title: Social support among HIV-positive and HIV-negative adolescents in Umlazi, South Africa: changes in family and partner relationships during pregnancy and the postpartum period.
abstract: BACKGROUND
  Pregnancy is common among adolescents in South Africa, yet the social experiences of adolescents during the pregnancy and postpartum period remain understudied in this context. We aimed to explore how adolescent women's discovery and disclosure of both their pregnancy and HIV status affected their relationships with family members and sexual partners, with a particular focus on whether and how support changed throughout this time period.
  
  
  METHODS
  We conducted in-depth semi-structured interviews with 15 HIV-positive and HIV-negative adolescent women who were either pregnant or had delivered in the last 18 months from one urban clinic in Umlazi, South Africa. Interviews were audiotaped, transcribed, translated, and coded for analysis.
  
  
  RESULTS
  Young women described stress and instability in their relationships with family and partners during pregnancy and the postpartum period, though prior to and during HIV-status disclosure women generally experienced less stress than in disclosing their pregnancy to family members and partners. After a destabilizing period immediately following pregnancy disclosure, families became and remained the primary source of material and emotional support for the young women. Women discussed heightened closeness with their partners during pregnancy, but few women had close relationships with their partners postpartum. Support experiences did not differ by HIV status.
  
  
  CONCLUSIONS
  Programs should be aware of the relative importance of pregnancy-related concerns over HIV-related concerns in this population of young women. Engaging family members is critical in ensuring social support for this population of young pregnant women, and in encouraging timely initiation of antenatal care.
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. hilllm@email.unc.edu.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Hill
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. maman@email.unc.edu.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Maman
authors.affiliation: Department of Sociology, American University, Washington, DC, USA. groves@american.edu.
authors.forename: Allison K
authors.initials: AK
authors.lastname: Groves
authors.affiliation: Department of Obstetrics and Gynaecology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. Moodleyd1@ukzn.ac.za.
authors.forename: Dhayendre
authors.initials: D
authors.lastname: Moodley
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D030881:Disclosure; D005195:Family Relations; D005260:Female; D015658:HIV Infections; D006801:Humans; D007398:Interpersonal Relations; D010379:Peer Group; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011253:Pregnancy in Adolescence; D036301:Qualitative Research; D012747:Sexual Partners; D012944:Social Support; D013019:South Africa; D013315:Stress, Psychological