A BIOETHICS ANALYSIS OF COUPLES' PERCEPTIONS WHEN FACING AN HIV+ PREGNANCY

Anamaria Ferreira AZEVEDO
Nursing Department, Centro Universitario Euro-Americana

Dirce GUILHEM
College of Health Sciences, University of Brasilia

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     Last modified: April 16, 2006

Abstract
INTRODUCTION AND OBJECTIVE: The aim of this study is to analyze perceptions of the experience of bonding in couples which the woman is HIV-positive and pregnant, attempting to identify their perspectives in facing the disease. The theoretical axis focuses on feminist critical bioethics and on gender studies in order to look into the woman's vulnerability and her outlook on gender differences.
METHODS: This qualitative study was carried out on 14 couples by means of open interviews; the material was analyzed according to the technique of content analysis.
RESULTS: It was possible to verify the vulnerability of the HIV-positive expectant woman with regard to the bonding profile, according to the gender differences that mark the course of their lives and the overall situation they are facing. Patterns of bonding include culturally accepted standards, such as romantic love, the ideal of motherhood, the male life project as understood by the woman, which implies low self-esteem and insufficient care for herself. The female ethos takes on the role of responsibility as main care provider for the other, without much of a return on behalf of the woman herself, who expresses changing needs. Pregnancy is strained by the pressure caused by the fear of vertical transmission and the instability of the relationship with her spouse, despite representing a perspective for the future. The man is also vulnerable in relation to his own moral standings, mainly due to the disease. When test results clash, he will waver between the morally judgmental role and dutiful solicitude, while the woman will fear abandonment.
CONCLUSION: The experience of the disease is unique to each couple, as it brings out divergence and triggers conflict, although it may also foster commitment, contributing towards reflection and reorganization, at the individual level, as well as within the relationship. It also signals to the need for further investigation on the affective world concerning the situation of AIDS.

Key Words: gender, feminist bioethics, HIV/Aids, aids during pregnancy, connubial vulnerability