing Community Responses to HIV and AIDS: Operational Framework and Typology. World Bank [Internet]. 2011; Available from: https://www.researchgate.net/publication/228246676_Analyzing_Community_Responses_to_HIV_and_AIDS_Operational_Framework_and_Typology
Lee M, Nezu AM, Nezu CM. Positive and negative religious coping, depressive symptoms, and quality of life in people with HIV. Journal of Behavioral Medicine. 2014;37(5):921–30. doi : https://doi.org/10.1007/s10865-014-9552-y
Stuart GW. Nurse Key Fastest Nurse Insight Engine. 2017. The Stuart Stress Adaptation Model of Psychiatric Nursing Care. Available from: https://nursekey.com/the-stuart-stress-adaptation-model-of-psychiatric-nursing-care/
Chaudhury S, Bakhla AK, Saini R. Prevalence, impact, and management of depression and anxiety in patients with HIV: A review. Neurobehav HIV Med. 2016;7:15–30.
Ngocho JS, Watt MH, Minja L, Knettel BA, Mmbaga BT, Williams P, et al. Depression and anxiety among pregnant women living with HIV in Kilimanjaro region, Tanzania. PLoS One [Internet]. 2019;14(10):1–15. Available from: http://dx.doi.org/10.1371/journal.pone.0224515
Hailemariam KW. The Mental Health Problems of HIV Positive Mothers During Pregnancy and After Giving Birth in Mekelle Hospital. Psychology and Behavioral Sciences. 2015;4(3):132. doi : http://dx.doi.org/10.11648/j.pbs.20150403.17
Liu Y, Gong H, Yang G, Yan J. Perceived stigma, mental health and unsafe sexual behaviors of people living with HIV/AIDS. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2014;Jul;39(7):658–63. doi : https://doi.org/10.11817/j.issn.1672-7347.2014.07.002
Xiaowen W, Guangping G, Ling Z, Jiarui Z, Xiumin L, Zhaoqin L, et al. Depression and anxiety mediate perceived social support to predict health-related quality of life in pregnant women living with HIV. AIDS Care - Psychol Socio-Medical Asp AIDS/HIV [Internet]. 2018;30(9):1147–55. Available from: https://doi.org/10.1080/09540121.2018.1456640
Ma X, Wang Y, Hu H, Tao XG, Zhang Y, Shi H. The impact of resilience on prenatal anxiety and depression among pregnant women in Shanghai. Journal of Affective Disorders. 2019;250(January):57–64. doi : https://doi.org/10.1016/j.jad.2019.02.058
Akinsolu FT, Abodunrin OR, Lawale AA, Bankole SA, Adegbite ZO, Adewole IE, et al. Depression and perceived stress among perinatal women living with HIV in Nigeria. Front Public Health. 2023;11(November).
Camara A, Sow MS, Touré A, Sako FB, Camara I, Soumaoro K, et al. Anxiety and depression among HIV patients of the infectious disease department of Conakry University Hospital in 2018. Epidemiology and Infection. 2019; doi : https://doi.org/10.1017/s095026881900222x
Tlhajoane M, Eaton JW, Takaruza A, Rhead R, Maswera R, Schur N, et al. Prevalence and Associations of Psychological Distress, HIV Infection and HIV Care Service Utilization in East Zimbabwe. AIDS Behav. 2018;22(5):1485–95.
Yonga AM, Kiss L, Onarheim KH. A systematic review of the effects of intimate partner violence on HIV-positive pregnant women in sub-Saharan Africa. BMC Public Health [Internet]. 2022;22(1):1–15. Available from: https://doi.org/10.1186/s12889-022-12619-w
DOI: http://dx.doi.org/10.21927/jnki.2024.12(3).%25p
Refbacks
- There are currently no refbacks.
Jurnal Ners dan Kebidanan Indonesia (JNKI) indexed by:
View My Stats