Depressive symptoms among women of reproductive age with and without HIV in the Southern United States

Objectives:To explore the prevalence of depressive symptoms and associated factors among reproductive-aged women participating in the Study of Treatment and Reproductive outcomes (STAR) cohort.Design:Cross-sectional analysis.Methods:We analyzed baseline data from women with HIV (WWH) and women without HIV (WwoH) but at risk for HIV enrolled in the STAR, a prospective observational cohort of reproductive-aged women in six Southern US states. We used the Center for Epidemiologic Studies Depression (CES-D) scale to measure depressive symptoms. Crude prevalence ratios were used to describe depressive symptoms by sociodemographic, substance use, psychological, and reproductive characteristics.Results:A total of 473 WWH [median age 37, interquartile range (IQR): 32-42] and 286 WwoH (median age 32, IQR: 26-40) enrolled as of August 2023 in the STAR. Thirty-eight percentage of WWH and 34% of WwoH reported a CES-D score at least 16 (henceforth 'depressive symptoms'; WWH: median score 11, IQR: 5-21 and WwoH: median score 10, IQR: 6-21). Hazardous alcohol use and history of using crack/cocaine were each associated with increased prevalence of depressive symptoms. The prevalence of depressive symptoms rose with each one standard deviation increase in loneliness, perceived stress, and lack of neighborhood safety. In contrast, we found a lower prevalence of depressive symptoms with increasing resilience and social support scores.Conclusion:Depressive symptoms are common among reproductive-aged women regardless of HIV status. Future analyses will help to confirm these initial findings and begin to identify intervention targets to alleviate depressive symptoms.