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Psychological Morbidity and parenting stress in mothers of primary school children by timing of acquisition of HIV infection: a longitudinal cohort study in rural South Africa

Rochat, T J; Houle, Brian; Stein, A; Pearson, R M; Newell, M L; Bland, R M

Description

Longitudinal maternal mental health data are needed from high HIV prevalence settings. The Siyakhula Cohort (SC) is a population-based cohort of HIV-positive and negative mothers (n=1506) with HIV-negative children (n=1536) from rural South Africa. SC includes 767 HIV-negative mothers; 465 HIV-positive in pregnancy; 272 HIV-positive since pregnancy (n=2 missing HIV status). A subgroup (n=890) participated in a non-randomized breastfeeding intervention [Vertical Transmission Study (VTS)]; the...[Show more]

dc.contributor.authorRochat, T J
dc.contributor.authorHoule, Brian
dc.contributor.authorStein, A
dc.contributor.authorPearson, R M
dc.contributor.authorNewell, M L
dc.contributor.authorBland, R M
dc.date.accessioned2021-11-24T23:07:17Z
dc.identifier.issn2040-1744
dc.identifier.urihttp://hdl.handle.net/1885/251958
dc.description.abstractLongitudinal maternal mental health data are needed from high HIV prevalence settings. The Siyakhula Cohort (SC) is a population-based cohort of HIV-positive and negative mothers (n=1506) with HIV-negative children (n=1536) from rural South Africa. SC includes 767 HIV-negative mothers; 465 HIV-positive in pregnancy; 272 HIV-positive since pregnancy (n=2 missing HIV status). A subgroup (n=890) participated in a non-randomized breastfeeding intervention [Vertical Transmission Study (VTS)]; the remaining (n=616) were resident in the same area and received antenatal care at the time of the VTS, but were not part of the VTS, instead receiving the standard of care Prevention of Mother-to-Child Transmission (PMTCT) Programme. In secondary analysis we investigated the prevalence of, and factors associated with, psychological morbidity amongst mothers who were still the primary caregiver of the child (1265 out of 1506) at follow-up (7–11 years post-birth). We measured maternal depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder Scale-7) and parenting stress (Parenting Stress Index-36), using standardized cut-offs and algorithms. In total, 75 (5.9%) mothers met criteria for depression, 37 (2.9%) anxiety and 134 (10.6%) parenting stress. Using complete case logistic regression (n=1206 out of 1265 mothers) as compared to being HIV-negative, testing HIV-positive in pregnancy doubled odds of depression [adjusted odd ratios (aOR)=1.96 [1.0–3.7] P=0.039]. Parenting stress was positively associated with acquisition of HIV after pregnancy (aOR=3.11 [1.9–5.2] P<0.001) and exposure to household crime (aOR=2.02 [1.3–3.2] P=0.003); negatively associated with higher maternal education (aOR=0.29 [0.1–0.8] P=0.014), maternal employment (aOR=0.55 [0.3–0.9] P=0.024). Compared with the standard of care PMTCT, VTS mothers had reduced odds of parenting stress (aOR=0.61 [0.4–0.9] P=0.016). Integrating parental support into mostly bio-medical treatment programmes, during and beyond pregnancy, is important.
dc.description.sponsorshipThe reenrolment and assessment of the cohort was funded by Grand Challenges Canada, Saving Brains (Grand Challenges 0063-03). The sponsor of the study (Grand Challenges, Canada) required a standard set of core metrics across all 11 funded cohorts, including socio-demographic and economic variables and data on child cognition. Other than this the funder played no role in study design, data collection, data analysis, data interpretation or writing the manuscript. The Africa Centre for Population Health, now called the AHRI, where the research took place is funded by the Wellcome Trust (Grant Numbers: Previous Africa Centre 097410/Z/11/Z Current AHRI 201433/Z/16/Z). The DSS is co-funded by the South African Department of Science and Technology through the DST/MRC South African Population Research Infrastructure Network (SAPRIN). The original VTS was funded separately (Wellcome Trust, UK 063009/Z/00/2). The support of the DST-NRF Centre of Excellence (CoE) in Human Development towards data analysis is acknowledged. Opinions expressed and conclusions arrived at are those of the authors and are not necessarily to beattributed to the funders. T.R. receives salary support from the Human Sciences Research Council in South Africa and is supported by the Newton Advanced Fellowship Scheme (AF160108) through the University of Bristol. T.R. and A.S. receive support from an MRC Public Health Intervention Development scheme grant (MC_PC_14096).
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherCambridge University Press
dc.rights© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2017
dc.sourceJournal of Developmental Origins of Health and Disease
dc.subjectanxiety
dc.subjectdepression
dc.subjectHIV
dc.subjectmaternal
dc.subjectparenting stress
dc.titlePsychological Morbidity and parenting stress in mothers of primary school children by timing of acquisition of HIV infection: a longitudinal cohort study in rural South Africa
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume9
dc.date.issued2018
local.identifier.absfor160301 - Family and Household Studies
local.identifier.absfor111714 - Mental Health
local.identifier.ariespublicationu3555277xPUB300
local.publisher.urlhttp://journals.cambridge.org/action/displayJournal?jid=DOH
local.type.statusPublished Version
local.contributor.affiliationRochat, T J, Africa Health Research Institute, Durban, South Africa
local.contributor.affiliationHoule, Brian, College of Arts and Social Sciences, ANU
local.contributor.affiliationStein, A, Department of Psychiatry
local.contributor.affiliationPearson, R M, Department of Psychiatry
local.contributor.affiliationNewell, M L, Global Health Research Institute
local.contributor.affiliationBland, R M, Africa Health Research Institute,
local.description.embargo2099-12-31
local.bibliographicCitation.issue1
local.bibliographicCitation.startpage41
local.bibliographicCitation.lastpage57
local.identifier.doi10.1017/S204017441700068X
local.identifier.absseo920110 - Inherited Diseases (incl. Gene Therapy)
dc.date.updated2020-11-23T11:51:55Z
local.identifier.scopusID2-s2.0-85030656834
CollectionsANU Research Publications

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