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

Abstract

Objective: The success of antiretroviral therapy has resulted in the normalization of pregnancy among women living with HIV and a very low risk of perinatal transmission of HIV. Despite these advances, women living with HIV still face complex medical and psychosocial issues during pregnancy. The purpose of this study is to describe experiences of pregnancy and the relevance of social support among women living with HIV in Nordic countries. Methods: This qualitative study examined data from pregnant women living with HIV from sites in Denmark, Sweden and Finland from 2019 to 2020. Data were collected in the third trimester via individual interviews using a hybrid, narrative/semistructured format. The transcribed interviews were analyzed using narrative thematic analysis. Results: In total, 31 women living with HIV were enrolled, of whom 61% originated from an African country and 29% from a Nordic country. The analysis generated four primary narrative themes: just a normal pregnancy, unique considerations and concerns, interactions with healthcare, and social support. Women living with HIV have a strong desire to have normal pregnancies and to be treated like any other pregnant woman. However, this normality is fragile, and being pregnant and living with HIV does come with unique considerations and concerns, such as fear of transmission, antiretroviral therapy, and the need for specialized care, which are fundamental to the women’s experiences. Interactions with healthcare providers and social support influence their experiences in both positive and negative ways. Conclusion: The findings emphasize a sense of normality in pregnancy among women living with HIV. However, pregnancy does come with unique considerations and concerns, which highly influence the women’s experience of pregnancy. Healthcare providers should focus on person-centered care, ensuring continuity and that women living with HIV do not feel discriminated against throughout their pregnancy.

The Perspectives of Nurses and HIV-Positive Women on a Selected Model of Pregnancy Decision-Making Processes in Northeast Thailand

“…This study on Thai women living with HIV highlights the way that they still desire to have a childwhich is also seen elsewhere in the previous literature (Hernando et al, 2014;Huntington et al, 2013: Moseholm et al, 2022. However, the severity of stigmatization in Thai society is still widespread at the family and community level, including among health service staff, as stated in other contexts and studies (Cuca et al, 2012;Kavanaugh et al, 2013;Kownaklai, 2022;Nattabi et al, 2012).…”

“…Similarly, Hardon et al (2012) found that most pregnant women living with HIV (85%) in Africa felt that health providers and counselors respected their desire for confidentiality by protecting their HIV results. Moreover, Moseholm et al (2022) indicated that HIV-positive women's interactions with healthcare providers and community influence their experiences in both positive and negative ways.…”

“…Many studies also suggest that the social-cultural context within which women living with HIV of reproductive age live and how that affects pregnancy decisions should be better understood and treated by health professionals who hope to improve their quality of life and reproductive choices (Firth et al, 2012: Kownaklai et al, 2022Liamputtong & Haritavorn, 2014b: Moseholm et al, 2022Nattabi et.al., 2012).…”

Perception and Emotional Experiences of Infant Feeding Among Women Living With HIV in a High-Income Setting: A Longitudinal Mixed Methods Study

“…The 2BMOM study included a quantitative survey 27 and a qualitative interview study. 28 Here, we present the integrated results of the quantitative and qualitative data focusing on infant feeding (Fig. 1).…”

Unplanned pregnancies and social and partner support during pregnancy in Spanish women living with HIV

“…Although vertical transmission of HIV [10][11][12][13][14] and pregnancy outcomes associated with antiretroviral therapy (ART) [15][16][17][18][19] have been widely studied around the world, current pregnancy intentions of WLWH are poorly understood, evidenced by high rates of unintended pregnancy [20][21][22]. The few studies with descriptive information of psychosocial outcomes across the pregnancy that have been published in Europe have been restricted to Nordic countries [7,23,24], the UK [4] and Ukraine [25] and there is a lack of information in the southern area. In Spain, in particular, no studies have assessed psychological or social issues regarding pregnancy among WLWH, with the exception of two studies that explored the desire to get pregnant in the CoRIS cohort [3,5].…”