Frozen in a moment in time: The experiences of mothers being diagnosed with HIV infection

The HIV pandemic persists despite advances in treatment options and access to care. Currently, the life expectancy of people living with HIV (PLWH) who are receiving antiretroviral therapy (ART) is comparable to that of the general population, and HIV is increasingly considered to be a chronic health condition. Despite the normalization of HIV, the psychological and social impact of HIV remains (Bravo et al., 2010, Flowers, 2010, Mazanderani and Paparini, 2015, Perrson, 2012). Globally, HIV testing is the cornerstone of HIV prevention, as it is only by establishing who is infected that further infections can be stopped. However, receiving this diagnosis can be an emotionally challenging time for newly diagnosed individuals, especially for mothers and pregnant women, who must assimilate HIV into their identities (Reichert, 2010). Despite the fact that the chances of vertical transmission occurring during pregnancy is minimal with antiretroviral prophylaxis, an HIV diagnosis remains life-changing and can bring uncertainty (Walsh, Horvath, Fisher, & Courtenay-Quirk, 2012). The predominant discourse with mothers living with HIV infection is about avoiding vertical transmission (Loutfy, Sonnenberg-Schwan, Margolese, & Sherr, 2013). Worldwide, perinatal HIV infections have decreased significantly (Joint United Nations Programme on HIV/AIDS, 2016) due to prioritization of ART during pregnancy to prevent vertical transmission. Having children is important to many women with HIV (Logan-Kennedy et al., 2014), and many opt to have children following an HIV diagnosis. French, Cortina-Borja, Thorne, and Tookey (2012)) drew attention to the continued increase of HIV repeat pregnancies in the United Kingdom and Ireland. The most recent Irish figures revealed that, in 2016, 22% (n = 508) of newly diagnosed individuals were women of childbearing age (Health Protection Surveillance Centre, 2017). Recently, Willcocks, Evangeli, Anderson, Zetler, and Scourse (2016)) highlighted the emotional and psychological impact of an antenatal diagnosis, as preventing vertical transmission often takes priority over the mother's well-being (Kelly et al., 2009, Kelly et al., 2012). This study explored the experiences of women who were diagnosed with HIV when pregnant or as mothers. Gaining an understanding of the HIV diagnosis experience at different points on the mothering trajectory allowed the emotional impact of the news of an HIV infection to be considered so that care provision could be more mother centered