Exploring the influence of male partners on perinatal mental health among Kenyan women at risk for and living with HIV

Abstract

Mental health conditions are a major global health concern, especially in Sub-Saharan Africa (SSA), where women are disproportionately affected by perinatal mental distress. This issue is particularly severe among women living with HIV (WLHIV), who face a heightened risk of depression and anxiety. Despite the crucial role male partners play in the health of women and children, their impact on perinatal mental health is not well understood.To explore this, we conducted semi-structured qualitative interviews and focus group discussions with women who were either at risk of HIV or living with HIV. Through thematic analysis, we identified that women commonly reported symptoms of depression and anxiety, such as poor sleep quality, physical pain, reduced appetite, unclear thinking, and apathy. Some women even expressed a diminished will to live and suicidal thoughts. Frequent sources of stress included pregnancy-related changes, fear of transmitting HIV to their babies, and fear of acquiring HIV among those on PrEP and their male partners. Male partners emerged as the most significant source of stress for postpartum women, often due to relationship instability, inadequate financial support, and in some cases, verbal or physical abuse. Women living with HIV experienced increased relationship tension and rejection related to their HIV status. Additionally, many women noticed signs of mental health challenges in their male partners, such as anger and chronic stress, and observed that these men often lacked support to address these issues. To cope with perinatal mental health challenges, women employed various strategies, including praying, singing, listening to music, taking walks, social interaction, and participating in church or community-based support groups. Recognizing the significant influence men have on women's mental health and the impact of men's stressors on women's well-being, family-oriented mental health programs could be instrumental in improving perinatal mental health. Expanding mental health services to include commonly used coping strategies, such as church, community, or peer support, would likely be beneficial.