The coping strategies used over a two-year period by HIV-positive women who were diagnosed during pregnancy

Abstract

In order to investigate the coping styles used by HIV-positive pregnant women over the first two years after diagnosis, structured interviews were conducted with 224 women at antenatal clinics in Tshwane, South Africa. The baseline interview was conducted four weeks after diagnosis during pregnancy, and three follow-up interviews were conducted postpartum. Coping was measured with an adapted version of the Brief COPE (Carver, 1997). Differences between each assessment period with regard to the different coping strategies were assessed by means of paired t-tests. Variables associated with coping were identified with mixed linear analysis. It was found that active coping was used more often than avoidant coping throughout the two-year period. The most frequently used coping strategies included acceptance, direct action, positive reframing, religion and distraction. Self-blame and out-of-control decreased substantially over time, whereas helping others increased markedly over time. Active coping was associated with low internalised stigma, low depression, high self-esteem, high positive social support, knowing someone who is HIV-positive, living above the poverty line and not receiving antiretroviral treatment. Avoidant coping was associated with low HIV-knowledge, low self-esteem, high internalised stigma, high depression as well as education below tertiary level. Recommendations for psychological support services, policy and further research are made.