Understanding coping strategies during pregnancy and the postpartum period: A qualitative study of women living with HIV in rural Uganda

Scholastic Ashaba, Angela Kaida, Bridget Frances Burns, Kasey O'Neil, Emma Dunkley, Christina Psaros, Jasmine Kastner, Alexander C. Tsai, David Bangsberg, Lynn T. Matthews

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: In sub-Saharan Africa, 58% of adults living with HIV are women. In Uganda, HIV prevalence is 8.3% for women compared to 6.1% for men. Access to antiretroviral therapy (ART) and prevention of mother to child transmission (PMTCT) programs have enabled women living with HIV (WLWH) to have children with minimal risk of perinatal transmission. Nevertheless, pregnant WLWH face many challenges. We explored women's perceptions of how they cope with the challenges of pregnancy and the postpartum period as HIV-infected women. Methods: We conducted semi-structured interviews with postpartum WLWH accessing ART who had a pregnancy within 2 years prior to recruitment between February-August, 2014. Childbearing associated stressors and coping strategies were discussed. We used content analysis to identify major themes and NVivo 10 software facilitated data analysis. Results: Twenty women were interviewed with median age 33 (IQR: 28-35) years, CD4 cell count 677 cells/mm3 (IQR: 440-767), number of live births 4 (IQR: 2-6), and number of living children 3 (IQR: 2-4.3). We summarize five identified coping strategies within a socio-ecological framework according to Bronfenbrenner's Ecological Model. Coping strategies on the individual level included acceptance of self and HIV status, and self-reliance. On the interpersonal level, participants reported coping through support from partners, family, and friends. On the organizational level, participants reported coping through HIV-related healthcare delivery and system supports. At the community level, women reported coping through support from church and spirituality. Conclusions: The results highlight coping strategies used by WLWH to manage the myriad challenges faced during pregnancy and the postpartum period. Intervention programs for WLWH must emphasize psychosocial care and incorporate strategies that address psychosocial challenges in the HIV care package in order to optimize well-being. Additionally policies that support networks of WLWH should be put in place and funding support should be provided through existing funding mechanisms in order to respond to the needs and challenges of WLWH. Programmes that support WLWH for economic empowerment and improved livelihoods should be strengthened across all regions in the country.

Original languageEnglish (US)
Article number138
JournalBMC Pregnancy and Childbirth
Volume17
Issue number1
DOIs
StatePublished - May 8 2017
Externally publishedYes

Fingerprint

Uganda
Postpartum Period
HIV
Pregnancy
Delivery of Health Care
Spirituality
Ego
Africa South of the Sahara
Live Birth
CD4 Lymphocyte Count
Pregnant Women

Keywords

  • Coping strategies
  • HIV
  • Postpartum
  • Pregnancy
  • Rural Uganda
  • Women

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Understanding coping strategies during pregnancy and the postpartum period : A qualitative study of women living with HIV in rural Uganda. / Ashaba, Scholastic; Kaida, Angela; Burns, Bridget Frances; O'Neil, Kasey; Dunkley, Emma; Psaros, Christina; Kastner, Jasmine; Tsai, Alexander C.; Bangsberg, David; Matthews, Lynn T.

In: BMC Pregnancy and Childbirth, Vol. 17, No. 1, 138, 08.05.2017.

Research output: Contribution to journalArticle

Ashaba, Scholastic ; Kaida, Angela ; Burns, Bridget Frances ; O'Neil, Kasey ; Dunkley, Emma ; Psaros, Christina ; Kastner, Jasmine ; Tsai, Alexander C. ; Bangsberg, David ; Matthews, Lynn T. / Understanding coping strategies during pregnancy and the postpartum period : A qualitative study of women living with HIV in rural Uganda. In: BMC Pregnancy and Childbirth. 2017 ; Vol. 17, No. 1.
@article{8079cb7fdf834b568c08c32510e570a2,
title = "Understanding coping strategies during pregnancy and the postpartum period: A qualitative study of women living with HIV in rural Uganda",
abstract = "Background: In sub-Saharan Africa, 58{\%} of adults living with HIV are women. In Uganda, HIV prevalence is 8.3{\%} for women compared to 6.1{\%} for men. Access to antiretroviral therapy (ART) and prevention of mother to child transmission (PMTCT) programs have enabled women living with HIV (WLWH) to have children with minimal risk of perinatal transmission. Nevertheless, pregnant WLWH face many challenges. We explored women's perceptions of how they cope with the challenges of pregnancy and the postpartum period as HIV-infected women. Methods: We conducted semi-structured interviews with postpartum WLWH accessing ART who had a pregnancy within 2 years prior to recruitment between February-August, 2014. Childbearing associated stressors and coping strategies were discussed. We used content analysis to identify major themes and NVivo 10 software facilitated data analysis. Results: Twenty women were interviewed with median age 33 (IQR: 28-35) years, CD4 cell count 677 cells/mm3 (IQR: 440-767), number of live births 4 (IQR: 2-6), and number of living children 3 (IQR: 2-4.3). We summarize five identified coping strategies within a socio-ecological framework according to Bronfenbrenner's Ecological Model. Coping strategies on the individual level included acceptance of self and HIV status, and self-reliance. On the interpersonal level, participants reported coping through support from partners, family, and friends. On the organizational level, participants reported coping through HIV-related healthcare delivery and system supports. At the community level, women reported coping through support from church and spirituality. Conclusions: The results highlight coping strategies used by WLWH to manage the myriad challenges faced during pregnancy and the postpartum period. Intervention programs for WLWH must emphasize psychosocial care and incorporate strategies that address psychosocial challenges in the HIV care package in order to optimize well-being. Additionally policies that support networks of WLWH should be put in place and funding support should be provided through existing funding mechanisms in order to respond to the needs and challenges of WLWH. Programmes that support WLWH for economic empowerment and improved livelihoods should be strengthened across all regions in the country.",
keywords = "Coping strategies, HIV, Postpartum, Pregnancy, Rural Uganda, Women",
author = "Scholastic Ashaba and Angela Kaida and Burns, {Bridget Frances} and Kasey O'Neil and Emma Dunkley and Christina Psaros and Jasmine Kastner and Tsai, {Alexander C.} and David Bangsberg and Matthews, {Lynn T.}",
year = "2017",
month = "5",
day = "8",
doi = "10.1186/s12884-017-1321-9",
language = "English (US)",
volume = "17",
journal = "BMC Pregnancy and Childbirth",
issn = "1471-2393",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Understanding coping strategies during pregnancy and the postpartum period

