Amsterdam 2015
Amsterdam 2015
Abstract book - Abstract - 2161
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Abstract #2161  -  Challenging situations
Session:
  53.5: Challenging situations (Parallel) on Friday @ 11.00-12.30 in C002 Chaired by Heidi van Rooyen,
Rich Wolitski

Authors:
  Presenting Author:   Dr Michael Evangeli - Royal Holloway University of London, United Kingdom
 
  Additional Authors:   
Aim:
Women with perinatally acquired HIV (PAH) are surviving into adulthood, with many becoming mothers. Little is known about the experience of having a child in the context of PAH. This study used a qualitative approach to explore (a) links between the experience of growing up with a parent with HIV and now becoming a parent, (b) the relationship between mothers’ ability to bond with their children and their own HIV status, (c) the influence of the pregnancy and birth on the relationship between women with PAH and their own mothers.
 
Method / Issue:
Women were approached to take part in the study if they had PAH, were over 18 at the time that they gave birth and their youngest child was under the age of five. Face to face in depth semi-structured interviews were conducted. The data was analysed using Grounded Theory methods.
 
Results / Comments:
Seven women (median age 25.6 years, range 21-29) with a total of 11 children (6 girls, 5 boys, youngest child aged between 8 weeks and 4 years) were recruited from three London sites (two NHS clinics and one charity). Six were of sub-Saharan African origin and 5 were born abroad. Nine out of 11 pregnancies were reported to be unplanned. All of the children had been bottle-fed and 10 of the 11 children were confirmed to be HIV-negative with 2 or more negative HIV plasma RNA after 6 weeks of age and/or loss of maternal antibody for those aged greater than 18 months. All except one child had been born by caesarian section. Three theoretical codes were derived: 1. Conceiving, conception and pregnancy. Women wanted a baby but were worried about the possibility of being abandoned by their partner and the reaction of others. They felt a duty to protect the baby during pregnancy and wanted a different childhood for their child than they themselves had experienced. 2. Birth bonding and breastfeeding. Women struggled with accepting their child being born by caesarian section and bottle-fed, feeling that they had ‘failed’. They feared for their child’s health but found that bonding with their baby helped to look after their own health. Becoming a mother positively affected relationships with their own mothers or triggered memories of mothers who had died (n=5). 3. Establishing motherhood and future related thoughts. The experience of motherhood was enhanced given previous expectations that this would not be possible. There was a wish to learn from the experience of having a mother who had lived with HIV.
 
Discussion:
Women with PAH’s experience of becoming a mother was characterized by powerful feelings of bonding with their children, warmth towards their mother and personal growth. Many women wanted to use their own experiences of growing up with HIV and being parented by an HIV-positive mother in a positive way to benefit their child. Feelings of anxiety and failure were also common, however, and affected the antenatal and perinatal periods in particular. These findings may help healthcare professionals in discussing pregnancy and motherhood with women with PAH.
 
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