The experiences and meaning for UK-based African women after being diagnosed with HIV during their pregnancy

Section A provides a conceptual critical review of the literature pertinent to the consideration of Mothers living with HIV/AIDS (MLWHA), with a particular focus on African mothers. This review first highlights relevant contextual factors, including discussing prevalence rates and the current reconceptualisations of HIV. This is followed by theories and research relevant to MLWHA, whilst considering wider contextual, social and cultural factors. Thirdly, the theoretical links of the reviewed literature to coping models and strategies are made, and specific cultural factors considered. Finally, suggestions for future research are highlighted.
Section B provides the findings of a qualitative investigation conducted to explore the experience of African women living in the UK after being diagnosed with HIV during their pregnancy. Twelve participants completed a short demographic questionnaire, and participated in a one-to-one semi-structured interview. The interview was designed to address multiple personal, interpersonal, and systemic issues related to their HIV status, and HIV in the context of motherhood. Data were analysed using interpretative phenomenological analysis (IPA). Themes which emerged included: HIV being part of one’s wider tapestry, community and systemic influences and responses to HIV, experiencing a different story of HIV, and the mother-child relationship. Strikingly, the aspect of HIV that these women reported finding most distressing was their inability to breastfeed, which seemed central to their cultural identity as mothers. While the generalisability of these findings is clearly limited, nevertheless it seems important for clinicians to (i) recognise that HIV may not always be the primary difficulty facing their clients, and may be amongst numerous other factors, (ii) consider systemic and contextual factors, including cultural influences and past trauma, (iii) focus on client resources and capacity for resilience, and (iv) support clients to access local resources, including support groups, (v) attend to issues around confidentiality, disclosure decisions and breastfeeding, and (vi) hold in mind the potentially powerful and helpful affect for these women of witnessing different narratives around HIV. The continuing need to counteract stigma and discrimination, including from health professionals and from the media, was also apparent.
Section C provides a critical appraisal and reflection on the research process, including, evaluating what research skills were learned, which research skills the researcher wishes to develop in the future, what would the researcher have done differently given the chance, how will the research shape or inform the researcher’s clinical practice, and what future research related to the studied area would the researcher consider carrying out.