Study protocol: becoming and being a mother living with HIV - a multicentre longitudinal mixed methods study among pregnant women living with HIV, non-pregnant women living with HIV and pregnant women not living with HIV in a high-income setting (the 2B MOM study)

Abstract

IntroductionThe success of combination antiretroviral therapy has decreased the risk of perinatal HIV transmission and normalised pregnancy in women living with HIV (WLWH). Despite these advances, WLWH still face complex medical and psychosocial issues during pregnancy and postpartum, and there is a gap of knowledge on the experiences of becoming and being a mother living with HIV in today’s context. The overall aim of this study is to investigate psychosocial outcomes and experiences of WLWH in Scandinavia during pregnancy and early motherhood.Methods and analysisThis is a multicentre longitudinal convergent mixed methods study consisting of a quantitative survey study, a qualitative interview study and a mixed methods analysis. The survey study aims to examine psychosocial outcomes of WLWH across the pregnancy – postpartum trajectory. Participants are pregnant WLWH living in Scandinavia. Two control groups of HIV-negative pregnant women and non-pregnant WLWH are also included. Data is collected in the third trimester, 3 and 6 months postpartum using standardised questionnaires. Statistical analysis will assess changes over time and identify predictors of adverse outcomes. The interview study seeks to understand experiences of pregnancy and becoming a mother while living with HIV. Pregnant WLWH who are enrolled in the survey study will be asked to participate in individual interviews in the third trimester and 6 months postpartum. Data will be analysed using narrative analysis. The survey and interview results will be merged in a mixed methods analysis to assess confirmation, expansion or discordance between the data sets.Ethics and disseminationApproval from the Danish Data Protection Agency (VD-2018–253), and the Finnish and Swedish Ethics Committees have been obtained (HUS/1330/2019 and Dnr: 2019–04451, respectively). Study results will be disseminated to patient organisations, through publications in peer-reviewed journals and at scientific conferences.

Psychosocial health in pregnancy and postpartum among women living with - and without HIV and non-pregnant women living with HIV living in Nordic countries – Results from a longitudinal survey study

“…Using quantitative data from the 2BMOM study [ 27 ] this study found a high prevalence of probable depression and other psychosocial challenges among WWH compared to WWOH throughout the pregnancy – postpartum trajectory. There were no significant differences in depression scores, perceived stress scores, or social support scores between pregnant WWH and non-pregnant WWH at any time point.…”

“…Quantitative data was collected by self-administered electronic questionnaires, with a sub-sample of pregnant WWH taking part in semi-structured qualitative interviews ( n = 31). Methods are described in detail elsewhere [ 27 ]. All women gave informed consent to participate and the study was approved by the Danish Data Protection Agency (VD-2018-253), and the Finnish and Swedish Ethics Committees (HUS/1330/2019 and Dnr: 2019–04451, respectively).…”

“…Using quantitative data from the 2BMOM Study, a multicentre longitudinal mixed methods study among pregnant WWH, non-pregnant WWH, and pregnant WWOH in the Nordic countries Denmark, Finland, and Sweden [ 27 ], we aim to explore psychosocial health outcomes of WWH across the pregnancy–postpartum trajectory, assess differences in psychosocial health outcomes between pregnant WWH, non-pregnant WWH and pregnant WWOH, and identify factors associated with depression in the third trimester and postpartum for WWH and WWOH.…”

The experience of pregnancy among women living with HIV in Nordic countries: A qualitative narrative enquiry

“…undetectable = not transmittable) has become known to women and more people in the society 47 ; this may have impacted the finding that women felt more supported. A key limitation is that the study only reflects those who were willing to take part in the overall mixed-methods study, 18 raising the possibility that there could be some important differences between those who agreed to take part and those who chose not to do so. Country of residence and country of birth varied between the women, which could have influenced the generalizability of the results.…”

Nursing students’ experiences of service-learning at community and hospital pharmacies in Belize: Pedagogical implications for nursing pharmacology

“…The audio-recorded interviews were first transcribed verbatim and analyzed thematically. The thematic analysis procedure summarized by Moseholm et al [ 25 ] was employed as the general strategy for the focus groups. In order to obtain a sense of the whole, the interview transcripts were read several times.…”