AIDS and Behavior

, Volume 23, Issue 1, pp 126–131 | Cite as

The Use of Efavirenz During Pregnancy is Associated with Suicidal Ideation in Postpartum Women in Rural South Africa

  • Deborah L. JonesEmail author
  • Violeta J. Rodriguez
  • Maria L. Alcaide
  • Stephen M. Weiss
  • Karl Peltzer
Original Paper


Efavirenz is used for the management of HIV infection during pregnancy in South Africa (SA), but it is contraindicated in patients with history of depression due to possible suicidal ideation. This study compared suicidal ideation 12-months postpartum among women receiving and not receiving efavirenz in rural SA, where high rates of depression have been identified. Antenatal psychological intimate partner violence (IPV; AOR = 1.04), depression (AOR = 1.06) and detection of efavirenz in dried blood spot at 32 weeks predicted suicidal ideation 12-months postnatally (AOR = 2.29), controlling for antenatal stigma and physical IPV. Findings support using alternative agents for the management of HIV during pregnancy.


Pregnancy WOMEN Efavirenz Suicidal ideation Postpartum South Africa 


Efavirenz es comúnmente utilizado para el tratamiento de la infección por el VIH durante el embarazo en Sudáfrica, pero está contraindicado en pacientes con antecedentes de depresión debido a la posible asociación de su uso con la ideación suicida. Este estudio comparó la ideación suicida a los 12 meses después del parto en mujeres que tomaron o no tomaron Efavirenz durante el embarazo en zonas rurales de Sudáfrica, donde se han identificado altas tasas de depresión. La violencia psicológica prenatal en la pareja (IPV, AOR = 1.04), la depresión (AOR = 1.06) y la detección de Efavirenz en la sangre (medida en muestras de sangre seca) a las 32 semanas predijeron ideación suicida a los 12 meses postparto (AOR = 2.29) en un analysis controlando el estigma prenatal y la IPV física. Los hallazgos respaldan el uso de agentes alternativos para el tratamiento del VIH durante el embarazo.



This study was funded by a grant from the National Institutes of Health, R01HD078187, and with the support of the University of Miami Miller School of Medicine Center for AIDS Research, funded by an NIH grant, P30AI073961.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10461_2018_2213_MOESM1_ESM.docx (18 kb)
Supplementary material 1 (DOCX 17 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral SciencesUniversity of Miami Miller School of MedicineMiamiUSA
  2. 2.Department of PsychologyUniversity of GeorgiaAthensUSA
  3. 3.Ford Foundation Fellow, National Academies of Sciences, Engineering, and MedicineWashingtonUSA
  4. 4.Division of Infectious Diseases, Department of MedicineUniversity of Miami Miller School of MedicineMiamiUSA
  5. 5.HIV/AIDS/STIs and TB (HAST) Research ProgrammeHuman Sciences Research CouncilPretoriaSouth Africa
  6. 6.Department of Research & InnovationUniversity of LimpopoSovengaSouth Africa

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