Revisiting maternity and perinatal mental health experiences of women living with HIV for an HIV-free generation (REVISE Study – revisit and eliminate)

Pregnant women living with HIV are disproportionately affected by obstetric violence and perinatal depression, leading to poor uptake of prevention of mother-to-child transmission (PMTCT) services and increased risk of vertical transmission of HIV. In Ethiopia and Guinea, these problems are pervasive, yet perinatal mental health and respectful maternity care remain neglected. Globally, there is a critical evidence gap and need for context-sensitive implementation research to address these challenges and protect the rights and mental health of women living with HIV. I will conduct a longitudinal and participatory mixed methods implementation research in Ethiopia and Guinea to: 1) examine the causal effect of obstetric violence and perinatal depression on PMTCT care outcomes, and to 2) co-design, implement, and evaluate an intervention to integrate perinatal mental health and respectful maternity care into the care of pregnant and postpartum women living with HIV. I will collect data using longitudinal surveys of women, in-depth interviews (IDIs) with women and health system informants, facility observations, and reviews of patient files. Data analysis methods will include multilevel mixed-effects modelling (women’s survey), henomenological analysis (IDIs with women), and theory-driven thematic analysis (IDIs with health system informants). Findings will provide critical insights to guide future initiatives to improve maternal health, perinatal mental health, and PMTCT care.