Loneliness and perceived social support in pregnancy and early postpartum of mothers living with HIV in Ontario, Canada

• Published in: AIDS care Vol. 31; no. 3; pp. 318 - 325
• Main Authors: Khan, S., Ion, A., Alyass, A., Greene, S., Kwaramba, G., Smith, S., Carvalhal, A., Kennedy, V.L., Walmsley, S., Loutfy, M.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 04.03.2019; Taylor & Francis Ltd
• Subjects: Adult; AIDS/HIV; Black people; CD4 antigen; CD4 Lymphocyte Count; Depression - etiology; Discrimination; Female; HIV; HIV Infections - immunology; HIV Infections - psychology; Human immunodeficiency virus; Humans; Immune response; Income; Loneliness; Loneliness - psychology; Marital Status; Marriage; Medicine; Mental depression; Mothers; Mothers - psychology; Ontario; Perceived social support; Postpartum; Postpartum depression; Postpartum Period; Pregnancy; Prenatal care; Prospective Studies; Psychiatric Status Rating Scales; Psychosocial factors; Quantitative analysis; Racism; Risk analysis; Risk Factors; Social interactions; Social Support; Time; Variables; Womens health; Ontario; Canada; social support; loneliness; HIV; pregnancy
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2018.1515469

The HIV Mothering Study (n = 72) was a prospective, observational, cohort study exploring psychosocial experiences and needs of WLWHIV in pregnancy and postpartum. We performed quantitative analysis of determinants of loneliness (UCLA Loneliness Scale) and lower perceived social support (SS) (Medical Outcomes Study-Social Support Survey). The hypothesized determinants included: age, years with HIV, racism (Everyday Discrimination Scale), depression (Edinburgh Postnatal Depression Scale [EPDS]), nadir CD4 (<200 cells/μL), tertiary vs. community HIV care, and marital status. The median age was 33 (IQR = 30-37); 65.3% were African/Caribbean/Black. Multivariable analyses revealed associations between marital status and perceived social support (β = −16.48, p < 0.0001), and this association was also seen with change over time (p = 0.02). Variables associated with SS that did not change over time were: income, EDS racism, EPDS score. Significant associations with loneliness were seen with the same variables associated with SS. Variables associated with loneliness that also changed over time were: EDS Racism (β = 0.22, p = 0.0005, and over time p = 0.003), and EPDS score (β = 0.74, p < 0.0001), and over time (p = 0.0211). Variables associated with loneliness but that did not change over time were: marital status and income. This analysis provides clinicians with prenatal risk factors which may be associated with increase loneliness and lower SS during pregnancy and postpartum: marital status, income, racism and depression.