TY - JOUR
T1 - The relationship between adverse childhood experiences and common mental disorders among pregnant women living with HIV in Malawi
AU - Masiano, Steven P.
AU - Yu, Xiaoying
AU - Tembo, Tapiwa
AU - Wetzel, Elizabeth
AU - Mphande, Mtisunge
AU - Khama, Innocent
AU - Mkandawire, Angella
AU - Chitani, Mike
AU - Liwimbi, Olive
AU - Udedi, Michael
AU - Mazenga, Alick
AU - Nyasulu, Phoebe
AU - Abrams, Elaine
AU - Ahmed, Saeed
AU - Kim, Maria H.
N1 - Funding Information:
The research reported in this publication was supported by the National Institute of Mental Health under Award Number R01MH115793-01A1. Xiaoying Yu is supported by a research career development award (K12HD052023: Building Interdisciplinary Research Careers in Women's Health Program-BIRCWH; Berenson, PI) from the National Institutes of Health/Office of the Director (OD)/National Institute of Allergy and Infectious Diseases (NIAID), and Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD). The findings and conclusions in this report are those of the authors and do not represent the official position of the funding sources.
Funding Information:
The research reported in this publication was supported by the National Institute of Mental Health under Award Number R01MH115793-01A1 . Xiaoying Yu is supported by a research career development award (K12HD052023: Building Interdisciplinary Research Careers in Women's Health Program-BIRCWH; Berenson, PI) from the National Institutes of Health / Office of the Director (OD)/ National Institute of Allergy and Infectious Diseases (NIAID), and Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD). The findings and conclusions in this report are those of the authors and do not represent the official position of the funding sources.
Publisher Copyright:
© 2022
PY - 2022/9/1
Y1 - 2022/9/1
N2 - Introduction: Adverse childhood experiences (ACEs) have been linked to common mental disorders (CMDs) such as anxiety and depressive thoughts. We examined the prevalence of ACEs and their association with CMDs among pregnant women living with HIV (PWLHIV) in Malawi—an HIV endemic resource-limited setting. Methods: This is a cross-sectional study of 798 PWLHIV enrolled in the VITAL Start trial in Malawi (10/2018 to 06/2021) (NCT03654898). ACE histories were assessed using WHO's Adverse Childhood Experiences International Questionnaire (ACE-IQ) tool. Depressive symptoms (somatic complaints, reduced vital energy, anxiety, and depressive thoughts) were assessed using WHO's Self Reporting Questionnaire 20-Item (SRQ-20) tool. Log-binomial regressions were used to examine the association between cumulative ACEs and each depressive symptom, as well as identify ACEs driving this association. Results: The mean age of our sample was 27.5 years. Over 95 % reported having experienced ≥1 ACE. On average, each participant reported four ACEs; 11 % reported sexual abuse. About 52 % and 44 % reported anxiety and depressive thoughts, respectively. In regressions, cumulative ACE scores were significantly associated with depressive symptoms—even after adjusting for multiple testing. This association was primarily driven by reports of sexual abuse. Limitations: Data on maternal ACEs were self-reported and could suffer from measurement error because of recall bias. Conclusions: ACEs are widespread and have a graded relationship with depressive symptoms in motherhood. Sexual abuse was found to be a primary driver of this association. Earlier recognition of ACEs and provision of trauma-informed interventions to improve care in PWLHIV may reduce negative mental health sequelae.
AB - Introduction: Adverse childhood experiences (ACEs) have been linked to common mental disorders (CMDs) such as anxiety and depressive thoughts. We examined the prevalence of ACEs and their association with CMDs among pregnant women living with HIV (PWLHIV) in Malawi—an HIV endemic resource-limited setting. Methods: This is a cross-sectional study of 798 PWLHIV enrolled in the VITAL Start trial in Malawi (10/2018 to 06/2021) (NCT03654898). ACE histories were assessed using WHO's Adverse Childhood Experiences International Questionnaire (ACE-IQ) tool. Depressive symptoms (somatic complaints, reduced vital energy, anxiety, and depressive thoughts) were assessed using WHO's Self Reporting Questionnaire 20-Item (SRQ-20) tool. Log-binomial regressions were used to examine the association between cumulative ACEs and each depressive symptom, as well as identify ACEs driving this association. Results: The mean age of our sample was 27.5 years. Over 95 % reported having experienced ≥1 ACE. On average, each participant reported four ACEs; 11 % reported sexual abuse. About 52 % and 44 % reported anxiety and depressive thoughts, respectively. In regressions, cumulative ACE scores were significantly associated with depressive symptoms—even after adjusting for multiple testing. This association was primarily driven by reports of sexual abuse. Limitations: Data on maternal ACEs were self-reported and could suffer from measurement error because of recall bias. Conclusions: ACEs are widespread and have a graded relationship with depressive symptoms in motherhood. Sexual abuse was found to be a primary driver of this association. Earlier recognition of ACEs and provision of trauma-informed interventions to improve care in PWLHIV may reduce negative mental health sequelae.
KW - ACE-IQ
KW - Adverse childhood experiences
KW - Mental health
KW - Pregnant women living with HIV
KW - Prevalence
KW - Resource-limited settings
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U2 - 10.1016/j.jad.2022.06.028
DO - 10.1016/j.jad.2022.06.028
M3 - Article
C2 - 35752220
AN - SCOPUS:85132893002
SN - 0165-0327
VL - 312
SP - 159
EP - 168
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -