The current study employed narrative research design. The purpose of the research was to investigate the association between Intimate Partner Violence (IPV) and HIV adherence to PMTCT interventions (Hatcher et al., 2016). Narrative research design was the most appropriate method for addressing the purpose of the study. In this design, researchers examine the real-life experiences of the participants through stories told by the respondents. Because the variables being studied could not be measured numerically, narrative research offered a useful of having an in-depth description of the respondents experience as well as the meanings derived by the participants from these experiences. Moreover, narrative design helps to understand processes that merge over time, such as IPV.
In the present study, the predictor variable was intimate partner violence (IPV) influence pregnant while the outcome variable was postpartum women's adherence to PMTCT. Both of these variables are qualitative, hence were best addressed using a qualitative research design. More specifically, the use of narrative design made it possible for the participants to tell their story resulting in the development of a theory useful in understanding the practices and concerns of women experiencing IPV and how violence affect adherence to PMTCT. It is worth noting that narrative approach helps in silent amplifying voices. More specifically, it helps to access rich layers of information that cannot be obtained through close-ended questions.
In conducting the present study, the authors justified the use of narrative research design. Specifically, the researchers posited that the use of narrative design when discussing IPV experiences is helpful because it serves as a form of reflection for participants. Additionally, the researchers argued that through narrative methodology in IPV research, coherence is achieved in otherwise chaotic, uncontrollable situations.
The Central Phenomenon; Participants; Research Site; And Conceptual Framework
The sample for this study comprised of 32 participants. The participants were sampled for the study using purposive sampling technique. Purposive sampling was appropriate for this study because the variables being studied, especially IPV, could not be manipulated because of ethical and practical reasons. Also, the use of a purposive sample was appropriate because it enabled the researchers to pick members of the sample based on their unique characteristics. In this case, the characteristics of interest were women experiencing IPV and living with HIV. The participants picked for this study were appropriate since they contained the necessary traits relevant to the purpose of the study and the variables of the study. The setting of this study was Johannesburg, South Africa. Because of this, the participants were recruited from four antenatal clinics in Johannesburg. Johannesburg was the most appropriate context for the present research due to its high prevalence of prenatal HIV, a 29% (Hatcher et al., 2016).
This research was guided by a conceptual framework. The socio-ecological framework applied to both infant and maternal health. According to the framework, individual, relationship, and structural factors determine health outcomes. The framework has been found to be useful in IPV studies because it integrates many complex factors that have an impact on partner violence. In this model, individual factors refer to the personal attributes or behaviors that impact an individuals health. In IPV and HIV research some of these factors include stigma, depression, and costs related to attendance of clinics. On the other hand, partner relationship factors were conceptualized as a males failure to participate in antenatal care, the threat of future violence, and non-disclosure to a partner. These factors were posited to aggravate PMTCT behaviors. Within this framework, the relationship between partner factors and PMTCT uptake were explained using the theory of gender and power which hypothesizes that unequal power relationships undermine the ability of women to have control in intimate relationships. Lastly, structural factors include the broader societal factors that affect health. They include poor health systems, the absence of social support, stigma, and poverty. These factors were posited to affect PMTCT adversely. The model posits that the same structural factors explain IPV and HIV and that societal factors affect womens adherence to HIV medication as well as the degree to which they undergo IPV (Hatcher et al., 2016).
The conceptual framework used in this study seems to be appropriate because it captured the major features of the model thus it is easy to understand the conceptual basis of the study. The framework is also consistent with the purpose of the study and this appropriate for this research. All the relevant concepts and variables can also be easily identified within the socio-ecological framework.
Data analysis revealed four pathways associated with women's experience of IPV and their ability to adhere to PMTCT interventions. First, partner disclosure made women to hide their HIV status. Specifically, violence in a relationship was found to lead women hiding their HIV statuses. Second, mental health, especially depression associated with IPV led to missed medication. Third, partner control and isolation, which delinked women with social support need for good adherence was blamed for non-adherence. Lastly, coping strategies for adhering to treatment, especially motherhood, helped women to adhere to the medications (Hatcher et al., 2016).
Hatcher, A. M., Stockl, H., Christofides, N., Woollett, N., Pallitto, C. C., Garcia-Moreno, C., & Turan, J. M. (2016). Mechanisms linking intimate partner violence and prevention of mother-to-child transmission of HIV: A qualitative study in South Africa. Social Science & Medicine, 168, 130-139.
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