Vertically transmitted HIV+/AIDS: The impact on maternal attachment

Sharon E. Walker (1996)

Women comprise the fastest growing group of People with AIDS in the United States. The majority of women with AIDS, at this time, are Latina or African-American, and live in areas where poverty and crime are prevalent. Vertically transmitted HIV+/AIDS is expected to become a leading cause of childhood death in the next decade. Research on HIV+/AIDS has largely ignored mothers' psychological reactions to the disease trajectory or to vertical transmission. This qualitative study elucidated womens' psychological sequelae to this catastrophic illness, and the impact of seropositivity on attachment, by interviewing thirteen women with HIV+/AIDS, whose children had either died as a result of AIDS, were living with AIDS, or were potentially seropositive. The major findings of the study indicate that most women with AIDS live in isolation and fear of disclosure, as they contend with the disease sequelae; yet are desirous of talking about their AIDS-related feelings. Regardless of prior risk behavior, most of the women were "shocked" when diagnosed with HIV+/AIDS. Psychological sequelae were related to the disease trajectory, available support, and the development of a "will to live". Although abortion was prenatally suggested, the majority considered it to be tantamount to "killing." The women reported that they experienced greater distress when learning of their child's seropositivity, than their own. Regardless of the phase of psychological integration of the disease process, maternal attachment remained intensified with children with AIDS, or whose seropositivity was uncertain; mothers reported neglecting their own needs to care for their children. The women reported that AIDS-related exhaustion, and the physical symptoms of other AIDS-related illnesses, often prevented them from providing optimal care to their children. Mothers looked to children who were not seropositive (who were as young as 8-years-old) for assistance with household tasks, for care giving their younger siblings, and for emotional support.