| INDIVIDUAL |
Fear/Anxiety about HIV status |
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I.1: I just was scared, because we never know if we have it [HIV] or not, if we get it or not. What way we could get it. Because it could be hidden. I never had been tested. (25 yo, received HIV VCT during prenatal care)
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I.2: All [testing results] were negative, thank God. My worries were through the roof. (32 yo, received HIV VCT)
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| Stigma and Discrimination seen against HIV infected individuals |
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I3: I know that nowadays it [HIV] is a disease we can live with, but it brings many complications, plus there is all the prejudice..... I don’t know, maybe I would be more resistant to giving care for my child out of fear. I am the do-it-all kind of person, so I always have my hands hurt. I could transmit it. (43 yo, did not attend prenatal care)
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I4: Don’t even joke! Even more when other people know. I know that in my neighborhood there is a man who has it [HIV], and nobody wants to stay close to him. It’s bad. It changes many things. He doesn’t treasure anything.... I can’t tell, but I wouldn’t want to be around anyone if I had HIV… If I knew I had it and she didn’t, I would leave. I couldn’t consider transmitting it to her[wife. (23 yo, received HIV VCT during prenatal care)
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| Unaware of the increased risk of HIV transmission and acquisition during pregnancy |
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I5: I believe the risk [of transmission] is the same; the risk is passing it on to the child. (33 yo, attended prenatal care, not offered HIV VCT)
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| Assumption that man’s HIV status is the same as women’s/children’s status |
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I6: They did a lot of tests on her, and if she doesn’t have it I don’t have it, even though I never tested. (18 yo, did not attend prenatal care)
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| RELATIONSHIP |
Contentious relationship with arguments about jealousy and money matters |
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R1: She is jealous of my own mother, of my family; she says I give more attention to them, and don’t give her. But I don’t know if that is related to the pregnancy, like hormones. It was one of the motives that lead us to split up. (29 yo, did not attend prenatal care)
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R2: I won’t say it’s [relationship] great. We have some arguments because of the jealousy, lots of discussions. We don’t fight in a physical sense, but we have our daily arguments. (35 yo, did not attend prenatal care)
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R3: She always charged me because of work. That I was going to complete 8 months of unemployment. I didn’t have formal work, but I was doing some gigs. It wasn’t [enough] to support the family, pay the land where we live, it’s hard, even more with the crisis. So when I found work, it got better. (18 yo, did not attend prenatal care)
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| Man not involved in planning pregnancy or unplanned pregnancy |
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R4: No, none of our kids were planned…Children for me are blessings, they were never punishments. They are gifts from God. He gave me to raise them, they are extensions of what I am; I put 4 seeds that represent that in this world. But now I have to get a vasectomy. (43 yo, did not attend prenatal care)
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R5: I was suspicious, didn’t know if it was true, because we already had a miscarriage, I felt betrayed; our intention was to plan, for her to take care, at first I got surprised, but still was involved a lot; the second time I felt betrayed, there was no way it could be accidental. (29 yo, did not attend prenatal care)
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| Concerns about money/costs of baby during pregnancy |
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R6: I always worry about that [finances]. We started gathering money, opened a bank account, so that nothing would lack at home. We always worry. There is no way of knowing what will happen. Then for any emergency we have some money saved. |
Interviewer: Did you have any concerns over the baby’s health?
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| There are concerns, because we don’t know what will happen, but I was more worried with the financial part than with the health part. (27 yo, did not attend prenatal care)
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| SYSTEM |
Not feeling “invited” to prenatal care |
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S1: Sometimes the man goes but stays in the waiting room and the mother has the consultation by herself. I went once to a consultation, but I didn’t enter the room. The doctor saw me but didn’t invite me in and I didn’t go. (26 yo, received HIV VCT at prenatal care)
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S2: Just by inviting to take the test. When both parents go to the consultation together, or when the mothers go by themselves, offer a brochure to invite the father. (32 yo, attended prenatal care but not offered HIV VCT)
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| Inability to miss work because of financial repercussions |
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S3: I would go, but we would have to see about the schedule, because I work and I can only miss it if it’s extremely necessary. If she didn’t have any way to go by herself. Because I have bonus payments at work if I arrive on time, if I’m not late. But I’ll lose it if I have to go to the health unit. (29 yo, did not attend prenatal care)
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| History of prior bad experiences with local health units/Sistema Unico de Saude (Brazilian national Health System) |
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S4: Yes, unfortunately SUS [Brazilian national health system] is very treacherous. It is efficient in some cases for example; today that my wife went into labor and was very well handled. I got no complaints there. But for my situation [man has high blood pressure] I do have a complaint, because it has been eight months that I have booked but it has not even been confirmed. I researched it, and it may be eight, nine months, or even a year before I know what has happened to me. I take controlled medicines and my blood pressure has stabilized so I stopped worrying so much, not to the point of exaggeration nor not worrying at all, and that reduced the symptoms I had. (21 yo, received HIV VCT)
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S5: I have nothing against Cuban doctors. However, during consultation, they don`t understand they don`t explain it…We asked two even three times, and she said the same thing, we couldn`t hear the heartbeat because she said the device was broken and had no battery. Anyway, she [Cuban doctor] looked fine, she was there, but she didn`t look like she wanted to be there. (26 yo, received HIV VCT)
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| Concerns over health insurance/costs |
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S6: I was [covered], but it was through private insurance and I wasn’t working, I only had the money for the appointment, not for the exams. (18 yo, did not attend prenatal care, diagnosed with gonorrhea, but never received HIV VCT)
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| Lack of non-needle/non-clinic options |
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S7: There are a lot of coward men, who are afraid of needles, I think it could help then; you would do it there and then, unless you had to take it to a lab or doctor. But I believe most don’t do it from fear of the results. (28 yo, attended prenatal care, but not offered HIV VCT)
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S8: I’m not going to say needles, but of going to the doctor in general, only if I’m really bad. I have a thing with white coats, (28 yo, did not attend prenatal care)
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