A.8.Women’s reflections on past life and future possibilities: Situating HIV Diagnosis within the life course
J. M. Levy
Objectives and Scope: This research explores the experience of HIV diagnosis for women who learn of their positive status while pregnant through the prevention of mother to child transmission (PMTCT) program. This project investigates the impact of HIV diagnosis on women’s present and future lives. Moreover, it locates HIV diagnosis in relation to previous life events.
Methodology: Qualitative, anthropological research was carried out at a PMTCT program in Area 25, Lilongwe. From September 2004 to present, thirty-four women were recruited into the study immediately following HIV positive diagnosis and were each interviewed between one and seven times. In addition, twenty-one women were recruited for focus group discussions from a post-natal support group for women living with HIV.
Results: HIV diagnosis disrupts the course of women’s lives and impacts all arenas of their life worlds, including their present and prospective relationships, reproductive decisions, psychological well being, and economic possibilities. Women, however, are caught off-guard by the wide ranging impacts of “knowing their status” and struggle to come to terms and negotiate the new possibilities of their lives.
Conclusion: Situating HIV diagnosis in the context of a life-being-lived not only illuminates causal factors in HIV diagnosis, but suggests the impact of HIV diagnosis on the future life course. For women diagnosed with HIV in the PMTCT program, knowledge of ones positive status is an unexpected crisis in the normal course of daily life. Women are thus unprepared for the multiple changes, both immediate and long term, that diagnosis brings to life.
Recommendations: HIV counseling and testing for pregnant women must be accompanied by on-going counseling and support resources, which both help women in anticipating life change through HIV diagnosis and offer tools and resources to assist women in negotiating and coping with those changes.