Tags

Type your tag names separated by a space and hit enter

Understanding coping strategies during pregnancy and the postpartum period: a qualitative study of women living with HIV in rural Uganda.
BMC Pregnancy Childbirth. 2017 May 08; 17(1):138.BP

Abstract

BACKGROUND

In sub-Saharan Africa, 58% of adults living with HIV are women. In Uganda, HIV prevalence is 8.3% for women compared to 6.1% for men. Access to antiretroviral therapy (ART) and prevention of mother to child transmission (PMTCT) programs have enabled women living with HIV (WLWH) to have children with minimal risk of perinatal transmission. Nevertheless, pregnant WLWH face many challenges. We explored women's perceptions of how they cope with the challenges of pregnancy and the postpartum period as HIV-infected women.

METHODS

We conducted semi-structured interviews with postpartum WLWH accessing ART who had a pregnancy within 2 years prior to recruitment between February-August, 2014. Childbearing associated stressors and coping strategies were discussed. We used content analysis to identify major themes and NVivo 10 software facilitated data analysis.

RESULTS

Twenty women were interviewed with median age 33 (IQR: 28-35) years, CD4 cell count 677 cells/mm3 (IQR: 440-767), number of live births 4 (IQR: 2-6), and number of living children 3 (IQR: 2-4.3). We summarize five identified coping strategies within a socio-ecological framework according to Bronfenbrenner's Ecological Model. Coping strategies on the individual level included acceptance of self and HIV status, and self-reliance. On the interpersonal level, participants reported coping through support from partners, family, and friends. On the organizational level, participants reported coping through HIV-related healthcare delivery and system supports. At the community level, women reported coping through support from church and spirituality.

CONCLUSIONS

The results highlight coping strategies used by WLWH to manage the myriad challenges faced during pregnancy and the postpartum period. Intervention programs for WLWH must emphasize psychosocial care and incorporate strategies that address psychosocial challenges in the HIV care package in order to optimize well-being. Additionally policies that support networks of WLWH should be put in place and funding support should be provided through existing funding mechanisms in order to respond to the needs and challenges of WLWH. Programmes that support WLWH for economic empowerment and improved livelihoods should be strengthened across all regions in the country.

Authors+Show Affiliations

Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda. sashaba@must.ac.ug.Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.MGH Global Health, Massachusetts General Hospital, Boston, MA, USA.MGH Global Health, Massachusetts General Hospital, Boston, MA, USA.Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA.Research Institute McGill University Health Centre Montreal, Montreal, Canada.Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA.MGH Global Health, Massachusetts General Hospital, Boston, MA, USA. Harvard Medical School, Boston, MA, USA.MGH Global Health, Massachusetts General Hospital, Boston, MA, USA. Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28482821

Citation

Ashaba, Scholastic, et al. "Understanding Coping Strategies During Pregnancy and the Postpartum Period: a Qualitative Study of Women Living With HIV in Rural Uganda." BMC Pregnancy and Childbirth, vol. 17, no. 1, 2017, p. 138.
Ashaba S, Kaida A, Burns BF, et al. Understanding coping strategies during pregnancy and the postpartum period: a qualitative study of women living with HIV in rural Uganda. BMC Pregnancy Childbirth. 2017;17(1):138.
Ashaba, S., Kaida, A., Burns, B. F., O'Neil, K., Dunkley, E., Psaros, C., Kastner, J., Tsai, A. C., Bangsberg, D. R., & Matthews, L. T. (2017). Understanding coping strategies during pregnancy and the postpartum period: a qualitative study of women living with HIV in rural Uganda. BMC Pregnancy and Childbirth, 17(1), 138. https://doi.org/10.1186/s12884-017-1321-9
Ashaba S, et al. Understanding Coping Strategies During Pregnancy and the Postpartum Period: a Qualitative Study of Women Living With HIV in Rural Uganda. BMC Pregnancy Childbirth. 2017 May 8;17(1):138. PubMed PMID: 28482821.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Understanding coping strategies during pregnancy and the postpartum period: a qualitative study of women living with HIV in rural Uganda. AU - Ashaba,Scholastic, AU - Kaida,Angela, AU - Burns,Bridget Frances, AU - O'Neil,Kasey, AU - Dunkley,Emma, AU - Psaros,Christina, AU - Kastner,Jasmine, AU - Tsai,Alexander C, AU - Bangsberg,David R, AU - Matthews,Lynn T, Y1 - 2017/05/08/ PY - 2016/05/03/received PY - 2017/05/03/accepted PY - 2017/5/10/entrez PY - 2017/5/10/pubmed PY - 2018/3/20/medline KW - Coping strategies KW - HIV KW - Postpartum KW - Pregnancy KW - Rural Uganda KW - Women SP - 138 EP - 138 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 17 IS - 1 N2 - BACKGROUND: In sub-Saharan Africa, 58% of adults living with HIV are women. In Uganda, HIV prevalence is 8.3% for women compared to 6.1% for men. Access to antiretroviral therapy (ART) and prevention of mother to child transmission (PMTCT) programs have enabled women living with HIV (WLWH) to have children with minimal risk of perinatal transmission. Nevertheless, pregnant WLWH face many challenges. We explored women's perceptions of how they cope with the challenges of pregnancy and the postpartum period as HIV-infected women. METHODS: We conducted semi-structured interviews with postpartum WLWH accessing ART who had a pregnancy within 2 years prior to recruitment between February-August, 2014. Childbearing associated stressors and coping strategies were discussed. We used content analysis to identify major themes and NVivo 10 software facilitated data analysis. RESULTS: Twenty women were interviewed with median age 33 (IQR: 28-35) years, CD4 cell count 677 cells/mm3 (IQR: 440-767), number of live births 4 (IQR: 2-6), and number of living children 3 (IQR: 2-4.3). We summarize five identified coping strategies within a socio-ecological framework according to Bronfenbrenner's Ecological Model. Coping strategies on the individual level included acceptance of self and HIV status, and self-reliance. On the interpersonal level, participants reported coping through support from partners, family, and friends. On the organizational level, participants reported coping through HIV-related healthcare delivery and system supports. At the community level, women reported coping through support from church and spirituality. CONCLUSIONS: The results highlight coping strategies used by WLWH to manage the myriad challenges faced during pregnancy and the postpartum period. Intervention programs for WLWH must emphasize psychosocial care and incorporate strategies that address psychosocial challenges in the HIV care package in order to optimize well-being. Additionally policies that support networks of WLWH should be put in place and funding support should be provided through existing funding mechanisms in order to respond to the needs and challenges of WLWH. Programmes that support WLWH for economic empowerment and improved livelihoods should be strengthened across all regions in the country. SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/28482821/Understanding_coping_strategies_during_pregnancy_and_the_postpartum_period:_a_qualitative_study_of_women_living_with_HIV_in_rural_Uganda_ L2 - https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1321-9 DB - PRIME DP - Unbound Medicine ER -