The Lived Experience of Pregancy among HIV-positive Refugee Women: A Qualitative Study

Previous research has revealed that the experience of HIV-positive refugee women arriving from endemic countries is complicated by social, structural, and cultural issues. If and when they become pregnant, HIV-positive refugee women face a unique situation that is poorly understood by health care providers. The intersecting influences of HIV and refugee status in the context of pregnancy have been essentially unexplored in the Canadian context. The objective of this study was to describe the lived experience of pregnancy among HIV-positive refugee women; to explore the meaning of pregnancy from the perspective of HIV-positive women; and to understand the complexity of issues facing HIV-positive refugee women. An interpretive qualitative research design viewed through a critical post-colonial lens guided the study. Women were interviewed using a semi-structured in-depth approach. Four core themes emerged from the phenomenological analysis. The findings suggest that the experience of HIV and pregnancy among refugee women in Canada involves both disconnection and restoration. They must manage the dynamics of pregnancy, the impact of HIV and the cultural, political and geographic ‘newness’ of Canada. Noteworthy, are the efforts women take to conceal the HIV diagnosis. Additional insight was gained through an intersectional analysis of the data. The findings of this analysis suggest that women: 1) experienced alterations in identity 2) faced significant social disruption, and 3) are impacted by macro-level polices that influence both their initiation and access to the health care system. The lived experience of pregnancy among HIV-positive refugee women in Canada is analogous to moving through a liminal reality. HIV-positive refugee women work to restore a disrupted and “Othered” identity. Pregnancy is integral to that restoration. The results of the study have implications for nursing’s ability to support the transformative aspects of the liminal reality of pregnant HIV-positive refugee women. The potential for these transformations draw attention to nursing at practice, policy, education and research levels