Sweta Kumari, Anjeet Kumar, Vaibhav Chaudhary, Biplab Pal
Depressive symptoms are common among HIV-positive pregnant women and can negatively affect maternal well-being, antiretroviral therapy adherence, and prevention of mother-to-child transmission. This systematic review and meta-analysis aimed to estimate the pooled prevalence of depressive symptoms and identify associated risk factors among HIV-positive pregnant women in Asia. PubMed, Scopus, and Google Scholar were searched to identify relevant studies from inception to December 2025. Observational studies reporting depressive symptoms among HIV-positive pregnant women were included. Study selection, data extraction, and quality assessment were independently performed by two reviewers. A random-effects model was used to calculate the pooled prevalence in RStudio. Six studies involving 778 participants were included. The pooled prevalence of depressive symptoms was 61.4% (95% CI: 48.2-73.1), with substantial heterogeneity (I2 = 90.2%, p < 0.001). Prevalence was highest in India (66.5%), followed by Thailand (58.0%) and China (54.1%). Studies with large sample sizes exhibited lower prevalence (51.9%) than those with small sample sizes (69.8%). Associated factors included rural residence, primigravida status, inadequate antenatal care, non-disclosure of HIV status, limited partner support, HIV diagnosis during pregnancy, and negative illness perception. Integration of routine mental health screening and psychosocial support into antenatal and HIV care services is essential.