"I Have to Stand Up on My Own and Do the Best I Can for My Kids": Work (Re-)entry Among New Mothers Living with HIV in Cape Town, South Africa

Authors

Mamaswatsi Kopeka, Brown University School of Public Health, Rhode Island, USA. mamaswatsi_kopeka@alumni.brown.edu.
Michael Barton Laws, Department of Health Services, Policy and Practice, Brown University School of Public Health, Rhode Island, USA.
Abigail Harrison, Department of Behavioral and Social Sciences, Brown University School of Public Health, Rhode Island, USA.
Nokwazi Tsawe, Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Lucia Knight, Division of Social and Behavioural Sciences, Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Jennifer Pellowski, Department of Behavioral and Social Sciences, Brown University School of Public Health, Rhode Island, USA.

Document Type

Journal Article

Publication Date

9-6-2024

Journal

AIDS and behavior

DOI

10.1007/s10461-024-04478-w

Keywords

Exclusive breastfeeding; HIV/AIDS; Labor participation; WLHIV

Abstract

In recent years, significant progress has been made in treatment access for women living with HIV (WLHIV). For example, option B+, which requires that all pregnant persons who test positive for HIV start on antiretroviral treatment, has been instrumental in reducing the risk of vertical transmission. For birthing individuals who have a low HIV viral load, there is a minimized risk of vertical transmission during breastfeeding. However, an alarming rate of WLHIV in South Africa disengage from care during postpartum. Given that work is intricately linked to individuals' socioeconomic status, and thus health outcomes, and their health-seeking ability, it is important to explore the role of work in decisions that impact HIV-related care for the dyad postpartum. Semi-structured interviews were conducted with 26 women living with HIV at 6-8 weeks postpartum in Cape Town, South Africa. A secondary qualitative data analysis was conducted following thematic content analysis. Three themes were identified, spanning participants' financial considerations, navigating childcare needs, and considerations for exclusive breastfeeding. For many participants, there was often a conflict between returning to work, childcare, and the decision whether or not to breastfeed-in addition to their HIV care. This conflict between participants' commitments suggests an increased pressure that WLHIV may face postpartum, which could impact their ability to remain engaged in their healthcare and adherent to medication. Although exclusive breastfeeding is an important recommendation for the baby's health outcomes; there is a need for structural support for WLHIV as they navigate work re-entry during postpartum.

APA Citation

Kopeka, Mamaswatsi; Laws, Michael Barton; Harrison, Abigail; Tsawe, Nokwazi; Knight, Lucia; and Pellowski, Jennifer, ""I Have to Stand Up on My Own and Do the Best I Can for My Kids": Work (Re-)entry Among New Mothers Living with HIV in Cape Town, South Africa" (2024). GW Authored Works. Paper 5671.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5671

Department

Public Health Student Works