“If He’s Abusing You . . . the Baby Is Going to Be Affected”: HIV-Positive Pregnant Women’s Experiences of Intimate Partner Violence

Marais, Adéle; Kuo, Caroline; Julies, Robin; Stein, Dan J.; Joska, John A.; Zlotnick, Caron

doi:10.1177/1077801218802640

Cited by 7 publications

(7 citation statements)

References 57 publications

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“…For example, the mothers in this study experienced feelings of failure, guilt, and inadequacy in not being able to protect their children. This is consistent with previous South African research that has found that experiences of IPV can undermine a woman’s confidence in her ability to adequately care for and protect her children from harm [ 35 ]. The societal notions of the ‘good mother’ which were founded upon idealized versions of motherhood may especially create additional tension for women who mother within the context of IPV [ 27 ].…”

Section: Discussionsupporting

confidence: 91%

‘I’m not the mother I wanted to be’: Understanding the increased responsibility, decreased control, and double level of intentionality, experienced by abused mothers

Dekel

Abrahams

2023

PLoS ONE

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A paucity of research has been conducted within South Africa on abused women’s experiences of motherhood, even though abused women tend to be at increased risk of negative physical and mental health difficulties, which can interfere with their ability to take care of themselves and their children. The aim of this qualitative study was to explore women’s experiences of mothering in the context of an abusive relationship. Data was collected via individual, telephonic, semi-structured, in-depth interviews with 16 mothers from three South African provinces, and analyzed according to the principles of grounded theory. Our findings highlight the mothers’ experiences of: a simultaneous increased sense of responsibility with regards to their children and a loss of control over their mothering; as well as experiencing abuse aimed at either the mother or the child, which is simultaneously meant to affect the other; and lastly, mothers’ assessing themselves negatively through normative paradigms of ‘good mothering’, regardless that they often mother in the best way they know how to, given challenging circumstances. Therefore, this study highlights that the motherhood institution continues to create ‘good mothering’ benchmarks against which women themselves evaluate their mothering, often leading to feelings of inadequacy. Our findings also emphasize that the environment created by men’s abuse is in conflict with the great expectations placed upon mothers in abusive relationships. Thus, mothers may experience huge pressure, which may lead to feelings of failure, self-blame, and guilt. This study has demonstrated that the abuse mothers’ encounter adversely impacted on their mothering. We therefore emphasize the need to better understand how mothering is influenced by and responsive to violence. This is important as understanding abused women’s experiences can assist us to further develop appropriate support mechanisms needed to ensure minimal impact on both women and their children.

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Section: Discussionsupporting

confidence: 91%

‘I’m not the mother I wanted to be’: Understanding the increased responsibility, decreased control, and double level of intentionality, experienced by abused mothers

Dekel

Abrahams

2023

PLoS ONE

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“…In one qualitative study, Marais et al (2019) interviewed 12 HIV-positive pregnant women asking questions about their experiences of IPV during their current pregnancy and the impact of the violence on their mental, physical, and sexual health. The respondents described a wide range of experiences including physical, emotional, and sexual abuse.…”

Section: Resultsmentioning

confidence: 99%

“…The six qualitative studies were conducted in South Africa (Marais et al, 2019), Kenya (Colombini et al, 2016; Onu et al, 2017), Swaziland (Colombini et al, 2016; Mulrenan et al, 2015), Malawi (Chilemba et al, 2014), and Uganda (Emusu et al, 2009). Participants were mostly HIV-positive women aged 18 and older sampled from various health-care centers.…”

Section: Resultsmentioning

confidence: 99%

Intimate Partner Violence (IPV) Against HIV-Positive Women in Sub-Saharan Africa: A Mixed-Method Systematic Review and Meta-Analysis

