Structured interviews were conducted with 224 HIV-positive women diagnosed during pregnancy, at antenatal
clinics in Tshwane, South Africa, in order to investigate the use of coping strategies during the first two years after
diagnosis. Interviews were conducted between one and four weeks after diagnosis during pregnancy, with three
follow-up interviews conducted post-partum. Coping strategies were assessed with an adapted version of the Brief
COPE. It was found that active coping was used more often than avoidant coping throughout the study period.
Active coping increased over time, while avoidant coping decreased at first but increased again between 6 and 21
months after diagnosis. The most frequently used coping strategies included acceptance, direct action, positive
reframing, religion and distraction. At first, women coped through internalised strategies. Over time, outwardfocused
strategies developed. Avoidant coping patterns differed from previous research indicating that women
diagnosed during pregnancy deal with the consequences of HIV after the baby is born. Recommendations for
mental health services are made.