PMID- 28482821
OWN - NLM
STAT- MEDLINE
DCOM- 20180319
LR  - 20220330
IS  - 1471-2393 (Electronic)
IS  - 1471-2393 (Linking)
VI  - 17
IP  - 1
DP  - 2017 May 8
TI  - Understanding coping strategies during pregnancy and the postpartum period: a 
      qualitative study of women living with HIV in rural Uganda.
PG  - 138
LID - 10.1186/s12884-017-1321-9 [doi]
LID - 138
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/mm(3) (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.
FAU - Ashaba, Scholastic
AU  - Ashaba S
AD  - Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, 
      Uganda. sashaba@must.ac.ug.
FAU - Kaida, Angela
AU  - Kaida A
AD  - Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.
FAU - Burns, Bridget Frances
AU  - Burns BF
AD  - MGH Global Health, Massachusetts General Hospital, Boston, MA, USA.
FAU - O'Neil, Kasey
AU  - O'Neil K
AD  - MGH Global Health, Massachusetts General Hospital, Boston, MA, USA.
FAU - Dunkley, Emma
AU  - Dunkley E
AD  - Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.
FAU - Psaros, Christina
AU  - Psaros C
AD  - Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
AD  - Harvard Medical School, Boston, MA, USA.
FAU - Kastner, Jasmine
AU  - Kastner J
AD  - Research Institute McGill University Health Centre Montreal, Montreal, Canada.
FAU - Tsai, Alexander C
AU  - Tsai AC
AD  - Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
AD  - Harvard Medical School, Boston, MA, USA.
FAU - Bangsberg, David R
AU  - Bangsberg DR
AD  - MGH Global Health, Massachusetts General Hospital, Boston, MA, USA.
AD  - Harvard Medical School, Boston, MA, USA.
FAU - Matthews, Lynn T
AU  - Matthews LT
AD  - MGH Global Health, Massachusetts General Hospital, Boston, MA, USA.
AD  - Division of Infectious Diseases, Department of Medicine, Massachusetts General 
      Hospital, Boston, MA, USA.
LA  - eng
GR  - R01 MH087328/MH/NIMH NIH HHS/United States
GR  - R01 MH054907/MH/NIMH NIH HHS/United States
GR  - R21 HD069194/HD/NICHD NIH HHS/United States
GR  - K23 MH095655/MH/NIMH NIH HHS/United States
GR  - K24 MH087227/MH/NIMH NIH HHS/United States
GR  - U01 CA066529/CA/NCI NIH HHS/United States
GR  - P30 AI027763/AI/NIAID NIH HHS/United States
GR  - D43 TW010128/TW/FIC NIH HHS/United States
GR  - K23 MH099916/MH/NIMH NIH HHS/United States
PT  - Journal Article
DEP - 20170508
PL  - England
TA  - BMC Pregnancy Childbirth
JT  - BMC pregnancy and childbirth
JID - 100967799
SB  - IM
MH  - *Adaptation, Psychological
MH  - Adult
MH  - Female
MH  - HIV Infections/*psychology
MH  - Humans
MH  - Postpartum Period/*psychology
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious/*psychology/virology
MH  - Qualitative Research
MH  - Rural Population
MH  - Uganda
PMC - PMC5423027
OTO - NOTNLM
OT  - Coping strategies
OT  - HIV
OT  - Postpartum
OT  - Pregnancy
OT  - Rural Uganda
OT  - Women
EDAT- 2017/05/10 06:00
MHDA- 2018/03/20 06:00
PMCR- 2017/05/08
CRDT- 2017/05/10 06:00
PHST- 2016/05/03 00:00 [received]
PHST- 2017/05/03 00:00 [accepted]
PHST- 2017/05/10 06:00 [entrez]
PHST- 2017/05/10 06:00 [pubmed]
PHST- 2018/03/20 06:00 [medline]
PHST- 2017/05/08 00:00 [pmc-release]
AID - 10.1186/s12884-017-1321-9 [pii]
AID - 1321 [pii]
AID - 10.1186/s12884-017-1321-9 [doi]
PST - epublish
SO  - BMC Pregnancy Childbirth. 2017 May 8;17(1):138. doi: 10.1186/s12884-017-1321-9.