{"doi":"10.1002/jia2.25959","title":"Interpersonal therapy versus antidepressant medication for treatment of postpartum depression and anxiety among women with HIV in Zambia: a randomized feasibility trial","abstract":"INTRODUCTION: Postpartum depression (PPD) is a prevalent and debilitating disease that may affect medication adherence and thus maternal health and vertical transmission among women with HIV. We assessed the feasibility of a trial of interpersonal psychotherapy (IPT) versus antidepressant medication (ADM) to treat PPD and/or anxiety among postpartum women with HIV in Lusaka, Zambia. METHODS: Between 29 October 2019 and 8 September 2020, we pre-screened women 6-8 weeks after delivery with the Edinburgh Postnatal Depression Scale (EPDS) and diagnosed PPD or anxiety with the Mini International Neuropsychiatric Interview. Consenting participants were randomized 1:1 to up to 11 sessions of IPT or daily self-administered sertraline and followed for 24 weeks. We assessed EPDS score, Clinical Global Impression-Severity of Illness (CGI-S) and medication side effects at each visit and measured maternal HIV viral load at baseline and final study visit. Retention, visit adherence, change in EPDS, CGI-S and log viral load were compared between groups with t-tests and Wilcoxon signed rank tests; we report mean differences, relative risks and 95% confidence intervals. A participant satisfaction survey assessed trial acceptability. RESULTS: 78/80 (98%) participants were retained at the final study visit. In the context of the COVID-19 pandemic, visit adherence was greater among women allocated to ADM (9.9 visits, SD 2.2) versus IPT (8.9 visits, SD 2.4; p = 0.06). EPDS scores decreased from baseline to final visit overall, though mean change was greater in the IPT group (-13.8 points, SD 4.7) compared to the ADM group (-11.4 points, SD 5.5; p = 0.04). Both groups showed similar changes in mean log viral load from baseline to final study visit (mean difference -0.43, 95% CI -0.32, 1.18; p = 0.48). In the IPT group, viral load decreased significantly from baseline (0.9 log copies/ml, SD 1.7) to final visit (0.2 log copies/ml, SD 0.9; p = 0.01). CONCLUSIONS: This pilot study demonstrates that a trial of two forms of PPD treatment is feasible and acceptable among women with HIV in Zambia. IPT and ADM both improved measures of depression severity; however, a full-scale trial is required to determine whether treatment of PPD and anxiety improves maternal-infant HIV outcomes.","journal":"Journal of the International AIDS Society","year":2022,"id":264271,"datarank":0.4943193732679415,"base_score":2.5649493574615367,"endowment":2.5649493574615367,"self_citation_contribution":0.38474240361923057,"citation_network_contribution":0.10957696964871097,"self_endowment_contribution":0.38474240361923057,"citer_contribution":0.10957696964871097,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":11,"citers_with_citation_signal":8,"citers_with_endowment":8,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9596,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT04094870"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":921885,"name":"Ravi Paul","orcid":"0000-0003-0246-7096","position":1,"is_corresponding":false},{"id":426089,"name":"Bryan S. Blette","orcid":"0000-0002-3121-7718","position":2,"is_corresponding":false},{"id":266091,"name":"Samantha Meltzer‐Brody","orcid":"0000-0002-8509-408X","position":3,"is_corresponding":false},{"id":593236,"name":"Crystal Edler Schiller","orcid":"0000-0001-6186-701X","position":4,"is_corresponding":false},{"id":922338,"name":"Joyce M. Ncheka","orcid":null,"position":5,"is_corresponding":false},{"id":401976,"name":"Margaret P. Kasaro","orcid":"0000-0001-7285-998X","position":6,"is_corresponding":false},{"id":401970,"name":"Joan T. Price","orcid":"0000-0003-4178-0405","position":7,"is_corresponding":false},{"id":248972,"name":"Jeffrey S. A. Stringer","orcid":"0000-0002-9590-7216","position":8,"is_corresponding":false},{"id":401975,"name":"Elizabeth M. Stringer","orcid":"0000-0003-4210-381X","position":9,"is_corresponding":false},{"id":637022,"name":"M. Bridget Spelke","orcid":"0000-0002-5950-8197","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-19T00:26:37.567338Z","pmid":"35803896","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}