An Uphill Battle with a Baby on the Way

HIV positive pregnant women on Medicaid have high level of depression

(RxWiki News) As if low-income, HIV-positive, pregnant women don't have enough on their plates, many also have to contend with depression - though it's possible not enough doctors are noticing.

A recent study has found that over a quarter of low-income, HIV-positive pregnant women report having depression - and those are only the women actually being treated for depression.

"Seek help from your doctor if you're feeling depressed."

Rajesh Balkrishnan, PhD, an associate professor at the University of Michigan College of Pharmacy and the UM School of Public Health, and colleagues used a database of several states' Medicaid administration claims from 2003 to 2007 to study 650 pregnant women who were HIV positive, including 431 black women and 219 white women.

Across the whole group, 28 percent had been diagnosed with depression and were being treated for it. About 20 percent of black women and 43 percent of white women had depression, although the significantly lower rate among black women may be misleading.

Balkrishnan said he expects the actual rate of depression is higher for black women since past research has revealed that they are less likely to report symptoms of depression or to seek treatment for it.

African-American women also report experiencing more stereotyping from their doctors and a higher level of general mistrust of doctors and the medical industry.

They also tend not to receive an equitable quality of care compared to white women, thereby increasing the likelihood that they don't receive high-quality treatment for depression and possibly don't have their concerns taken as seriously by doctors.

Meanwhile, doctors have said they do not feel that they have the training to communicate with minority women about depression.

"Because African-American women are less likely to seek treatment for their depression, it makes it even more of an issue," Balkrishnan said. "Basically, the takeaway is that depression is very common in this very vulnerable population. I think we need to make sure depression is screened and treated in this population."

The paper was published online March 26 in the journal Health Outcomes Research in Medicine. No information was available regarding funding or possible conflicts of interest.

Review Date: 
June 13, 2012