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Screening for Psychological Morbidity in HIV-Infected and HIV-Uninfected Pregnant Women Using Community Counselors in Zimbabwe

Departments of Pediatrics and Child Health, College of Health Sciences, University of Zimbabwe; Zimbabwe AIDS Prevention Project–University of Zimbabwe, Department of Community Medicine, University of Zimbabwe School of Medicine

Dixon Chibanda, MBChB, MMED

Albert Chingono, MSc

Departments of Pediatrics and Psychiatry, College of Health Sciences, University of Zimbabwe

Elizabeth Montgomery, MPH

Jennifer Wells, MPH

University of Zimbabwe–University of California, San Francisco Collaborative Research Program in Women's Health

Yvonne Maldonado, MD

Department of Pediatrics, Stanford University School of Medicine

Tsungai Chipato, MBChB, FRCOG

University of Zimbabwe–University of California, San Francisco Collaborative Research Program in Women's Health

Avinash K. Shetty, MD

Zimbabwe AIDS Prevention Project–University of Zimbabwe, Department of Community Medicine, University of Zimbabwe School of Medicine; Department of Pediatrics, Wake Forest University Health Sciences and Brenner Children's Hospital, Medical Center Blvd, Winston-Salem, NC 27157; ashetty{at}wfubmc.edu

Objective: To examine the prevalence of psychological morbidity in HIV-infected and uninfected pregnant women seeking antenatal care in Zimbabwe. Methods: Pregnant women were screened for psychological morbidity at the initial antenatal care visit using the 14-item Shona Symptom Questionnaire (SSQ) before voluntary HIV counseling and testing (VCT). The primary outcome measure was "cases," as determined by a SSQ score of= 8. Demographic characteristics and HIV status were compared between cases and noncases to determine the risk factors for psychological morbidity. Results: Of the 437 participants, psychological morbidity was detected in 73 (17%) women before undergoing VCT. Risk factors for psychological morbidity included having a spouse older than 35 years of age. HIV infection by itself was not a risk factor for psychological morbidity for women. Conclusions: There is a high burden of psychological morbidity among pregnant women in Zimbabwe. Mental health services should be integrated into antenatal care to improve psychological health for all women in Zimbabwe.

Key Words: psychological morbidity • HIV • pregnant women • Zimbabwe

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 4, No. 4, 83-88 (2005)
DOI: 10.1177/1545109706286555


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