Tenkorang

Asamoah-Boaheng

Owusu

2020

Trauma, Violence, & Abuse

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Objectives: To systematically analyze and summarize the literature on intimate partner violence (IPV) against HIV-positive women in sub-Saharan Africa (SSA) and to identify their risk factors for IPV. Method: A comprehensive review of the literature using the Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) and Meta-Analyses of Observational Studies in Epidemiology (MOOSE) yielded 1,879 articles (PubMed = 1,251, Embase = 491, Web of Science = 132, and identified additional records = 5). Twenty were selected for quantitative and qualitative assessment and synthesis. We employed a random effects model with generic inverse variance method and estimated the odds ratios. Findings: Results indicated a high prevalence of physical, sexual, and emotional violence against women living with HIV/AIDS in SSA. Educational background, alcohol use, marital status, previous experiences with IPV, and employment status were identified as significant risk factors. We also assessed the methodological quality of the articles by examining publication bias and some heterogeneity statistics. Conclusion: There is limited research on IPV against HIV-positive women in SSA. However, the few existing studies agree on the importance of targeting HIV-positive women with specific interventions given their vulnerability to IPV and to address factors exacerbating these risks and vulnerabilities.

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“…Even if IPV or HIV are not disclosed, internalised stigma can still impact a person’s ability to seek help, therefore jeopardising opportunities for diagnosis and management [ 38 , 39 ], or worsening their mental health [ 38 , 65 , 66 ]. The presence of both HIV and IPV stigma in this review have been described to leave expectant and current mothers feeling isolated [ 67 , 68 ], creating a barrier to both HIV-related and pregnancy-related care [ 68 ]. A crucial step in IPV management, after these services have been made available, is recognising the need for them.…”

Section: Discussionmentioning

confidence: 99%

“…This is corroborated by previous qualitative research [ 40 ]. IPV and fear of IPV can result in women not feeling confident enough to request condom use [ 57 ], placing them at increased risk of HIV and other STIs [ 40 , 68 , 70 ]. Furthermore, Hampanda [ 50 ] demonstrates how IPV can reduce PMTCT medication adherence.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the effects of intimate partner violence on HIV-positive pregnant women in sub-Saharan Africa

2022

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Background Intimate partner violence (IPV) affects more than one in three women in sub-Saharan Africa (SSA). It is associated with both pregnancy and HIV, adversely affecting women in this region. This is the first systematic examination of the effects of IPV on HIV-positive (HIV+) pregnant women in SSA. Methods A systematic review of the literature on HIV+ pregnant women experiencing IPV in SSA was carried out. Searches were carried out in PubMed, Web of Science and African Journals Online databases. Articles published between January 2010 and June 2020, in English, were included. Data extraction included details on study locations, study design, study participants and the study outcome variables (depression, IPV, medication adherence, postpartum unsafe sex, and HIV disclosure). Results Fourteen studies (ten cross-sectional studies, four cohort studies) were included. Results indicate a high prevalence of IPV amongst pregnant women with HIV in SSA (18.0 to 63.1%). The results suggest an association between HIV-positive status and consequences of IPV during pregnancy, particularly mental health effects, such as depression symptoms and suicidal ideation. HIV-related stigma has a key role within the relationship between HIV and IPV during pregnancy. One study described that the presence of IPV reduces adherence to Prevention of Mother-To-Child Transmission (PMTCT) medication. Three studies reported no association between HIV positive status or HIV status disclosure and IPV during pregnancy. Discussion/conclusions The systematic review confirms interconnections between IPV and HIV seropositivity amongst pregnant women in SSA. Importantly, stigma, social isolation and poor mental health hinder help-seeking, disclosure, and treatment adherence among HIV+ pregnant women exposed to IPV in SSA. As a result, the potential of community interventions to tackle issues associated with IPV in HIV-positive pregnant women in this area should be explored in research, policy, and practice.

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“If He’s Abusing You . . . the Baby Is Going to Be Affected”: HIV-Positive Pregnant Women’s Experiences of Intimate Partner Violence

Cited by 7 publications

References 57 publications

‘I’m not the mother I wanted to be’: Understanding the increased responsibility, decreased control, and double level of intentionality, experienced by abused mothers

‘I’m not the mother I wanted to be’: Understanding the increased responsibility, decreased control, and double level of intentionality, experienced by abused mothers

Intimate Partner Violence (IPV) Against HIV-Positive Women in Sub-Saharan Africa: A Mixed-Method Systematic Review and Meta-Analysis

A systematic review of the effects of intimate partner violence on HIV-positive pregnant women in sub-Saharan Africa

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