Telling their story: perspectives of young women, their caregivers and service providers regarding the experiences of growing up with perinatally-acquired HIV in Malawi

Mwalabu, Gertrude Grey Tiwonge (2014) Telling their story: perspectives of young women, their caregivers and service providers regarding the experiences of growing up with perinatally-acquired HIV in Malawi. PhD thesis, University of Nottingham.

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Abstract

Background

Globally, the number of adolescents living with perinatally-acquired HIV continues to rise including in Malawi. To date, this group has received relatively less attention in the field of HIV care; yet they are increasingly surviving into adulthood. There is a growing need for the development of appropriate care and support services for this group; however their sexual and reproductive health (SRH) needs remain poorly addressed.

Research Aim

This study aimed to explore perinatally-infected young women’s experiences of growing up with HIV in order to understand their SRH outcomes within their wider socio-cultural and structural context.

Methods

A qualitative case study design was adopted whereby each ‘case’ comprised a female adolescent (15-19 years), a nominated caregiver and a service provider. Data was collected for 14 cases through in-depth interviews. The interviews with adolescents were based on an innovative visual method known as ‘my story book’.

Results

The study found that young women endured multiple losses that negatively impacted upon their sense of self and belonging. Emotional, material and social support were essential in helping them to build a sense of identity, but their access to such resources was highly variable. Young women’s strategies to seek love, acceptance or support often led them to take sexual risks and left them with little control over their reproductive health. Both the service providers and caregivers often ‘turned a blind eye’ to young women’s sexual activities, leading to poor SRH outcomes. Lack of open discussion on SRH issues was related to cultural and religious norms hindering young women’s access to information and contraception.

Conclusion

Addressing the complex needs of the young women poses a key challenge for Malawi’s HIV services. One way forward is to explore ways in which services could develop integrated models of care, offering a ‘one-stop shop’ to this vulnerable group.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Evans, C.
Redsell, S.
Keywords: HIV, Life experiences, Health outcomes, Psychosocial aspects of HIV, Health services, Caregivers
Subjects: W Medicine and related subjects (NLM Classification) > WC Communicable diseases
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Health Sciences
Item ID: 14506
Depositing User: EP, Services
Date Deposited: 20 Feb 2015 11:38
Last Modified: 15 Sep 2016 00:37
URI: http://eprints.nottingham.ac.uk/id/eprint/14506

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