‘If she gave birth to a healthy child, then she may forget about her own health’: Postpartum engagement in HIV care and treatment among women living with HIV in Russia

ABSTRACT

There is a dearth of information about the factors influencing postpartum engagement in HIV treatment and care in Russia, a country with an expanding HIV epidemic and poor treatment coverage. The goal of our community-based study was to identify and explore the factors influencing engagement in care after pregnancy. We conducted in-depth interviews with 50 women living with HIV who had recently given birth, and with 20 health care and social service providers in two locations: a large metropolitan city (St. Petersburg) and a semi-urban town near the Ural Mountains. Thematic analysis led us to identify the following themes in regard to factors influencing postpartum engagement in care: feeling overwhelmed with caring for an infant; sense of responsibility for child’s health and well-being; misinformation and AIDS denialism; HIV-related stigma and fear; benefits versus side-effects of ART; professional and personal support; drug and alcohol use; and structural factors. Structural factors include poverty, continued provision of ART after pregnancy, dosage, obtaining necessary documents, and distance to clinic. These findings are important to consider in developing much-needed interventions to promote women’s longer-term engagement in HIV care and treatment in Russia.

KEYWORDS:

• Postpartum
• HIV treatment and care
• women living with HIV
• Russia

Acknowledgements

We thank the participants who generously shared their time, perspectives, and experiences. We would like to acknowledge members of EVA Association who conducted the interviews, and Natanie Anilovich and Mariya Nakonechna at the University of Michigan for their research assistance with data coding.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Participants are identified by category (S = Service Provider; WLHIV = Woman living with HIV), location (SP = St. Petersburg; SO = Sverdlovskaya Oblast’), and participant number.

Additional information

Funding

This research was funded by a faculty seed grant from the Institute for Research on Women and Gender at the University of Michigan.