Perinatal Depression in HIV-Infected African Women: A Systematic Review

Objective: To systematically review the literature on prevalence and incidence of perinatal depression in human immunodeficiency virus (HIV)-infected African women.

Data Sources: We searched 17 databases, including PubMed, PsycINFO, Cochrane, EMBASE, Web of Science, ClinicalTrials.gov, Google Scholar, and OpenGrey, from inception through August 2014 using the search strategy ((antenatal OR peripartum OR perinatal OR postnatal OR postpartum) AND (depression OR mental disorder) AND HIV AND Africa NOT (-) American).

Study Selection: We included English-language articles on studies conducted in Africa with prevalence or incidence rates of diagnostically confirmed depression or suspected depression in HIV-infected women during pregnancy through 12 months postpartum.

Data Extraction: We examined details of study design, location, means of measurement, incidence and prevalence rates of diagnostically confirmed depression or suspected depression and any associated risk factors for development of depression. Mean prevalence rates were calculated and weighted based on study size.

Results: Twenty-two articles met inclusion criteria. Two reported diagnostically confirmed antenatal depression, and 9 reported suspected antenatal depression prevalence. Two reported diagnostically confirmed postnatal depression, and 10 reported suspected postnatal depression prevalence. Weighted mean prevalence of antenatal depression was 23.4%, and suspected antenatal depression was 43.5%. Weighted mean prevalence of postnatal depression was 22.5%, and suspected postnatal depression was 31.1%. No studies reported incidence rates.

Conclusions: Few studies have examined the rate of perinatal depression in HIV-infected African women. Existing studies show a high prevalence of perinatal depression, with even higher prevalence rates of suspected depression. No data on the incidence of perinatal depression in this population exist.