Hill Lauren M, Maman Suzanne, Groves Allison K, Moodley Dhayendre
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Department of Sociology, American University, Washington, DC, USA.
BMC Pregnancy Childbirth. 2015 May 17;15:117. doi: 10.1186/s12884-015-0542-z.
Pregnancy is common among adolescents in South Africa, yet the social experiences of adolescents during the pregnancy and postpartum period remain understudied in this context. We aimed to explore how adolescent women's discovery and disclosure of both their pregnancy and HIV status affected their relationships with family members and sexual partners, with a particular focus on whether and how support changed throughout this time period.
We conducted in-depth semi-structured interviews with 15 HIV-positive and HIV-negative adolescent women who were either pregnant or had delivered in the last 18 months from one urban clinic in Umlazi, South Africa. Interviews were audiotaped, transcribed, translated, and coded for analysis.
Young women described stress and instability in their relationships with family and partners during pregnancy and the postpartum period, though prior to and during HIV-status disclosure women generally experienced less stress than in disclosing their pregnancy to family members and partners. After a destabilizing period immediately following pregnancy disclosure, families became and remained the primary source of material and emotional support for the young women. Women discussed heightened closeness with their partners during pregnancy, but few women had close relationships with their partners postpartum. Support experiences did not differ by HIV status.
Programs should be aware of the relative importance of pregnancy-related concerns over HIV-related concerns in this population of young women. Engaging family members is critical in ensuring social support for this population of young pregnant women, and in encouraging timely initiation of antenatal care.
在南非，青少年怀孕现象很常见，但在这种背景下，青少年在孕期和产后的社会经历仍未得到充分研究。我们旨在探讨青少年女性对其怀孕和艾滋病毒感染状况的发现与披露如何影响她们与家庭成员及性伴侣的关系，特别关注在此期间支持是否以及如何发生变化。
我们对15名艾滋病毒呈阳性和阴性的青少年女性进行了深入的半结构化访谈，这些女性均来自南非乌姆拉齐的一家城市诊所，她们在过去18个月内怀孕或已分娩。访谈进行了录音、转录、翻译和编码以便分析。
年轻女性描述了孕期和产后与家人及伴侣关系中的压力和不稳定，不过在披露艾滋病毒感染状况之前和期间，女性通常比向家人和伴侣披露怀孕时经历的压力要小。在披露怀孕后紧接着的一段不稳定时期过后，家庭成为并一直是年轻女性物质和情感支持的主要来源。女性谈到孕期与伴侣的亲密关系增强，但产后很少有女性与伴侣保持亲密关系。支持经历不因艾滋病毒感染状况而异。
项目应意识到在这群年轻女性中，与怀孕相关的担忧相对于与艾滋病毒相关的担忧的相对重要性。让家庭成员参与对于确保为这群年轻孕妇提供社会支持以及鼓励及时开始产前护理至关重要。
