Psychological and Physical Intimate Partner Violence and Maternal Depressive Symptoms during the Pre- and Post-Partum Period among Women Living with HIV in Rural South Africa

Women in South Africa have high rates of depression and intimate partner violence (IPV), and they often co-occur. Women living with HIV who experience IPV are particularly likely to experience elevated levels of depressive symptoms and are more likely to persist. Although the association between IPV and depression has been examined extensively, the role of depression on IPV has not. Therefore, this study examined the bidirectional association between IPV and depressive symptoms in South Africa (SA). Participants were N = 699 pregnant women with HIV in rural SA who completed measures of depressive symptoms and IPV at baseline (M = 17.52 ± 5.77 weeks of pregnancy), 32 weeks antenatally, and 6- and 12-months postnatally. Depressive symptoms were linked to increased psychological IPV from baseline to 32-weeks, and from 32-weeks to 6-months. However, from 6-months to 12-months, depressive symptoms were associated with decreased psychological IPV. Psychological IPV was linked to depressive symptoms from baseline to 32-weeks. Depressive symptoms were associated with physical IPV from 32-weeks to 6-months, and 6-months to 12-months. Physical IPV was associated with increased depressive symptoms from baseline to 32-weeks, and from 32-weeks to 6-months. Findings merit replication, as there may be measurement differences of psychological IPV in SA. However, targeting depressive symptoms and IPV concurrently in prevention and intervention programs may help optimize maternal and outcomes in the context of prevention of mother-to-child transmission of HIV.