Affirming life despite a poisoned fate : a grounded theory of reproductive decision-making among women living with HIV

Amandah Lea Hoogbruin
The purpose of this qualitative research study was to investigate the cultural, psychological, and social processes of reproductive decision-making among women living with HIV. In using grounded theory method, the primary objective of this study was to generate a substantive theory. Audiotaped interviews were completed with 29 women living with HIV and nine of their primary support persons. Other sources of data included field notes about each interview, non-fictional literature, and articles
more » ... ure, and articles in the popular press that described the experiences of reproductive decision-making for women living with HIV. Data were analyzed by using techniques of constant comparison for qualitative data. 'Affirming life despite a poisoned fate' was identified as the core process in reproductive decision-making by women living with HIV. This process consisted of two competing elements: 'struggling with vulnerability' and 'striving for longevity.' These elements interacted dialectically so that change in a woman's sense of her own vulnerability affected her capacity to strive to live longer. This interaction depended on the woman's experience of 'wanting to live,' 'managing fears of HIV,' 'awakening personal spirituality,' and 'yearning for connection.' A woman's sense of balance in 'struggling while striving' contributed to decisions about 'risking deadly connections,' i.e., whether she would risk possibly giving others HIV when having sex or giving birth. The women considered a range of practical, romantic, intellectual, and ethical determinants in deciding "how risky is risky?" This personal calculation of risk accounted for the diverse and sometimes contradictory feelings and thoughts described by women as they made these decisions, and allowed each woman consciously or unconsciously to justify their choices. Throughout the overarching process of 'affirming life despite a poisoned fate,' each turning point in the women's decision-making depended on their life context including their own sense of 'mothering [...]
doi:10.14288/1.0089235 fatcat:hrvfeabv3vbxzdxhpo237ijawa