# An assessment of anxiety and depression among HIV-positive pregnant women in a tertiary hospital located in southeast Nigeria: a cross-sectional comparative analysis

## TL;DR

The study found that HIV-positive pregnant women in Nigeria have significantly higher rates of anxiety and depression compared to HIV-negative women.

## Contribution

This study provides new insights into the mental health disparities between HIV-positive and HIV-negative pregnant women in Nigeria.

## Key findings

- HIV-positive pregnant women had significantly higher anxiety and depression scores than HIV-negative women.
- Over 70% of HIV-positive women showed moderate to severe anxiety, and nearly 50% had moderate to severe depression.
- Younger age, lower education, and being married were significant factors for mental health issues in both groups.

## Abstract

The periods of pregnancy are critical for the mental well-being of women. HIV positive pregnant women are especially vulnerable to experiencing depression and anxiety.

To determine the prevalence and determinant of depression and anxiety among HIV-positive and HIV negative pregnant women in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, Nigeria.

Between January 1 and May 30, 2024, 342 HIV-positive pregnant individuals and an equivalent number of HIV-negative prenatal attendees participated in a cross-sectional survey conducted at NAUTH in Nnewi. A structured questionnaire, the Generalized Anxiety Disorder Assessment, and the Patient Health Questionnaire were used to interview the subjects. IBM Statistical Package for Social Science version 26 was used to analyze the data, and a significance level of less than 0.05 was chosen.

The research involved 684 participants, all of whom screened positive for anxiety and depression. The average scores for anxiety in HIV-positive and HIV-negative women were 16.8 ± 3.8 compared to 8.7 ± 2.3; P <0.001, while for depression the scores were 11.1 ± 4.3 versus 3.1 ± 3.3; P < 0.001, respectively. A significant presence of major depressive and anxiety disorders was discovered among HIV-positive women, with moderate and severe depression affecting 47.7% and 21.9%, respectively, while moderate and severe anxiety were observed in 21.3% and 73.6% of the women. The majority of women in the control group exhibited mild mental health disorders. For HIV-positive women, the significant factors influencing depression included being 30 years old or younger, having a gestational age of 30 weeks or less, possessing a lower educational level, being employed, and being married; for anxiety, key factors were being para 0-3, experiencing psychological IPV, and being married. Among HIV-negative women, significant determinants of depression included being 30 years old or younger, having a low educational level, and being married.

The prevalence of mental health disorders in the study group is extremely high. The rate is unacceptably elevated among pregnant women who are HIV-positive. This emphasizes the need to integrate mental health services into standard maternal healthcare for all women, especially those living with HIV.