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Recruitment Poster

ARE YOU A WOMAN ABOVE THE AGE OF 18 WHO IS HIV-POSITIVE AND: TRYING TO GET PREGNANT? ARE PREGNANT? HAVE BEEN PREGNANT POST-DIAGNOSIS?

YOUR PARTICIPATION IS REQUESTED!

November 17, 2012 - I am a Master's student in the Department of Sociology at the University of Calgary interested in understanding how women infected with HIV in Calgary experience the decision to become pregnant in order to mother, and experience pregnancy. I would like to invite you to contribute your experiences to this area of interest in women's lives, by talking with me about your experiences.

In appreciation of your time you will receive
a $25 git card to The Real Canadian Superstore

For more information about this study
or to volunteer for this study, contact:
Ms. Sonja Schuetz
Department of Sociology Faculty of Arts
(403) 542- 5257
sschuetz@ucalgary.ca

This study has been reviewed by, and received ethics approval through, The University of Calgay Conjoint Facultiies Research Ethics Board.

Research Proposal

Research context: In Canada, a prevention-of-mother-to-child-transmission (PMTCT) plan is in place to decrease the number of infants perinatally exposed to human immunodeficiency virus (HIV) (Public Health Agency of Canada, 2010). This federal initiative seeks to prevent transmission of new infections, slow the progression of HIV and improve quality of life and reduce social and economic impacts of HIV (Public Health Agency of Canada, 2007). The accessibility and provision of antiretroviral therapy, one strategy to reduce mother-to-child-transmission (MTCT), has both decreased MTCT, as well as increased the number of women infected with HIV who desire to bear children, in Canada (Public Health Agency of Canada, 2010). In addition, the average life-expectancy of HIV individuals has improved with the implementation of antiretroviral drugs. This increases the chances that HIV-positive women will bear HIV-negative children and raise children to adulthood (Mantell et al., 2009).

Research suggests there is no difference in pregnancy desires for women who are HIV-positive and women who are HIV-negative (see Ogilvie, 2007; Kirshenbaum et al., 2004). This in turn suggests an underlying gender and cultural component to reproductive desire. Being able to identify as a mother is important to women diagnosed HIV-positive, as some studies have found women believe motherhood is interchangeable with womanhood and fulfills a desire for completion (see Long, 2009; Sanders, 2008). Also, the experience of motherhood allows women to present themselves as valuable, capable of producing healthy children (see Cooper et al., 2007). Children have been found to provide women with: unconditional love, purpose in life and a place for women to have control and power (see Wesley et al., 2010).

This understanding of reproduction and motherhood is in contrast to negative discourses of illness and abnormality associated with HIV (see Kelly et al., 2011; Lawless et al., 1996). Stinson and Myer (2012) contend that HIV-positive women who mother has been constructed as deviant and "bad" on the basis that society condemns women for failing to protect their children from harm, placing women in a double bind, which is defined by Ingram and Huchinson (2000) as "untenable, no-win situations", where women are expected to bear children, but are discouraged when they are HIV-positive (p.118).

Purpose and significance: Understanding how women infected with HIV experience reproductive decision-making and reproduction is an important area of inquiry. As Canadian policy has been implemented to reduce MTCT, women's personal experiences should be explored to recognize their needs and understandings concerning reproduction. The purpose of this study is to explore how gendered understandings of motherhood affect the reproductive decisions of women who are infected with HIV. Specifically, the main focus of this study will be to investigate women's experiences of reproductive decision-making and reproduction in Canada, which will provide Canadian context to women's experiences, as no qualitative sociological study in Canada has explored this topic. Findings that result from this study will be used to fulfill thesis requirements for a Master's degree in sociology.

Although no personal benefit may be gained by participants in this research, this study is being conducted with the aim of benefiting other women who are HIV-positive. Further research beyond this initial study which takes account of women's experiences, understandings and needs, may contribute to an improvement in Canadian initiatives to reduce mother-to-child transmission of HIV. Additionally, this research may benefit organizations that directly serve individuals affected by HIV, and consequently may benefit the HIV/AIDS community indirectly; the researcher intends to provide a brief report of key findings to organizations from which participants are recruited.

Theoretical context: To understand how women infected with HIV experience reproduction and reproductive decision-making, the constructed meanings of motherhood and mothering will be considered. When considering mothering and motherhood as socially constructed, encompassing meaning, practice, ideology and identity, social constructionist and feminist theory provide a lens through which to understand women's experiences. Specifically, this framework will provide one way to understand the meaning of mothering and motherhood for women infected with HIV.

