Experiences of human immunodeficiency virus-positive postpartum women in Angola: Challenges and opportunities in preventing vertical transmission

Abstract

Background: Despite advances in the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV), challenges persist in retention in care, antiretroviral therapy (ART) adherence and follow-up of HIV-exposed infants, particularly postpartum. In Angola, qualitative evidence on women’s lived experiences remains limited.
Aim: To explore the experiences of HIV-positive postpartum women and identify opportunities to strengthen PMTCT services in Angola.
Setting: The study was conducted at Lucrécia Paim Maternity Hospital, a major maternal and child health referral centre in Luanda, Angola.
Methods: A qualitative study with an experiential orientation informed by phenomenological sensitivity was conducted between April 2025 and July 2025. Semi-structured interviews were conducted with 20 women up to 6 months postpartum, recruited through purposeful sampling from institutional records. Interviews were transcribed verbatim and analysed using reflexive thematic analysis following Braun and Clarke, supported by qualitative data analysis (MAXQDA) software.
Results: Four themes emerged: discovery and acceptance of diagnosis, marked by emotional distress and gradual adaptation; pregnancy and childbirth, characterised by supportive care and episodes of stigmatisation; postpartum and baby care, involving heightened responsibility and challenges with medication and infant feeding; and infant testing, experienced with anxiety until confirmation of serological status. Post hoc comparisons by age group and partner status suggested variations in psychosocial needs and care experiences.
Conclusion: Postpartum PMTCT is influenced by emotional, relational and institutional determinants affecting continuity of care. Strengthening integrated, woman-centred models with psychosocial support, consistent communication and stigma reduction is essential.
Contribution: This study provides context-specific qualitative evidence to improve postpartum PMTCT services in Angola and similar settings.