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Psychological and Physical Intimate Partner Violence and Maternal Depressive Symptoms during the Pre- and Post-Partum Period among Women Living with HIV in Rural South Africa

Abstract

Women in South Africa have high rates of depression and intimate partner violence (IPV), and they often co-occur. Women living with HIV who experience IPV are particularly likely to experience elevated levels of depressive symptoms and are more likely to persist. Although the association between IPV and depression has been examined extensively, the role of depression on IPV has not. Therefore, this study examined the bidirectional association between IPV and depressive symptoms in South Africa (SA). Participants were N = 699 pregnant women with HIV in rural SA who completed measures of depressive symptoms and IPV at baseline (M = 17.52 ± 5.77 weeks of pregnancy), 32 weeks antenatally, and 6- and 12-months postnatally. Depressive symptoms were linked to increased psychological IPV from baseline to 32-weeks, and from 32-weeks to 6-months. However, from 6-months to 12-months, depressive symptoms were associated with decreased psychological IPV. Psychological IPV was linked to depressive symptoms from baseline to 32-weeks. Depressive symptoms were associated with physical IPV from 32-weeks to 6-months, and 6-months to 12-months. Physical IPV was associated with increased depressive symptoms from baseline to 32-weeks, and from 32-weeks to 6-months. Findings merit replication, as there may be measurement differences of psychological IPV in SA. However, targeting depressive symptoms and IPV concurrently in prevention and intervention programs may help optimize maternal and outcomes in the context of prevention of mother-to-child transmission of HIV.

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Acknowledgments

This study was funded by National Institute of Child Health and Human Development grant number R01HD078187, with support from Miami Center for AIDS Research, funded by a grant (P30AI073961) from the National Institute of Allergy and Infectious Diseases. A substantial part of the manuscript was carried out under a Ford Foundation Fellowship to Violeta Rodriguez. We thank the research personnel at the Human Sciences Research Council, the many doctors, nurses, and fieldworkers at the community health centers who made this study possible, and above all, the women who participated in this study.

Author information

KP, DLJ and SMW conceived the study. VJR drafted the manuscript with AS. VJR conducted all analyses with oversight by TKL and AS. DLJ, SMW, KP participated in study execution and coordination. VJR, TLK, AS, DLJ, SMW and KP assisted in editing and finalizing the manuscript and gave critical review. All authors read and approved the final manuscript.

Correspondence to Violeta J. Rodriguez.

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Rodriguez, V.J., Shaffer, A., Lee, T.K. et al. Psychological and Physical Intimate Partner Violence and Maternal Depressive Symptoms during the Pre- and Post-Partum Period among Women Living with HIV in Rural South Africa. J Fam Viol 35, 73–83 (2020) doi:10.1007/s10896-018-0027-8

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Keywords

  • Women
  • HIV
  • Pregnancy
  • Intimate partner violence
  • Depression