Abstract
INTRODUCTION: Pregnancy often intensifies psychological vulnerabilities in women living with HIV due to increased stressors such as health concerns, infant infection risks, and the management of special neonatal needs like prophylactic antiretroviral care. METHODOLOGY: The study was conducted in four HIV treatment centres with participant selection based on the following criteria: an Edinburgh Postnatal Depression Scale (EPDS) score of 13 or above, gestational age between 14 and 40 weeks, less than five years of antiretroviral therapy (ART) usage, and history of partner conflict. This research forms a more extensive study of stress and depression amongst pregnant and postpartum women living with HIV. In-depth interviews, ranging from 20 to 40 min, were conducted with 26 HIV-positive pregnant women in private rooms within selected antiretroviral clinics from October and December 2022. Data analysis was done using thematic analysis to investigate the experiences of depression and other psychosocial challenges among women living with HIV during pregnancy and postpartum and their coping strategies. RESULTS AND DISCUSSION: The study discovered that the support received from healthcare providers concerning ART and Prevention of Mother-To-Child Transmission practices alleviated women’s fear of death and perinatal transmission, which bolstered their involvement in HIV care and fostered the birth of children not infected with HIV. Women perceived monogamy as a protective measure against HIV contraction. Participants who reported having partners engaging in unsafe sexual practices expressed anger and blame. The observation of other women with similar experiences aided in coping mechanisms, reaffirming previous findings that knowing someone living with HIV helps to accept their status due to the comfort derived from shared experiences. CONCLUSION: Healthcare providers attending to pregnant and postpartum women living with HIV can alleviate psychological distress by reinforcing positive coping strategies. These include consistent psychological distress screenings in HIV clinics and relevant mental health evaluations with appropriate care referrals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-23534-1.