title: Creating continuity out of the disruption of a diagnosis of HIV during pregnancy.
abstract: OBJECTIVE
  To understand the uniqueness of the experience of testing HIV positive from the perspective of pregnant women.
  
  
  BACKGROUND
  As more people learn of their HIV diagnosis through routine screening processes, it is timely to reflect on the impact of receiving an unexpected positive result.
  
  
  METHODS
  A prospective qualitative study.
  
  
  METHODS
  This paper draws on the case studies of four women who were participating in a larger prospective qualitative study of reproductive decision-making, pregnancy and childbirth following HIV diagnosis. Multiple interviews were conducted following diagnosis during pregnancy, and, after the birth of their babies. Thematic data analysis was undertaken.
  
  
  RESULTS
  Drawing on Becker's theory of disruption, we document the 'sudden disjuncture' of their antenatal diagnosis and the embodied emotional struggle the women engaged in to create continuity in their lives. A diagnosis of HIV disrupted the women's biographies in terms of their health, relationships and social identity. As pregnant women, the threat of HIV was experienced most significantly in relation to their unborn child. However, their narratives also revealed how a diagnosis of HIV in the context of pregnancy, whilst traumatic, provided a focus for regaining continuity in their lives, as the baby became a metaphor for hope and orientation toward the future.
  
  
  CONCLUSIONS
  As HIV testing becomes more 'routine', the findings of this study serve to remind health professionals that a positive diagnosis continues to constitute a major trauma to individuals and families.
  
  
  CONCLUSIONS
  We propose that appropriately educated nursing and midwifery staff could facilitate the 'meaning making' process that is required for newly diagnosed HIV positive persons to find a subjective sense of well-being in their lives.
authors.affiliation: Sexual Health Services, South Eastern Health and Social Care Trust and School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK. carmel.kelly@setrust.hscni.net
authors.forename: Carmel
authors.initials: C
authors.lastname: Kelly
authors.forename: Fiona
authors.initials: F
authors.lastname: Alderdice
authors.forename: Maria
authors.initials: M
authors.lastname: Lohan
authors.forename: Dale
authors.initials: D
authors.lastname: Spence
mesh_terms: D003266:Continuity of Patient Care; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011446:Prospective Studies