Marseille 2007
Marseille 2007
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Abstract #469  -  Biographical analysis of HIV positive mothers in South India - An anthropological approach for HIV and breast-feeding
Session:
  17.6: Challenges for Children (Parallel) on Monday @ 14.00-16.00 in Auditorium/Overflow Chaired by Patrice Engle, Christina Noestlinger
Authors:
  Presenting Author:   Dr Cohen Patrice - University of Rouen, France
 
  Additional Authors:  Dr Geetha K, Mrs Sethulakshmi K, Mr Krishnan AK, Mrs Sharma Jabin,  
Aim:
Very few researches in social sciences have been made on the specific situations of the HIV mothers living in India. So a socio-anthropological research on HIV and breastfeeding - funded by Sidaction, France - had been launched in 2004 through an Indo-French partnership approved by the Health Ministry Screening Committee, Government of India between GRIS (Rouen, France), IFP (Pondicherry, India) and YRG CARE (Chennai,India). This paper intends to present some results of this project based on the biographical dimensions of the HIV positive mothers living in Tamil Nadu facing risks of transmitting HIV to their babies.
 
Method / Issue:
Analysis of qualitative interviews (in tamil, their maternal language) conducted with HIV positive mothers (around 25) in Chennai (Tamil Nadu), during 2005. These women talked about their own experiences facing their positive status, their opportunistic infections, their maternal choices and functions. The narrative form of the interviews had been re-organised to a biographical approach linking personal, family, social and medical events and representations to HIV and breastfeeding issues. A contextual approach have completed these data: (1) women and HIV positive women status in Indian society, (2) HIV PMTCT setting in India and in Tamil Nadu, (3) the impact of the HIV/AIDS epidemic in the Indian society.
 
Results / Comments:
In India the social and familial pressure leads women to have at least one child right after marriage. Results show that the social image of a good spouse or a good mother is interfering with the risk of HIV transmission to the baby for these HIV positive mothers. Confrontation between matrimonial or maternal representations and duties and the risk of transmission is moved by a number of factors. (1) her perception of the consequences of the positive status announce on her familial and maternal current status and duties, (2) her perception and understanding of the natural history of her disease (mostly based on the different symptoms, and - for medical culture positive mothers - on CD4 numbers) and on the risk of transmission to babies, (3) the reaction of her familial surrounding (husband, mother, father, parents in-laws, etc.) after announce, and (4) the relationships with medical sector (counselling, information, care during pregnancy, delivery, stays in hospitals, etc.). According to the risk of the HIV transmission to baby, these women are formulating different responses: desire of abortion, confidence in medical professional for safety delivery, application of counselling messages (when they exist) for breast-feeding. But the real behaviours are the fruit of the confrontation of her biographical dynamics, her familial reactions, her sicker career, and the interactions with medical sector. Attitudes to breastfeeding for these positive mothers are here not only analysed as behaviour but also as a social, familial and personal construction. Some case studies will be proposed to illustrate this biographical analysis.
 
Discussion:
This research brings illustration to the impact of the current India policy for preventing MTCT towards the real situation of the Indian positive women. Results lead to a de-construction of medical-centred approaches.
 
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