Understanding Experiences of Diet, Exercise, and Gestational Weight Gain Among HIV Pregnant Women Living in South Africa - A Qualitative Analysis

Edwards, Krystal

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Year:: 2022
Contributor:: Edwards, Krystal (creator); Pellowski, Jennifer (Advisor); Shield, Renée (Reader); Brown University. School of Public Health (sponsor)
Genre:: theses
Subject:: Exercise; Diet; gestational weight gain; Qualitative research; Prenatal care; HIV-positive persons
Extent:: IV, 25 p.

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Abstract:: Background: South Africa has the largest prevalence of obesity in Sub-Saharan Africa, especially in women of childbearing age (18-44 years), research has linked obesity during pregnancy to adverse outcomes such as stillbirth, cesarean delivery, and large gestational age (Onubi et al., 2015). There is some evidence from South Africa to suggest that obese women tend to gain more weight during pregnancy than those with normal BMI, suggesting an even higher risk of adverse birth outcomes than for normal weight women (Madlala et al., 2020). Studies have shown that gestational weight gain in HIV‐infected women is also associated with high risk of high birthweight and spontaneous preterm delivery (Madlala et al., 2020). This suggests that there is a need to integrate weight management interventions with routine care to support women at high risk of high BMI and gestational weight gain to promote healthy pregnancies. Study Objectives: The objective of this study is to investigate the experiences of pregnant women living with HIV and obesity or other non-communicable diseases (NCDs) in regards to their diet, amount of physical activity, and their gestational weight gain. To meet this objective, we propose a secondary qualitative data analysis with the following specific aims: Aim 1: Explore personal experiences around day-to-day diet and physical activity in the context of pregnancy among women living with HIV (N=15). Aim 2: Investigate experiences around clinical guidance related to pregnancy complications Methods: All 15 participants were recruited from the Gugulethu Midwife Obstetrics Unit (MOU). Inclusion criteria consisted of i.) 18 years or older ii.) third trimester of pregnancy iii.) HIV-positive iv.) currently prescribed ART v.) diagnosed during current pregnancy with a complication indicative of an NCD (including pregnancy-associated obesity, hypertension, gestational diabetes, pre-eclampsia, cardiac disease, asthma, and anemia) vi.) speaks English or isiXhosa. Exclusion criteria consisted of: i.) self-reported participation in another ART adherence study and/or ii.) unable to understand consent process. The interviews focused on experiences of women living with HIV and obesity or other NCDs within the healthcare setting, women’s experiences engaging in health behaviors including HIV treatment adherence, health eating and exercising during pregnancy, perceptions about weight gain during pregnancy and plans for weight loss postpartum, as well as preparations for life with a newborn. Results: The data from this study showed that there are multiple disconnections between clinic nurses and HIV positive pregnant women that suffer from obesity and high blood pressure. The relationship the patients have with their nurses greatly contributes to their own health. Most of these women are not worried about their weight or are simply unaware of being obese. Clinic nurses also did not inform their patients of their excessive weight during routine checks. Another significant factor of availability of healthy foods were also limited for these patients either based upon location or socioeconomic status.
Notes:: Thesis (M. P. H.)--Brown University, 2022

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Citation

Edwards, Krystal, "Understanding Experiences of Diet, Exercise, and Gestational Weight Gain Among HIV Pregnant Women Living in South Africa - A Qualitative Analysis" (2022). Public Health Theses and Dissertations. Brown Digital Repository. Brown University Library. https://repository.library.brown.edu/studio/item/bdr:jhtfrh95/

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Public Health Theses and Dissertations

Theses and Dissertations for the Public Health department.
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