{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T17:47:47Z","timestamp":1782755267661,"version":"3.54.5"},"reference-count":75,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Many women living with HIV (WLHIV) in worldwide experience mental health conditions, particularly depression, which can negatively affect their overall wellbeing. Their lived experiences play a crucial WLHIV has been explored in various global context, there is limited research focusing on the specific women\u2019s lived experience of depression in Ethiopia. Understanding these experience is essential to inform the development of culturally appropriate and targeted mental health interventions and support system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A qualitative phenomenological design was employed to explore women\u2019s lived experience of depression in Ethiopia. Criterion-based sampling was used, and recruitment continued until data saturation was achieved. Data were collected through in-depth face to face interviews with 16 participants attending health facilities. An inductive approach was used for analysis, with code derived from the data using Ritchie and Spencer\u2019s analytical framework. Subsequently, Interpretive Phenomenological Analysis was applied to identify key themes and subthemes. Data analysis was supported by MAXQDA (version 22) software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study identified key themes on women\u2019s lived experience of depression, including symptoms, meaning, perceived causes, perpetuating and relieving factors, treatment perceptions, coping strategies, and challenges. Depression affected emotional, physical and social well-being, and was shaped by factors such as HIV status, stigma, financial hardship, and lack of support. Women used diverse coping strategies, including spiritual practices, social support, and daily routines. Some preferred spiritual healing over professional care. Depression also negatively affected memory, motivation, self-care, and ART adherence, contributing to isolation, unemployment, and decline health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Depression among WLHIV shaped by intersecting social, economic, and health related challenge. Addressing this requires the Ministry of Health to implement integrated, culturally sensitive mental health interventions and strengthen mental health awareness, combining psychosocial support, spiritual care, and improved access to professional services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0352678","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T17:27:12Z","timestamp":1782754032000},"page":"e0352678","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lived experience of depression in women living with Human Immunodeficiency Virus in Gondar City health facilities, Northwest, Ethiopia: A phenomenological study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5764-2985","authenticated-orcid":true,"given":"Tadele Amare","family":"Zeleke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadesse Awoke","family":"Ayele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zewditu Abdissa","family":"Denu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Mwanri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Telake","family":"Azale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"pone.0352678.ref001","unstructured":"World Health Organization. HIV statistics, globally and by WHO region; 2025."},{"issue":"3","key":"pone.0352678.ref002","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1037\/a0025957","article-title":"Mental health literacy: empowering the community to take action for better mental health","volume":"67","author":"AF Jorm","year":"2012","journal-title":"Am Psychol"},{"key":"pone.0352678.ref003","author":"UNAIDS","year":"2020"},{"key":"pone.0352678.ref004","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1186\/1756-0500-6-271","article-title":"The relationship between sexual violence and human immunodeficiency virus (HIV) infection among women using voluntary counseling and testing services in South Wollo Zone, Ethiopia","volume":"6","author":"F Hassen","year":"2013","journal-title":"BMC Res Notes"},{"issue":"2","key":"pone.0352678.ref005","first-page":"155","article-title":"In women\u2019s eyes: key barriers to women\u2019s access to HIV treatment and a rights-based approach to their sustained well-being","volume":"19","author":"L Orza","year":"2017","journal-title":"Health Hum Rights"},{"issue":"1","key":"pone.0352678.ref006","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s44263-024-00122-w","article-title":"Women living with HIV face intersectional stigma from infection, domestic violence, and other marginalized identities: a qualitative study in West Bengal, India","volume":"3","author":"R Mukerji","year":"2025","journal-title":"BMC Glob Public Health"},{"issue":"6","key":"pone.0352678.ref007","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1007\/s10461-021-03535-y","article-title":"Emotional violence is associated with increased HIV risk behavior among south african adolescent girls and young women in the HPTN 068 cohort","volume":"26","author":"AM Leddy","year":"2022","journal-title":"AIDS Behav"},{"issue":"3","key":"pone.0352678.ref008","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2024-017962","article-title":"The association between sexual violence and mental disorders among women victim-survivors in sub-Saharan Africa: a systematic review and meta-analysis","volume":"10","author":"SA Woldie","year":"2025","journal-title":"BMJ Glob Health"},{"key":"pone.0352678.ref009","unstructured":"Nyambura Achieng M. Navigating pregnancy with HIV: challenges and experiences of women in Uganda; 2025."