| Title: |
Interpersonal therapy versus antidepressant medication for treatment of postpartum depression and anxiety among women with HIV in Zambia: a randomized feasibility trial |
| Authors: |
Spelke, M. Bridget; Paul, Ravi; Blette, Bryan S.; Meltzer‐Brody, Samantha; Schiller, Crystal E.; Ncheka, J. M.; Kasaro, Margaret P.; Price, Joan T.; Stringer, Jeffrey S. A.; Stringer, Elizabeth M. |
| Contributors: |
National Institute of Mental Health; National Center for Advancing Translational Sciences; National Institutes of Health |
| Source: |
Journal of the International AIDS Society ; volume 25, issue 7 ; ISSN 1758-2652 1758-2652 |
| Publisher Information: |
Wiley |
| Publication Year: |
2022 |
| Collection: |
Wiley Online Library (Open Access Articles via Crossref) |
| Description: |
Introduction Postpartum depression (PPD) is a prevalent and debilitating disease that may affect medication adherence and thus maternal health and vertical transmission among women with HIV. We assessed the feasibility of a trial of interpersonal psychotherapy (IPT) versus antidepressant medication (ADM) to treat PPD and/or anxiety among postpartum women with HIV in Lusaka, Zambia. Methods Between 29 October 2019 and 8 September 2020, we pre‐screened women 6–8 weeks after delivery with the Edinburgh Postnatal Depression Scale (EPDS) and diagnosed PPD or anxiety with the Mini International Neuropsychiatric Interview. Consenting participants were randomized 1:1 to up to 11 sessions of IPT or daily self‐administered sertraline and followed for 24 weeks. We assessed EPDS score, Clinical Global Impression‐Severity of Illness (CGI‐S) and medication side effects at each visit and measured maternal HIV viral load at baseline and final study visit. Retention, visit adherence, change in EPDS, CGI‐S and log viral load were compared between groups with t ‐tests and Wilcoxon signed rank tests; we report mean differences, relative risks and 95% confidence intervals. A participant satisfaction survey assessed trial acceptability. Results 78/80 (98%) participants were retained at the final study visit. In the context of the COVID‐19 pandemic, visit adherence was greater among women allocated to ADM (9.9 visits, SD 2.2) versus IPT (8.9 visits, SD 2.4; p = 0.06). EPDS scores decreased from baseline to final visit overall, though mean change was greater in the IPT group (−13.8 points, SD 4.7) compared to the ADM group (−11.4 points, SD 5.5; p = 0.04). Both groups showed similar changes in mean log viral load from baseline to final study visit (mean difference −0.43, 95% CI −0.32, 1.18; p = 0.48). In the IPT group, viral load decreased significantly from baseline (0.9 log copies/ml, SD 1.7) to final visit (0.2 log copies/ml, SD 0.9; p = 0.01). Conclusions This pilot study demonstrates that a trial of two forms of PPD ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1002/jia2.25959 |
| Availability: |
https://doi.org/10.1002/jia2.25959; https://onlinelibrary.wiley.com/doi/pdf/10.1002/jia2.25959; https://onlinelibrary.wiley.com/doi/full-xml/10.1002/jia2.25959 |
| Rights: |
http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.AD377B05 |
| Database: |
BASE |