Top

Published in:

01-10-2018 | Original Paper

Correlates of Suicidal Ideation During Pregnancy and Postpartum Among Women Living with HIV in Rural South Africa

Authors: Violeta J. Rodriguez, Lissa N. Mandell, Suat Babayigit, Rhea R. Manohar, Stephen M. Weiss, Deborah L. Jones

Published in: AIDS and Behavior | Issue 10/2018

Abstract

In developing countries, up to 20% of maternal deaths during pregnancy are due to suicide, and being HIV-infected confers additional risk. This manuscript sought to identify perinatal correlates of suicidal ideation among women living with HIV (WLHIV) in rural South Africa. Pregnant WLHIV (N = 681) were recruited and re-assessed at 12-months postpartum. Mean age was 28.3 (SD = 5.7) years and 68% were below the poverty line. Prenatal suicidal ideation was 39%; suicidal ideation continued for 7% at 12 months, 13% experienced incident suicidal ideation, and for 19% suicidal ideation had stopped postnatally. Intimate partner violence (AOR = 1.17) and depression (AOR = 1.14) predicted sustained suicidal ideation. Increased income (AOR = 2.25) and greater stigma (AOR = 1.33) predicted incident suicidal ideation. Younger age (AOR = 0.94), disclosure of HIV status to partner (AOR = 0.60), and greater stigma (AOR = 1.24) predicted postnatal cessation of suicidal ideation. Perinatal care may provide windows of opportunity for identification and treatment of suicidal ideation.

Mahy M, Stover J, Stanecki K, Stoneburner R, Tassie J-M. Estimating the impact of antiretroviral therapy: regional and global estimates of life-years gained among adults. Sex Transm Infect. 2010;86(Suppl 2):i67–ii71.

Farahani M, Mulinder H, Farahani A, Marlink R. Prevalence and distribution of non-AIDS causes of death among HIV-infected individuals receiving antiretroviral therapy: a systematic review and meta-analysis. Int J STD AIDS. 2016;28(7):636–50.CrossRef

Catalan J, Harding R, Sibley E, Clucas C, Croome N, Sherr L. HIV infection and mental health: suicidal behaviour—systematic review. Psychol Health Med. 2011;16(5):588–611.CrossRef

Schlebusch L, Govender RD. Age, gender and suicidal ideation following voluntary HIV counseling and testing. Int J Environ Res Public Health. 2012;9(2):521–30.CrossRef

Kang CR, Bang JH, Cho SI, Kim KN, Lee HJ, Ryu BY, et al. Suicidal ideation and suicide attempts among human immunodeficiency virus-infected adults: differences in risk factors and their implications. AIDS Care. 2016;28(3):306–13.CrossRef

Bitew H, Andargie G, Tadesse A, Belete A, Fekadu W, Mekonen T. Suicidal ideation, attempt, and determining factors among HIV/AIDS patients, Ethiopia. Depress Res Treat. 2016;2016:8913160.PubMedPubMedCentral

Egbe CO, Dakum PS, Ekong E, Kohrt BA, Minto JG, Ticao CJ. Depression, suicidality, and alcohol use disorder among people living with HIV/AIDS in Nigeria. BMC Public Health. 2017;17(1):542.CrossRef

Ogundipe OA, Olagunju AT, Adeyemi JD. Suicidal ideation among attendees of a West African HIV clinic. Arch Suicide Res. 2015;19(1):103–16.CrossRef

Komiti A, Judd F, Grech P, Mijch A, Hoy J, Lloyd JH, et al. Suicidal behaviour in people with HIV/AIDS: a review. Aust N Z J Psychiatry. 2001;35(6):747–57.CrossRef

10.

Carrico AW, Johnson MO, Morin SF, Remien RH, Charlebois ED, Steward WT, et al. Correlates of suicidal ideation among HIV-positive persons. Aids. 2007;21(9):1199–203.CrossRef

11.

