Nutor, Jerry John, Thompson, Rachel G.A., Agbadi, Pascal, Tuthil, Emily, Weiser, Sheri, and Anguyo, Geoffrey (2022) Exploring postpartum women’s experiences of retention in HIV care through the perspective of the salutogenic model of health. Journal of Global Health Science, 4 (1). e2.

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Abstract

Background: Each year, approximately 300,000 children worldwide become infected with human immunodeficiency virus (HIV), mostly through mother-to-child transmission during pregnancy, childbirth or breastfeeding. More than two-thirds of these new HIV infections in children occur in developing countries, especially sub-Saharan Africa (SSA) and SouthEast Asia (SEA). However, in SSA and SEA, the majority of women living with HIV stop antiretroviral treatment (ART) after childbirth despite access to no-cost medication. Reasons for stopping ART have largely been discussed in the literature given that retention in HIV care is critical to reducing mother-to-child transmission of HIV. Therefore, our study, using the salutogenic model of health, aimed to explore the resources postpartum women on ART rely on to retain in HIV care.

Methods: Using convenience sampling methodology, we recruited postpartum women living with HIV in Uganda, and saturation was reached with 15 participants. Data were coded and analyzed using thematic network analysis approach. The salutogenic model of health was used to guide the development of codebook and framing.

Results: There were three main themes: stressors, generalized resistance resources (GRRs), and specialized resistance resources (SRRs). Stressor subthemes included psychological stressors, stigma and abuse by relatives and neighbors, side effects of ART, transportation challenges, and food insecurity. Four GRR subthemes were identified: self-determination and hope, support from others on ART, concern about children’s health, and adaptation in the use of ART. Finally, participants desired certain SRRs to continue in HIV care, under subthemes of interpersonal relations, support from healthcare workers, and resources within the healthcare facility and community.

Conclusion: Findings contribute to knowledge about positive resources to facilitate retention in HIV care rather than focusing on barriers to care. Postpartum women living with HIV in Uganda can benefit from social and community supportive resources to facilitate retention in HIV care and reduce risk of mother-to-child transmission.

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