},{"issue":"7","key":"pone.0352678.ref010","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1177\/070674370705200706","article-title":"Depression literacy in Alberta: findings from a general population sample","volume":"52","author":"J Wang","year":"2007","journal-title":"Can J Psychiatry"},{"issue":"1","key":"pone.0352678.ref011","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jana.2007.10.002","article-title":"Women\u2019s voices: the lived experience of pregnancy and motherhood after diagnosis with HIV","volume":"19","author":"LB Sanders","year":"2008","journal-title":"J Assoc Nurses AIDS Care"},{"key":"pone.0352678.ref012","unstructured":"Marni M, Nurtanti S, Handayani S, Ratnasari NY, Susanto T. The lived experience of women with HIV\/AIDS: a qualitative study. 2018."},{"issue":"8","key":"pone.0352678.ref013","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1016\/j.socscimed.2004.08.041","article-title":"\u201cMy fear is to fall in love again\u2026\u201d how HIV-positive African women survive in London","volume":"60","author":"L Doyal","year":"2005","journal-title":"Soc Sci Med"},{"key":"pone.0352678.ref014","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1186\/s12889-015-2197-0","article-title":"Stigma, HIV and health: a qualitative synthesis","volume":"15","author":"LA Chambers","year":"2015","journal-title":"BMC Public Health"},{"issue":"1","key":"pone.0352678.ref015","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1146\/annurev.soc.27.1.363","article-title":"Conceptualizing stigma","volume":"27","author":"BG Link","year":"2001","journal-title":"Annu Rev Sociol"},{"issue":"2","key":"pone.0352678.ref016","doi-asserted-by":"crossref","first-page":"639","DOI":"10.3390\/ijerph17020639","article-title":"Experiences and attitudes of people with HIV\/AIDS: a systematic review of qualitative studies","volume":"17","author":"T Arias-Colmenero","year":"2020","journal-title":"Int J Environ Res Public Health"},{"issue":"10","key":"pone.0352678.ref017","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0309231","article-title":"HIV-related perceived stigma and internalized stigma among people living with HIV\/AIDS in Africa: a systematic review and meta-analysis","volume":"19","author":"G Tadesse","year":"2024","journal-title":"PLoS One"},{"key":"pone.0352678.ref018","doi-asserted-by":"crossref","first-page":"45","DOI":"10.2147\/HIV.S447551","article-title":"Experiences of stigmatization and discrimination in accessing health care services among people living with HIV (PLHIV) in Akwa Ibom State, Nigeria","author":"P Adekoya","year":"2024","journal-title":"HIV\/AIDS-Res Palliative Care"},{"key":"pone.0352678.ref019","author":"K Morrison","year":"2006"},{"issue":"4","key":"pone.0352678.ref020","doi-asserted-by":"crossref","DOI":"10.21767\/2049-5471.100022","article-title":"The lived experience of living with HIV\/AIDS in the western region of Saudi Arabia","volume":"11","author":"T Omer","year":"2014","journal-title":"Divers Equal Health Care"},{"key":"pone.0352678.ref021","first-page":"272","article-title":"Life experiences of women (housewives) diagnosed HIV\u2013AIDS in Serang","author":"E Ernawati","year":"2019","journal-title":"KnE Life Sciences"},{"issue":"3","key":"pone.0352678.ref022","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1177\/0972063416666347","article-title":"Women living with HIV\/AIDS: psychosocial challenges in the Indian context","volume":"19","author":"A Malik","year":"2017","journal-title":"J Health 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Burgess","year":"2014","journal-title":"Transcult Psychiatry"},{"key":"pone.0352678.ref026","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/1472-6963-11-7","article-title":"Conceptual models for mental distress among HIV-infected and uninfected individuals: a contribution to clinical practice and research in primary-health-care centers in Zambia","volume":"11","author":"PJ Chipimo","year":"2011","journal-title":"BMC Health Serv Res"},{"issue":"11","key":"pone.0352678.ref027","doi-asserted-by":"crossref","first-page":"6879","DOI":"10.3390\/ijerph19116879","article-title":"Mental health challenges and the associated factors in women living with HIV who have children living with HIV in Indonesia: a qualitative study","volume":"19","author":"NK Fauk","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pone.0352678.ref028","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s13033-025-00665-x","article-title":"Coping