Mechanisms linking intimate partner violence and prevention of mother-to-child transmission of HIV: A qualitative study in South Africa

A.M. Hatcher, H. Stöckl, N. Christofides, N. Woollett, C.C. Pallitto, C. Garcia-Moreno and J.M. Turan

Social Science & Medicine, 2016, vol. 168, issue C, 130-139

Abstract: Prevention of mother-to-child transmission (PMTCT) can virtually eliminate HIV infection among infants, yet up to one-third of women miss PMTCT steps. Little is known about how partner dynamics such as intimate partner violence (IPV) influence pregnant and postpartum women's adherence to PMTCT. We conducted 32 qualitative interviews with HIV-positive pregnant and postpartum women in Johannesburg who experienced IPV. Trained researchers conducted in-depth interviews over the period of May 2014–Nov 2015 using narrative and social constructionist approaches. Interviews were transcribed verbatim and analyzed thematically and inductively using Dedoose qualitative software. Twenty-six women experienced recent IPV and one-third had poor adherence to PMTCT. Women's experience of partner violence influenced PMTCT behaviors through four pathways. First, fear of partner disclosure led some women to hide their HIV status to avoid a violent reaction. Despite strategic non-disclosure, several maintained good adherence by hiding medication or moving out from their partner's home. Second, IPV caused feelings of depression and anxiety that led to intentionally or accidentally missing medication. Five women stopped treatment altogether, in a type of passive suicidality, hoping to end the distress of IPV. Third, men's controlling behaviors reduced access to friends and family, limiting social support needed for good adherence. Fourth, in a protective pathway, women reported good adherence partly due to their mothering role. The identity around motherhood was used as a coping technique, reminding women that their infant's wellbeing depended on their own health. PMTCT is essential to prevent vertical HIV transmission, but women living with IPV face multiple pathways to non-adherence. Addressing IPV in antenatal care can support the health of women and infants and may enhance PMTCT coverage.

Keywords: South Africa; Intimate partner violence; HIV; Adherence; Qualitative; Perinatal (search for similar items in EconPapers)
Date: 2016
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S0277953616305123
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:socmed:v:168:y:2016:i:c:p:130-139

Ordering information: This journal article can be ordered from
http://www.elsevier.com/wps/find/supportfaq.cws_home/regional
http://www.elsevier. ... _01_ooc_1&version=01

DOI: 10.1016/j.socscimed.2016.09.013

Access Statistics for this article

Social Science & Medicine is currently edited by Ichiro (I.) Kawachi and S.V. (S.V.) Subramanian

More articles in Social Science & Medicine from Elsevier
Bibliographic data for series maintained by Catherine Liu ().