Method and research process: Approximately 15 to 20 women above the age of 18, who self-identify as having been diagnosed HIV-positive, will be asked to partake in one interview lasting approximately an hour. Interviews will be conducted by the Master's student, who is the principal investigator. To qualify as a participant, women must be in one of three stages of reproductive decision-making: have made the decision to, and currently attempting to, conceive; currently pregnant; postpartum. Women will be compensated for their time in the form of a $25 gift card to The Real Canadian Superstore. It is intended that compensation will off-set any time or financial costs that may be incurred as a result of participation.

Participants will be recruited by the researcher in two ways. First, the researcher will recruit through organizations that directly serve individuals affected by HIV and AIDS. Second, the researcher will conduct indirect snowball sampling in order to utilize participants existing networks.

During the interview, participants will be asked to reflect on questions provided by the researcher and answer to the best of their ability. Questions that will be asked of participants are related to their reproductive decision-making, reproductive experiences, motherhood desires, and perceptions of other HIV-positive women's pregnancy desires. The interview guide is semi-structured containing predetermined questions; however, these questions are open-ended to allow participants to answer questions as in-depth as possible. Interviews will be transcribed and analysed by the primary investigator.

References

Cooper, D., Harries, J., Myer, L., Orner, P., & Bracken, H. (2007). "Life is still going on": reproductive intentions among HIV-positive women and men in South Africa. Social Science & Medicine, 65(2), 274-283.

Ingram, D., & Hutchinson, S.A. (2000). Double binds and the reproductive and mothering experiences of HIV-positive women. Qualitative Health Research , 10(1), 117-132.

Kelly, C, Lohan, M, Alderdice, F, & Spence, D. (2011). Negotiation of risk in sexual relationships and reproductive decision-making amongst HIV sero-different couples. Culture, Health and Sexuality, 13(7), 815-827.

Kirshenbaum, S.B., Hirky, A.E., Correale, J., Goldstein, R.B., Johnson, M.O., Rotheram-Borus, M.J., & Ehrhardt, A.A. (2004). "Throwing the dice": pregnancy decision-making among HIV-positive women in four U.S. cities. Perspectives on Sexual and Reproductive Health, 36(3), 106-113 .

Lawless, S., Kippax, S., & Crawford, J. (1996). Dirty, diseased and undeserving: the positioning of HIV positive women. Soc. Sci. Med ., 43(9), 1371-1377.

Long, C. (2009). Contradicting Maternity: HIV Positive Motherhood in South Africa. Johannesburg, South Africa: Wits University Press.

Mantell, J. E., Smit, J.A., & Stein, Z.A. (2009). The right to choose parenthood among HIV- infected women and men. Journal of Public Health Policy , 30 (4), 367-378.

Ogilvie, G.S., Palepu, A., Remple, V.P., Maan, E., Heath, K., MacDonald, G., Christilaw, J., Berkowitz, J., Fisher, W.A., & Burdge, D.R. (2007). Fertility intentions of women of reproductive age living with HIV in British Columbia, Canada. Aids, 21(1), 83-88.

Public Health Agency of Canada (2010). Perinatal HIV transmission in Canada . Retrieved from http://www.phac-aspc.gc.ca/aids-sida/publication/epi/2010/pdf/EN_Chapter7_Web.pdf

Public Health Agency of Canada (2007). Federal initiative to address HIV/AIDS in Canada . Retrieved from http://www.phac-aspc.gc.ca/aids-sida/fi-if/index-eng.php

Sanders, L.B. (2008). Women's voices: the lived experience of pregnancy and motherhood after diagnosis with HIV. Journal of the Association of Nurses in AIDS Care, 9(1), 47-57.

Stinson, K., & Myer, L. (2012). HIV-infected women's experiences of pregnancy and motherhood in Cape Town, South Africa. Vulnerable Children and Youth Studies, 7(1), 36-46.

Wesley, Y., Smeltzer, S.C., Redeker, N.S., Walker, S., Palumbo, P., & Whipple, B. (2010). Reproductive decision making in mothers with HIV-1. Health Care for Women International, 21(4), 291-304.

###

"Reproduced with permission "

Ms. Sonja Schuetz
Department of Sociology Faculty of Arts, University of Calgary


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