Antenatal depression and its predictors among HIV positive women in Sub-Saharan Africa; a systematic review and meta-analysis

Abstract

Background: Antenatal depression in HIV-positive pregnant women can have significant adverse effects on both the mother and newborns, yet it is often overlooked in pregnancy care in Sub-Saharan Africa (SSA). Despite this, there is limited data on the combined prevalence of antenatal depression and its predictors among HIV-positive women in the region. Objective: To assess the pooled prevalence of antenatal depression and itsassociated factors among HIV-positive women in SSA.Methods: All primary cross-sectional studies published before 1st January/2024,were included. We conducted searches in relevant databases; PubMed, HINARI,Web of Science, PsycINFO, Psychiatry Online, ScienceDirect, and GoogleScholar. The Joanna Briggs Institute checklist was used to critically appraisethe selected studies. To assess heterogeneity among the studies, we utilised theI2 test. Publication bias was evaluated using a funnel plot and Egger’s test. The forest plot was used to present the combined proportion of antenatal depression and odds ratio, along with a 95% confidence interval. Results: The pooled prevalence of antenatal depression among HIV-positive women in Sub-Saharan Africa was found to be 30.6% (95% CI, 19.8%-41.3%). Factors significantly associated with antenatal depression among HIV-positivewomen in SSA included being unmarried (AOR: 3.09, 95% CI: 1.57 – 6.07), havinga previous history of depression (AOR: 2.97, 95% CI: 1.79 – 4.91), experiencingintimate partner violence (IPV) (AOR: 2.11, 95% CI: 1.44 – 3.09), and experiencingstigma (AOR: 1.36, 95% CI: 1.05 – 1.76) Conclusion: The high prevalence of antenatal depression among HIV-positive women in SSA underscores the need for prioritising identification and management. Interventions addressing factors like IPV and stigma, along with training for healthcare providers in recognising symptoms and providing support, are recommended. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/,identifier CRD42024508236