Examining patterns of intimate partner violence and depression amongst a cohort of pregnant and postpartum women in Cape Town, South Africa

Bagg, Kayla

Examining patterns of intimate partner violence and depression amongst a cohort of pregnant and postpartum women in Cape Town, South Africa

Thesis / Dissertation

2024

Publisher

University of Cape Town

Department

Department of Public Health and Family Medicine

Faculty

Faculty of Health Sciences

Abstract

Depression and intimate partner violence (IPV) frequently co-occur among women in South Africa (SA) with elevated risk in the antenatal and postnatal period. Both phenomena have also been shown to reduce uptake and adherence to human immunodeficiency virus (HIV) treatments. In this secondary analysis, we examined patterns of IPV exposure and depression in a cohort of pregnant HIV-negative women on oral pre-exposure prophylaxis (PrEP). Data from 1195 women at enrolment was retrospectively analyzed from an existing dataset. Participants were recruited from two midwife obstetric units in Cape Town and followed from enrolment to 12 months post-partum with 3-monthly interviews. Women between the ages of 16–18 years were 3.15 (95% CI: 1.30, 7.07) times as likely to score above 11 on the Edinburgh Postnatal Depression Scale (EPDS), indicating depression, compared to women >25 years. Women who self-reported experiencing IPV at baseline had 2.77 (95% CI: 1.61, 4.61) times the odds of an EPDS score ³11 compared to those who did not report experiencing IPV at baseline. In conjunction with this, the London Measure of Unplanned Pregnancies (LMUP) was used to determine the pregnancy intentions of the mothers. The prevalence of maternal mental health problems during pregnancy and postpartum is alarming, particularly among women in low- and middle-income countries (LMIC). These include IPV and depression which could lead to poor adherence to oral pre-exposure prophylaxis (PrEP) and ultimately HIV infection. Screening for depression in the postpartum period may also have an impact on IPV victimization. Identifying pregnant women who are experiencing either IPV or depression and linking them with the necessary services, may improve PrEP outcomes.

Keywords

family medicine

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