strategies for 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Assessment"},{"issue":"2","key":"pone.0352678.ref031","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1037\/0022-3514.56.2.267","article-title":"Assessing coping strategies: a theoretically based approach","volume":"56","author":"CS Carver","year":"1989","journal-title":"J Pers Soc Psychol"},{"key":"pone.0352678.ref032","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1080\/03630240902915036","article-title":"Spiritual well-being, depressive symptoms, and immune status among women living with HIV\/AIDS","volume":"49","author":"SG Dalmida","year":"2009","journal-title":"Women Health"},{"key":"pone.0352678.ref033","doi-asserted-by":"crossref","unstructured":"Yousuf A, Musa R, Isa MLM, Arifin SRM. Dual burden: the experience of depression among women living with HIV in Ethiopia-a qualitative study. 2020.","DOI":"10.21203\/rs.3.rs-42196\/v1"},{"key":"pone.0352678.ref034","volume-title":"Research design: qualitative, quantitative, and mixed methods approaches","author":"JW Creswell","year":"2017"},{"issue":"6","key":"pone.0352678.ref035","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"A Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"issue":"9","key":"pone.0352678.ref036","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"K Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"issue":"4","key":"pone.0352678.ref037","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1007\/s11135-017-0574-8","article-title":"Saturation in qualitative research: exploring its conceptualization and operationalization","volume":"52","author":"B Saunders","year":"2018","journal-title":"Qual Quant"},{"key":"pone.0352678.ref038","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1007\/s10488-013-0528-y","article-title":"Purposeful sampling for qualitative data collection and analysis in mixed method implementation research","volume":"42","author":"LA Palinkas","year":"2015","journal-title":"Admin Policy Mental Health Mental Health Services Res"},{"key":"pone.0352678.ref039","unstructured":"\u201cErciyes E. Three pillars of phenomenology: Husserl, Heidegger and Merleau-Ponty. In: Memphis, USA, 2015. Available from: https:\/\/www.memphis.edu\/philosophy\/opo2019\/pdfs\/erciyes-erdem.pdf"},{"issue":"05","key":"pone.0352678.ref040","doi-asserted-by":"crossref","DOI":"10.4172\/2167-1168.1000119","article-title":"Understanding the differences between Husserl\u2019s (descriptive) and Heidegger\u2019s (Interpretive) phenomenological research","volume":"01","author":"G M Reiners","year":"2012","journal-title":"J Nurs Care"},{"issue":"5","key":"pone.0352678.ref041","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1177\/1049732304263638","article-title":"Descriptive versus interpretive phenomenology: their contributions to nursing knowledge","volume":"14","author":"KA Lopez","year":"2004","journal-title":"Qual Health Res"},{"issue":"04","key":"pone.0352678.ref042","doi-asserted-by":"crossref","DOI":"10.4172\/2472-1654.100093","article-title":"A critical overview of interpretative phenomenological analysis: a contemporary qualitative research approach","volume":"02","author":"I Tuffour","year":"2017","journal-title":"J Healthc Commun"},{"key":"pone.0352678.ref043","volume-title":"Interpretative phenomenological analysis: theory, method and research","author":"JA Smith","year":"2021"},{"key":"pone.0352678.ref044","first-page":"173","article-title":"Qualitative data analysis for applied policy research","volume-title":"Analyzing qualitative data","author":"J Ritchie"},{"issue":"2","key":"pone.0352678.ref045","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"V Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"pone.0352678.ref046","volume-title":"Educational research: planning, conducting, and evaluating quantitative and qualitative research","author":"JW Creswell","year":"2015"},{"issue":"114","key":"pone.0352678.ref047","doi-asserted-by":"crossref","DOI":"10.1002\/ev.223","article-title":"Judging interpretations: but is it rigorous? Trustworthiness and authenticity in naturalistic evaluation","volume":"2007","author":"TA Schwandt","year":"2007","journal-title":"New Dir Eval"},{"key":"pone.0352678.ref048","volume-title":"Qualitative research and case study applications in education","author":"SB Merriam","year":"1998"},{"key":"pone.0352678.ref049","volume-title":"Qualitative evaluation and research methods","author":"MQ Patton","year":"1990"},{"issue":"3","key":"pone.0352678.ref050","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1207\/s15430421tip3903_2","article-title":"Determining validity in qualitative inquiry","volume":"39","author":"JW Creswell","year":"2000","journal-title":"Theory Into Practice"},{"issue":"2","key":"pone.0352678.ref051","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3233\/EFI-2004-22201","article-title":"Strategies for ensuring trustworthiness in qualitative research projects","volume":"22","author":"AK Shenton","year":"2004","journal-title":"Educ 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