Wu YL, Yang HY, Wang J, Yao H, Zhao X, Chen J, et al. Prevalence of suicidal ideation and associated factors among HIV-positive MSM in Anhui, China. Int J STD AIDS. 2015;26(7):496–503.CrossRef

12.

Gebremariam EH, Reta MM, Nasir Z, Amdie FZ. Prevalence and associated factors of suicidal ideation and attempt among people living with HIV/AIDS at Zewditu Memorial Hospital, Addis Ababa, Ethiopia: a cross-sectional study. Psychiatry J. 2017;2017:2301524.CrossRef

13.

Rochat TJ, Bland RM, Tomlinson M, Stein A. Suicide ideation, depression and HIV among pregnant women in rural South Africa. Health. 2013;5(3A):650–61.CrossRef

14.

Sherr L, Lampe F, Fisher M, Arthur G, Anderson J, Zetler S, et al. Suicidal ideation in UK HIV clinic attenders. AIDS. 2008;22(13):1651–8.CrossRef

15.

Gelaye B, Kajeepeta S, Williams MA. Suicidal ideation in pregnancy: an epidemiologic review. Arch Womens Ment Health. 2016;19(5):741–51.CrossRef

16.

Lindahl V, Pearson JL, Colpe L. Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health. 2005;8(2):77–87.CrossRef

17.

Paris R, Bolton RE, Weinberg MK. Postpartum depression, suicidality, and mother-infant interactions. Arch Womens Ment Health. 2009;12(5):309–21.CrossRef

18.

Hodgkinson SC, Colantuoni E, Roberts D, Berg-Cross L, Belcher HM. Depressive symptoms and birth outcomes among pregnant teenagers. J Pediatr Adolesc Gynecol. 2010;23(1):16–22.CrossRef

19.

Orsolini L, Valchera A, Vecchiotti R, Tomasetti C, Iasevoli F, Fornaro M, et al. Suicide during perinatal period: epidemiology, risk factors, and clinical correlates. Front Psychiatry. 2016;7:138.CrossRef

20.

Onah MN, Field S, Bantjes J, Honikman S. Perinatal suicidal ideation and behaviour: psychiatry and adversity. Arch Womens Ment Health. 2017;20(2):321–31.CrossRef

21.

Gentile S. Suicidal mothers. J Inj Violence Res. 2011;3(2):90–7.CrossRef

22.

Yeum TS, Kim B, Kim EY, Kim SH, Ha K, Ahn YM. Factors affecting suicide method lethality among suicide attempters in the Korea National Suicide Survey. J Nerv Ment Dis. 2018;206(3):202–10.PubMed

23.

Hasley JP, Ghosh B, Huggins J, Bell MR, Adler LE, Shroyer AL. A review of “suicidal intent” within the existing suicide literature. Suicide Life Threat Behav. 2008;38(5):576–91.CrossRef

24.

Horesh N, Levi Y, Apter A. Medically serious versus non-serious suicide attempts: relationships of lethality and intent to clinical and interpersonal characteristics. J Affect Disord. 2012;136(3):286–93.CrossRef

25.

University of Cape Town Suicide 2016. https://www.uct.ac.za/usr/wellness/counselling/supportinfo/Suicide.pdf.

26.

National Department of Health. The 2013 National Antenatal Sentinel HIV Prevalence Survey, South Africa. Pretoria: National Department of Health; 2015.

27.

Bernstein M, Phillips T, Zerbe A, McIntyre JA, Brittain K, Petro G, et al. Intimate partner violence experienced by HIV-infected pregnant women in South Africa: a cross-sectional study. BMJ Open. 2016;6(8):e011999.CrossRef

28.

Matseke G, Rodriguez VJ, Peltzer K, Jones D. Intimate partner violence among HIV positive pregnant women in South Africa. J Psychol Afr. 2016;26(3):259–66.CrossRef

29.

Abrahams N, Jewkes R, Martin LJ, Mathews S, Vetten L, Lombard C. Mortality of women from intimate partner violence in South Africa: a national epidemiological study. Violence Vict. 2009;24(4):546–56.CrossRef

30.

