The lived experiences of pregnant women on antiretroviral treatment (Free State Province, South Africa)
Machere, Mosilo Mina
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The universal access of antiretroviral treatment (ART) in South Africa has bent the trajectory of the HIV epidemic. The lifelong HIV treatment has moved the disease from a terminal to a chronic and manageable disease. The redefinition has brought hope and normality to many people living with HIV. For HIV-positive women, the prevention of mother-to-child transmission (PMTCT) prophylaxis has influenced their intentions to bear children along with issues related to their reproductive options and prospects. Studies on the influence of HIV on pregnancy have largely been about the baby with limited focus on the lived experiences and perceptions of the expecting mothers. Conceptualising the lived realities of HIV-positive women during pregnancy and motherhood in the context of ART requires a deeper understanding of their experiences. Guided by both descriptive and interpretive lenses of phenomenology, this research approach allowed a more in-depth look into this phenomenon, thereby capturing the complexity of issues women faced from their points of view. The study aimed to explore the experience of pregnancy from the perspective of HIV-positive women who are on ART. It sought to discover the meanings embedded in their everyday lives. This included, among other things, appreciating what these women regarded as noteworthy in relation to their experiences and learning about the impact that the diagnosis of HIV, and its lifelong treatment had on their lives, both as patients and as care-givers. The objective of the study was thus to understand the experiences of HIV-positive women who were on ART, both their own embodied experiences as well as their experiences in relation to others; how they perceive the chronic character of HIV; and moreover to explore how they made sense of their experiences of pregnancy and motherhood. Eight Sesotho speaking participants from the Free State province, South Africa, were recruited. A purposive sampling method was used as only women who were pregnant and on ART were interviewed. The narratives of the lived realities were elicited through in-depth interviews. The face-to-face interviews were digitally recorded and guided by an interview schedule to allow flexibility and engage participants in dialogue while they were narrating their experiences. The data was analysed in the context of HIV diagnosis, pregnancy and ART. This was to elicit what it meant for women to contemplate pregnancy in a context of ubiquitous HIV and new hope in the form of ART; both available for them and their babies. The systematic analysis provided a greater understanding of factors influencing the taken-for-granted experiences of HIV-positive women on ART during pregnancy and motherhood. The content analysis of qualitative data revealed two broad themes related to lived realities of pregnancy on the one hand, and motherhood on the other in the context of ART. Narrating their experiences during pregnancy, sub-themes that emerged were more inclined to point towards the protection of the unborn baby and developing coping mechanisms; while during motherhood there was a shift from the babies‟ to the mothers‟ well-being and their life prospects. Considering the duration of being on ART and the number of pregnancies they have had, the narratives provided a platform to track how experiences such as baby feeding practices, and coping with stigma and disclosure have ameliorated over time. This indicates how the landscape in which HIV-positive women experience pregnancy and motherhood has changed rather dramatically. The zeal for life displayed by these women bears testimony that HIV diagnosis no longer means that the prospect of death is the sole outlook on their lives and on the lives of their children.