‘Keeping healthy in the backseat’: How motherhood interrupted HIV treatment in recently delivered women in Kenya

  • Opondo Awiti-Ujiji
  • Anna Mia Ekström
  • Festus Ilako
  • Dorcas Indalo
  • Abigael Lukhwaro
  • David Wamalwa
  • Birgitta Rubenson

Abstract

Although there is a large body of literature related to the experiences of motherhood and aspects of the change that it brings about, how the experience of motherhood affects the healthcare of women with chronic illness is less documented. This study explores how motherhood in newly delivered HIV-infected mothers in Kenya interrupted their antiretroviral treatment (ART). Qualitative interviews were performed with 26 mothers on ART in a rural or urban area. The data were organised and interpreted using content analysis. The  study found that adherence to ART was influenced by contextual differences in  socio-cultural expectations and family relationships. Urban life enabled women  to make decisions on their own and to negotiate challenges that were often  unpredictable. Women in rural areas knew what was expected of them and decisions were normally not for them to make alone. The women in Busia and  Kibera had difficulties combining adherence with attaining the socio-cultural definition of good mothering. Lack of support from health providers and weak  healthcare systems contributed to inadequate stocks of HIV drugs and inaccessibility of HIV-related care. From the data, we developed the main theme ‘keeping healthy in the backseat’ and the two sub-themes ‘regaining self-worth through motherhood’ and ‘mother first — patient later.’ We suggest that motherhood is context-specific and follows socio-cultural practises, which made it difficult for the women in Kenya to follow ART instructions. There is a need to reassess HIV-related services for mothers on ART in order to give them a better chance to stay on treatment and satisfy their aspiration to be ‘good mothers.’ Contextspecific HIV-treatment policies are necessary for ensuring adherence and successful treatment outcomes.

Keywords: adherence; antiretroviral therapy; HIV prevention; Kenya; mothers; qualitative research; socio-cultural aspects; sub-Saharan Africa

African Journal of AIDS Research 2011, 10(2): 157–163

Author Biographies

Opondo Awiti-Ujiji
Karolinska Institutet, Department of Public Health Sciences, Division of Global Health, SE-171 77 Stockholm, Sweden
Anna Mia Ekström
Karolinska Institutet, Department of Public Health Sciences, Division of Global Health, SE-171 77 Stockholm, Sweden; Karolinska University Hospital, Department of Infectious Diseases, SE-141 86 Stockholm, Sweden
Festus Ilako
African Medical Research Foundation (AMREF) in Kenya, PO Box 125-00100, Nairobi, Kenya
Dorcas Indalo
AMREF Kibera Community Health Project, PO Box 30125-00100, Nairobi, Kenya
Abigael Lukhwaro
AMREF Kibera Community Health Project, PO Box 30125-00100, Nairobi, Kenya
David Wamalwa
AMREF Busia Child Survival Project (BCSP), PO Box 30125-00100, Nairobi, Kenya
Birgitta Rubenson
Karolinska Institutet, Department of Public Health Sciences, Division of Global Health, SE-171 77 Stockholm, Sweden
Section
Articles

Journal Identifiers


eISSN: 1608-5906
print ISSN: 1727-9445