THE MEANING AND UNDERSTANDING OF UNINTENDED PREGNANCY: A QUALITATIVE STUDY OF PREGNANCY AMONG AFRICAN AMERICAN WOMEN LIVING WITH HIV

Abstract

Few studies explore the phenomenon of unintended pregnancy among women living with the Human Immunodeficiency Virus (HIV). To decrease mother-to-child transmission and transmission to a sexual partner, contraceptive methods, cultural beliefs, in addition to protocols pertaining to preconception, pregnancy, labor, delivery and the postpartum period among persons living with HIV must be considered. Half of the pregnancies that occur among HIV-positive women are unintended and requires monitoring and additional prenatal care to reduce adverse health outcomes. This qualitative study sought to increase knowledge of the meaning and understanding of unintended pregnancy among a sample of twelve urban HIV-seropositive African American women. Women shared their experiences related to pregnancy, risk and living with HIV. The majority of participants reported they experienced an unintended pregnancy, discussed lapses in contraception use, knowledge of pregnancy and antiretrovirals, vertical transmission of the virus, sexual risk, and differences in adherence to antiretrovirals during and after pregnancy. Guided by grounded theory the major themes that emerged were used to develop a model that explained unintended pregnancy among the participants. The major themes included resilience, disclosure, and an instinct to protect. Additionally, culture, stigma, social support, contraception, and partner safety were secondary themes. Our review suggests that a model of unintended pregnancy containing social-ecological aspects can describe predictors of pregnancy and potential prevention strategies. Furthermore, the future exploration of the challenges that African American women living with HIV experience with unintended pregnancies, efforts to manage their condition and prepare for a pregnancy are needed.