Experiences and predictors of psychological distress in pregnant women living with HIV

OBJECTIVES: To explore the experiences and predictors of psychological distress in pregnant women living with HIV. DESIGN: A mixed‐methods research design. METHODS: A representative randomly sampled 840 (age range 22–46 years) HIV‐positive pregnant women in Akwa Ibom, Benue, and Rivers States of Nigeria enrolled for the study. Data were collected using standardized questionnaires and in‐depth interviews for 4 months and 3 weeks in 6 HIV treatment centres. Collected data were analysed using IBM SPSS statistics (v. 22.0) and thematic analysis. RESULTS: The mean score on psychological distress was 17.07 ± 5.86. Multiple regression analysis found a significant joint prediction of meaning in life, self‐compassion, and acceptance of illness on psychological distress, R = .64, R(2) = .41; F (3,828) = 186.18; p = .000, with 41% variance explained. Further, there was a significant independent prediction of each predictor at meaning in life (β = −.19, t = −5.08; p = .000), self‐compassion (β = −.23, t = −5.59; p = .000), and acceptance of illness (β = −.30, t = −7.23; p = .000), with acceptance of illness exerting the greatest independent predictive impact. Socio‐demographic variables (age, length of living with HIV, high‐risk state, highest education attained, marital status, and religious affiliation) had no significant contribution to psychological distress. Qualitative analysis found ‘anxious concerns’, ‘depressive reports, loneliness, and regrets’, ‘self‐blame and guilt feelings’, as the experiences of psychological distress, and these experiences were determined by respondents’ socio‐cultural contexts. CONCLUSION: These findings emphasize the importance of psychosocial care for HIV‐positive pregnant women.