Prenatal HIV Testing: The Compartmentalization of Women's Sexual Risk Exposure and the Return of the Maternal Fetal Conflict

Abstract

The purpose of the researchers in this study was to investigate how women who were being tested for HIV during their pregnancies were evaluating, conceptualizing, and negotiating their risk of infection. The study included two focus groups and 20 in-depth interviews with 30 patients, ages 17–38 years, from diverse ethnic/racial, social, and economic backgrounds. Qualitative analyses of the interview transcripts revealed support for the idea that pregnant women have a responsibility to minimize risks to their fetus, with all interviewees describing actions to minimize those risks while pregnant. Two sub-themes emerged that were related to the presence of differences in how interviewees conceptualized risk depending on the type of risk being discussed. In the case of diet and lifestyle influences, interviewees framed their health and the health of the fetus as connected. In contrast, when the issue of HIV risk and testing was raised, the interviewees described the risk of HIV to themselves and their fetuses as separate concerns and, with few exceptions, reported no effort to reduce the risk of becoming infected while pregnant (beyond consenting to HIV screening while receiving prenatal care). Findings suggest the importance of developing HIV prevention messages that counter the compartmentalization of risk during pregnancy.

Keywords:

• prenatal testing
• HIV/AIDS
• perinatal transmission
• patient perceptions

Notes

1. According to data compiled by the Kaiser Family Foundation, as of February 2008, 22 states had passed legislation requiring opt-out testing of pregnant women, 30 had opt-in testing of pregnant women, and 10 states had newborn testing (Kaiser Family Foundation, 2008).

2. One participant chose not to report this information.

3. While the interview questions administered included a specific question about women's use of cigarettes and alcohol during pregnancy, many of the women interviewed did not directly respond to these questions. The eleven women discussed in this paragraph are the entirety of those who directly answered questions about smoking and alcohol consumption.