April 13, 2015
A team of researchers at several universities and clinics in Montreal conducted a study to explore issues related to healthcare access and mental health among HIV-positive mothers. In detailed interviews with 100 mothers, the researchers uncovered several issues that affected the women's mental health. The team made recommendations for doctors, nurses and other care providers, which, if implemented, could greatly improve the mental health and wellbeing of HIV-positive women who have children.
Researchers from the following universities and in some cases their affiliated hospitals and clinics entered into collaboration:
Hospital clinics and community-based agencies helped advertise the study.
On average, participants were 41 years old, had been diagnosed with HIV for 12 years and had two children. Nearly half of the women had an annual income of less than $20,000.
Women reported having an average of four healthcare providers. (This can be common in some regions, particularly big cities, where there are many doctors available and women can make use of the services of a family doctor, infectious disease specialist, gynecologist and other specialists as needed.)
According to the researchers, overall, the women were "quite satisfied with the quality of communication with their healthcare providers and the services they provided."
The women told researchers that the most common barriers to accessing care were as follows:
The main sources of stigma identified by the women stemmed from the following:
Researchers found that about 45% of the women had symptoms of psychological distress. This figure is nearly twice as high as that reported for the average HIV-negative woman in Quebec. Furthermore, HIV-positive women with such distress reported more barriers to care, barriers to accessing care-related resources, and concerns about disclosure, and they tended to have what the researchers called a "negative self-image."
The researchers stated that the prevalence of psychological distress was not explained by any of the following factors:
The researchers reported that the women in the study had the following concerns regarding disclosing their HIV status (due to discrimination and other related issues): "controlling information, keeping secret one's HIV status, and worrying that people who knew their status would tell others. The more [that] participants were living in fear of [their HIV status] being discovered and being hyper-vigilant about possible threats about [revealing] their HIV status, the more likely they were to be clinically distressed ..."
The researchers found that the following factors acted as barriers to care:
Based on their findings, the researchers made the following recommendations:
Furthermore, the researchers encouraged social workers to help HIV-positive mothers develop the knowledge and skills to access resources that address their basic needs, including the following:
If implemented, these recommendations could greatly improve the lives of mothers living with HIV in Quebec and elsewhere.
The present study was cross-sectional in nature; that is, participants were only interviewed at one point in time. However, this study should be seen as an important first step. A second future study that assessed and interviewed participants over several years could yield valuable information that could be used to assess the care needs of HIV-positive mothers.
HIV and emotional wellness -- CATIE
Blais M, Fernet M, Proulx-Boucher K, et al. Barriers to health care and psychological distress among mothers living with HIV in Quebec (Canada). AIDS Care. 2015 Jun;27(6):731-8.
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