UCSF

The purpose of this prospective, longitudinal repeated measures study was to explore the relationships between HIV-infected mothers' perceptions of uncertainty about infant HIV serostatus and maternal stress, distress, and social support during the infants' HIV viral testing. HIV-infected women were eligible to participate if they were at least 18 years old, English speaking, and were the primary caretaker for their infants. Six study visits were required: a visit during the third trimester of pregnancy and 5 postpartum visits clustered around infants' second and final HIV viral testing. Data collection included maternal and infant demographics, clinical variables, standardized questionnaires, and maternal responses to questions addressing their most worrisome concern. During the final study visit, maternal interviews about their infants' HIV testing were audiotaped and transcribed. Descriptive statistics, Pearson's r, and RMANOVA were used to analyze quantitative data; qualitative methods were used to analyze interviews.

Twenty mothers enrolled: 40% African American, 40% white, 10% Hispanic, 10% Native American/Other; mean age = 32.25 years; mean education = 14.5 years. All infants in the study were determined to be HIV negative. Mothers were most concerned about infant health during the prenatal and early postpartum period. While infant concerns diminished after the second negative HIV test they rebounded prior to obtaining the final viral test. Family and psychosocial issues were the primary maternal concerns after infant viral testing was completed. Maternal health issues never surpassed infant or psychosocial issues as a primary concern. There was a significant decrease in maternal uncertainty about infant HIV serostatus over time (p<.001). Mothers with depressive symptoms (50%) demonstrated significantly more uncertainty after receiving results for the second viral test (p =.03). There was a strong inverse correlation between social support and uncertainty (r = -.67, p<.001), stress (r = -.79,

p<.001), distress (r = -.65, p<.01), and depression (r = -.68, p<.001). Maternal uncertainty about infant health declined significantly over time. Once infant viral testing was completed, mothers focused on issues other than their own health. Increased social support and other clinical interventions may reduce the uncertainty, stress, and distress HIV-infected mothers experience during infant HIV viral testing.

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