Social Support, Stigma and Antenatal Depression Among HIV-Infected Pregnant Women in South Africa

AIDS Behav. 2017 Jan;21(1):274-282. doi: 10.1007/s10461-016-1389-7.


Depression, HIV-related stigma and low levels of social support may be particularly prevalent and adversely affect health and treatment outcomes among HIV-infected pregnant women. We examined factors associated with social support and stigma among pregnant women initiating antiretroviral therapy in the Western Cape, South Africa; and explored associations with depressive symptoms (Edinburgh Postnatal Depression Scale; EPDS) in linear regression models. Among 623 participants, 11 and 19 % had elevated EPDS scores using thresholds described in the original development of the scale (scores ≥13 and ≥10, respectively). Social support and stigma were highly interrelated and were associated with depressive symptoms. Stigma was observed to moderate the association between social support and depression scores; when levels of stigma were high, no association between social support and depression scores was observed. Elevated depression scores are prevalent in this setting, and interventions to reduce stigma and to address risk factors for depressive symptoms are needed.

Keywords: Antenatal depression; Pregnancy; Social support; South Africa; Stigma.

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use
  • Depression / epidemiology
  • Depression / psychology*
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology*
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • HIV Infections / psychology*
  • Humans
  • Linear Models
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / psychology
  • Pregnancy Complications, Infectious / drug therapy
  • Pregnancy Complications, Infectious / epidemiology
  • Pregnancy Complications, Infectious / psychology*
  • Pregnant Women / psychology*
  • Prevalence
  • Risk Factors
  • Social Stigma*
  • Social Support*
  • South Africa / epidemiology
  • Young Adult


  • Anti-Retroviral Agents