Path Analysis of Physical Symptoms, Emotional Support, Self-esteem, and Depressive Symptoms in Hiv-positive Perinatal Women in Thailand - Path Analysis of Physical Symptoms, Emotional Support, Self-esteem, and Depressive Symptoms in Hiv-positive Perinatal Women in Thailand - Open Access Pub

Evidence shows that depressive symptoms are associated with faster progression to AIDS in HIV-infected populations. Physical symptoms, self-esteem, and emotional support have been reported to play a major role in contributing to depressive symptoms. However, comparisons of different sources of support—specifically family vs. friends— have only been made in a few previous HIV studies. Therefore, the objectives of this study among HIV-positive perinatal Thai women were to examine: 1) both the direct and indirect effects of physical symptoms and emotional support on depressive symptoms; 2) which source of support is more significant, family or friends; and 3) the direct effect of self-esteem on depressive symptoms. Results revealed that half of the participants experienced major depressive symptoms. Physical symptoms and self-esteem both had direct effects on depressive symptoms. Emotional support, from friends and family, had an indirect effect on depressive symptoms. Treating physical symptoms and increasing self-esteem through emotional support, could help decrease depressive symptoms in the target population. Finally, it is crucial that routine screening for depressive symptoms is established at all HIV clinics for perinatal women in Thailand. DOI 10.14302/issn.2324-7339.jcrhap-12-147 At the end of 2009, the Joint United Nations Programme on HIV/AIDS1 estimated that 33.3 million people were living with HIV, including at least 600,000 Thai adults (ages 15–49 years), 20,000 of whom were pregnant women2. In general, HIV infections cause greater problems in developing countries such as Thailand than in developed countries, partly because of a lack of antiretroviral medications. Studies have shown that depressive symptoms are associated with non-adherence to antiretroviral treatment 3, 4, 5 faster disease progression,5, 6, 7 and poorer quality of life.8 Among HIV-positive perinatal women, being single, having a low income, having a low level of education, being younger, and being unemployed are often found to be correlated with depressive symptoms.9, 10, 11, 12, 13 Other factors affecting depressive symptoms in those who are HIV positive include presence of physical symptoms, low emotional support, low self-esteem, and poor physical health.11, 12, 14, 15, 16, 17, 18, 19 Studies in various countries have found that HIV-positive perinatal women with low self-esteem tend to report more depressive symptoms than those with high self-esteem.11, 12, 17, 20 Qualitative studies have found that HIV-positive pregnant women in Thailand with low self-esteem are more