Van Orden KA, Witte TK, Gordon KH, Bender TW, Joiner TE. Suicidal desire and the capability for suicide: tests of the interpersonal-psychological theory of suicidal behavior among adults. J Consult Clin Psych. 2008;76(1):72–83.CrossRef

31.

Gilbert L, Walker L. ‘My biggest fear was that people would reject me once they knew my status…’: stigma as experienced by patients in an HIV/AIDS clinic in Johannesburg, South Africa. Health Soc Care Community. 2010;18(2):139–46.CrossRef

32.

Rukundo GZ, Mishara BL, Kinyanda E. Burden of suicidal ideation and attempt among persons living with HIV and AIDS in Semiurban Uganda. AIDS Res Treat. 2016;2016:3015468.PubMedPubMedCentral

33.

Schlebusch L, Vawda N. HIV-infection as a self-reported risk factor for attempted suicide in South Africa. Afr J Psychiatry (Johannesbg). 2010;13(4):280–3.

34.

Van Orden KA, Witte TK, Cukrowicz KC, Braithwaite SR, Selby EA, Joiner TE Jr. The interpersonal theory of suicide. Psychol Rev. 2010;117(2):575–600.CrossRef

35.

Rodriguez VJ, Cook R, Peltzer K, Jones DL. Prevalence and psychosocial correlates of suicidal ideation among pregnant women living with HIV in Mpumalanga Province, South Africa. AIDS Care. 2017;29(5):593–7.CrossRef

36.

Gaynes BN, Gavin N, Meltzer-Brody S, et al. Perinatal depression: prevalence, screening accuracy, and screening outcomes. Summary, evidence report/technology assessment: number 119. AHRQ publication number 05-E006-1, February 2005. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/epcsums/peridepsum.htm.

37.

Jones DL, Peltzer K, Weiss SM, Sifunda S, Dwane N, Ramlagan S, et al. Implementing comprehensive prevention of mother-to-child transmission and HIV prevention for South African couples: study protocol for a randomized controlled trial. Trials. 2014;15(1):417.CrossRef

38.

Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782–6.CrossRef

39.

Zhong Q, Gelaye B, Rondon MB, Sánchez SE, Simon GE, Henderson DC, et al. Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru. Arch Women’s Ment Health. 2015;18(6):783–92.CrossRef

40.

Peltzer K, Sikwane E, Majaja M. Factors associated with short-course antiretroviral prophylaxis (dual therapy) adherence for PMTCT in Nkangala district, South Africa. Acta Paediatr. 2011;100(9):1253–7.CrossRef

41.

Jones DL, Peltzer K, Villar-Loubet O, Shikwane E, Cook R, Vamos S, et al. Reducing the risk of HIV infection during pregnancy among South African women: a randomized controlled trial. AIDS Care. 2013;25(6):702–9.CrossRef

42.

Straus M. Measuring intrafamily conflict and violence: the conflict tactics (CT) scales. J Marriage Family. 1979;41:75–88.CrossRef

43.

Visser MJ, Neufeld S, de Villiers A, Makin JD, Forsyth BW. To tell or not to tell: South African women’s disclosure of HIV status during pregnancy. AIDS Care. 2008;20(9):1138–45.CrossRef

44.

Kalichman SC, Simbayi LC, Jooste S, Toefy Y, Cain D, Cherry C, et al. Development of a brief scale to measure AIDS-related stigma in South Africa. AIDS Behav. 2005;9(2):135–43.CrossRef

45.

Byamugisha R, Tumwine JK, Semiyaga N, Tylleskar T. Determinants of male involvement in the prevention of mother-to-child transmission of HIV programme in Eastern Uganda: a cross-sectional survey. Reprod Health. 2010;7:12.CrossRef

46.

Allen J, Le H. An additional measure of overall effect size for logistic regression models. J Educ Behav Stat. 2008;33(4):416–41.CrossRef

47.