T2 - A qualitative study of women living with HIV in rural Uganda

AU - Ashaba, Scholastic

AU - Kaida, Angela

AU - Burns, Bridget Frances

AU - O'Neil, Kasey

AU - Dunkley, Emma

AU - Psaros, Christina

AU - Kastner, Jasmine

AU - Tsai, Alexander C.

AU - Bangsberg, David

AU - Matthews, Lynn T.

PY - 2017/5/8

Y1 - 2017/5/8

N2 - Background: In sub-Saharan Africa, 58% of adults living with HIV are women. In Uganda, HIV prevalence is 8.3% for women compared to 6.1% for men. Access to antiretroviral therapy (ART) and prevention of mother to child transmission (PMTCT) programs have enabled women living with HIV (WLWH) to have children with minimal risk of perinatal transmission. Nevertheless, pregnant WLWH face many challenges. We explored women's perceptions of how they cope with the challenges of pregnancy and the postpartum period as HIV-infected women. Methods: We conducted semi-structured interviews with postpartum WLWH accessing ART who had a pregnancy within 2 years prior to recruitment between February-August, 2014. Childbearing associated stressors and coping strategies were discussed. We used content analysis to identify major themes and NVivo 10 software facilitated data analysis. Results: Twenty women were interviewed with median age 33 (IQR: 28-35) years, CD4 cell count 677 cells/mm3 (IQR: 440-767), number of live births 4 (IQR: 2-6), and number of living children 3 (IQR: 2-4.3). We summarize five identified coping strategies within a socio-ecological framework according to Bronfenbrenner's Ecological Model. Coping strategies on the individual level included acceptance of self and HIV status, and self-reliance. On the interpersonal level, participants reported coping through support from partners, family, and friends. On the organizational level, participants reported coping through HIV-related healthcare delivery and system supports. At the community level, women reported coping through support from church and spirituality. Conclusions: The results highlight coping strategies used by WLWH to manage the myriad challenges faced during pregnancy and the postpartum period. Intervention programs for WLWH must emphasize psychosocial care and incorporate strategies that address psychosocial challenges in the HIV care package in order to optimize well-being. Additionally policies that support networks of WLWH should be put in place and funding support should be provided through existing funding mechanisms in order to respond to the needs and challenges of WLWH. Programmes that support WLWH for economic empowerment and improved livelihoods should be strengthened across all regions in the country.

AB - Background: In sub-Saharan Africa, 58% of adults living with HIV are women. In Uganda, HIV prevalence is 8.3% for women compared to 6.1% for men. Access to antiretroviral therapy (ART) and prevention of mother to child transmission (PMTCT) programs have enabled women living with HIV (WLWH) to have children with minimal risk of perinatal transmission. Nevertheless, pregnant WLWH face many challenges. We explored women's perceptions of how they cope with the challenges of pregnancy and the postpartum period as HIV-infected women. Methods: We conducted semi-structured interviews with postpartum WLWH accessing ART who had a pregnancy within 2 years prior to recruitment between February-August, 2014. Childbearing associated stressors and coping strategies were discussed. We used content analysis to identify major themes and NVivo 10 software facilitated data analysis. Results: Twenty women were interviewed with median age 33 (IQR: 28-35) years, CD4 cell count 677 cells/mm3 (IQR: 440-767), number of live births 4 (IQR: 2-6), and number of living children 3 (IQR: 2-4.3). We summarize five identified coping strategies within a socio-ecological framework according to Bronfenbrenner's Ecological Model. Coping strategies on the individual level included acceptance of self and HIV status, and self-reliance. On the interpersonal level, participants reported coping through support from partners, family, and friends. On the organizational level, participants reported coping through HIV-related healthcare delivery and system supports. At the community level, women reported coping through support from church and spirituality. Conclusions: The results highlight coping strategies used by WLWH to manage the myriad challenges faced during pregnancy and the postpartum period. Intervention programs for WLWH must emphasize psychosocial care and incorporate strategies that address psychosocial challenges in the HIV care package in order to optimize well-being. Additionally policies that support networks of WLWH should be put in place and funding support should be provided through existing funding mechanisms in order to respond to the needs and challenges of WLWH. Programmes that support WLWH for economic empowerment and improved livelihoods should be strengthened across all regions in the country.

KW - Coping strategies

KW - HIV

KW - Postpartum

KW - Pregnancy

KW - Rural Uganda

KW - Women

UR - http://www.scopus.com/inward/record.url?scp=85018418371&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85018418371&partnerID=8YFLogxK

U2 - 10.1186/s12884-017-1321-9

DO - 10.1186/s12884-017-1321-9

M3 - Article

C2 - 28482821

AN - SCOPUS:85018418371

VL - 17

JO - BMC Pregnancy and Childbirth

JF - BMC Pregnancy and Childbirth

SN - 1471-2393

IS - 1

M1 - 138

ER -