Experience of family members providing care for HIV-exposed children: beginning of the trajectory

Abstract

During and after pregnancy, mothers with HIV can undergo treatment that is capable of preventing vertical transmission (VT) to their babies. The purpose of this study was to analyze the experience of family members that provide care for children whose mothers have HIV, to reduce the risk of VT, with emphasis on the beginning of this trajectory. This study was based on the qualitative approach and Symbolic Interactionism was adopted as a theoretical framework. A total of 36 family members participated in the study, all of whom were carers of children aged up to 18 months and waiting for confirmation of the HIV diagnosis. Data were collected in a hospital in north-eastern Brazil, between December 2012 and February 2013, and examined by means of content analysis. Child care began during pregnancy, when the possibility of the child having HIV was expected. Some had previous experience in providing care for exposed children. Understanding the early trajectory of care will help find ways to provide better support for carers during the trajectory of diagnosis confirmation.

Quality of life of elderly people living with HIV/AIDS in outpatient follow-up

“…According to the practicing religion, the increase in QoL in the "general function" and "satisfaction with life" categories may be related to the role of religion as a source of support and hope in coping with problems (16) . However, the risk of disclosure of the diagnostic condition may reinforce HIV as a sin, increasing responsibility for the acts and guilt for infection (1,15) .Closing the remoteness of many people from religious participation, hindering the relationship with God, by feeling of revolt with the serological condition, because they believe that the disease is a divine punishment (4,17) . For the HIV diagnostic time, it was noticed that the increase in the time of HIV infection would be related to the average increase in QoL, which can be justified by the increased experience of living and living with HIV, once that, although people see HIV/AIDS as a problem, over time the infection is seen as a learning situation (6,18) and may no longer adversely affect affective and sexual relationships.…”

Motherhood and HIV: reproductive desire, ambivalent feelings and a/an (not) offered care

“…Feelings of women living with HIV regarding the possibility of motherhood and in the course of a pregnancy Motivation for reproduction: the desire to be mothers versus the desire postponed or abolished after the diagnosis of HIV infection (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)31) Fears and insecurities regarding the uncertainties regarding the clinical outcomes of effective gestation (13)(14)(15)(19)(20)(22)(23)(24)(25)(26)(27)(28)(29) Effective gestation produces feelings of hope, renewal and greater motivation for self-care (13,15,(19)(20)(24)(25)(26)(27)(29)(30) Care provided and not provided by health professionals to women living with HIV with regard to reproductive health as a right Support for reproductive decisions on safe means to effect the desire for pregnancy in fact or during prenatal care (19,21,23,(32)(33)(34) Disregard for the reproductive demands of women living with HIV (14)(15)(19)(20)(21)(24...…”

“…A qualitative study in the northeast of Brazil with 36 relatives of children exposed to HIV pointed out that imagining themselves with an infected child gives rise to feelings, mainly of guilt for feeling responsible or unable to avoid this outcome. This is because pregnancy brings with it the constant memory of the diagnosis (28) . Some women, in a study in Thailand, stated that if the child had HIV it would be very difficult to deal with life in general (24) .…”

Nursing care for mother-to-child transmission of HIV

“…[9][10][11] For this, it is necessary to improve the attendance of seropositive pregnant women in the consultations, since this population has presented a lower frequency in prenatal consultations in relation to pregnant women without this type of infection, besides there is a high index of pregnant women who do not attend. [10,[13][14][15] It is known that there are great difficulties in accessing health services, especially antiretroviral drugs, laboratory tests and rapid testing during the prenatal period. Thus, the capture of these women is the first and main challenge of nurses in primary care.…”

“…[16][17][18] The puerperal period for the HIV-positive pregnant woman is marked by the feeling of impotence due to not being able to breastfeed her child, being configured in an avid moment by actions of health education, mainly by Nursing. [12][13][14][15][16] The main ways of combating such HIV transmission through breastfeeding are by taking important prevention measures, such as encouraging actions aimed at the early detection of HIV-infected pregnant women and their empowerment as early as possible for the initiation of available interventions, ne should see an improvement in maternal and child care. [11,15] The alternative feeding can take place in the availability of the bank of safe milk and also by the infant milk formula, emphasizing the Pre-nan and Aptamil pre in the substitution of the natural milk.…”