Muthén L, Muthén B. Mplus (Version 7.4). Los Angeles, CA. 2014.

48.

Devries KM, Mak JY, Bacchus LJ, Child JC, Falder G, Petzold M, et al. Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies. PLoS Med. 2013;10(5):e1001439.CrossRef

49.

Devries KM, Watts C, Yoshihama M, Kiss L, Schraiber LB, Deyessa N, et al. Violence against women is strongly associated with suicide attempts: evidence from the WHO multi-country study on women’s health and domestic violence against women. Soc Sci Med. 2011;73(1):79–86.CrossRef

50.

Kalichman SC, Heckman T, Kochman A, Sikkema K, Bergholte J. Depression and thoughts of suicide among middle-aged and older persons living with HIV-AIDS. Psychiatr Serv. 2000;51(7):903–7.CrossRef

51.

Tabb KM, Gavin AR, Guo YQ, Huang H, Debiec K, Katon W. Views and experiences of suicidal ideation during pregnancy and the postpartum: findings from interviews with maternal care clinic patients. Women Health. 2013;53(5):519–35.CrossRef

52.

Amiya RM, Poudel KC, Poudel-Tandukar K, Pandey BD, Jimba M. Perceived family support, depression, and suicidal ideation among people living with HIV/AIDS: a cross-sectional study in the Kathmandu Valley, Nepal. PLoS ONE. 2014;9(3):e90959.CrossRef

53.

Liu Y, Niu L, Wang M, Chen X, Xiao S, Luo D. Suicidal behaviors among newly diagnosed people living with HIV in Changsha, China. AIDS Care. 2017;29(11):1359–63.CrossRef

54.

Sivasubramanian M, Mimiaga MJ, Mayer KH, Anand VR, Johnson CV, Prabhugate P, et al. Suicidality, clinical depression, and anxiety disorders are highly prevalent in men who have sex with men in Mumbai, India: findings from a community-recruited sample. Psychol Health Med. 2011;16(4):450–62.CrossRef

55.

Krumpal I. Determinants of social desirability bias in sensitive surveys: a literature review. Qual Quant. 2013;47(4):2025–47.CrossRef

56.

Ribeiro JD, Witte TK, Van Orden KA, Selby EA, Gordon KH, Bender TW, et al. Fearlessness about death: the psychometric properties and construct validity of the revision to the acquired capability for suicide scale. Psychol Assess. 2014;26(1):115–26.CrossRef

Title: Correlates of Suicidal Ideation During Pregnancy and Postpartum Among Women Living with HIV in Rural South Africa
Authors: Violeta J. Rodriguez
Lissa N. Mandell
Suat Babayigit
Rhea R. Manohar
Stephen M. Weiss
Deborah L. Jones
Publication date: 01-10-2018
Publisher: Springer US
Published in: AIDS and Behavior / Issue 10/2018
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-018-2153-y

ACC 2024 Congress Coverage

Heart Failure Video

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Correlates of Suicidal Ideation During Pregnancy and Postpartum Among Women Living with HIV in Rural South Africa

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 10/2018

Empowering Lay-Counsellors with Technology: Masivukeni, a Standardized Multimedia Counselling Support Tool to Deliver ART Counselling

Mobile Health Technology for Improving Symptom Management in Low Income Persons Living with HIV

Adapting the Risk Environment Framework to Understand Substance Use, Gender-Based Violence, and HIV Risk Behaviors Among Female Sex Workers in Tanzania

Association of Depressive Symptoms with Lapses in Antiretroviral Medication Adherence Among People Living with HIV: A Test of an Indirect Pathway

Social Support and Violence-prone Relationships as Predictors of Disclosure of HIV Status Among Newly Diagnosed HIV-positive South Africans

Prevalence, Comorbidity, and Correlates of Psychiatric and Substance Use Disorders and Associations with HIV Risk Behaviors in a Multisite Cohort of Women Living with HIV

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page