Table 3.

Meta-themes, themes, and subthemes

Meta-themes	Themes	Sub-themes
Shattered Identity	Womanhood	I’m shocked
		I don’t feel like a woman anymore
		Permanence of HIV
		Loss of normality
		Broken plans
		Reduced sexual desire
	Motherhood	Becoming mothers as a route to normality
		Missed mothering opportunities
		Motherhood as a social responsibility
		Motherhood as a personal desire (value and identity)
Barriers, Inequities, and Misinformation	System barriers	External barriers preventing access to care
	Clinician barriers	Negative support from healthcare providers
		They never asked me if I want to have a baby
		Coercion and concealment
	Inadequate information	Need for information
		Weighing the different options
	Individual barriers	Knowing about HIV
		Knowing about conception methods
		Incorrect beliefs about HIV and pregnancy
		Uncertainty and fears	Fear of transmission
			Fear of birth defects
			Fear of leaving children alone
		Guilt
	Family barriers	Lack of familial support
	HIV-related stigma	Stigmatizing and stereotyping
		Self-isolating and internalizing stigma
		Fear to disclose, will be rejected
	Gender-based inequalities	I just want to be loved
		Unequal power in relationships
	Socioeconomic barriers	Unstable situation
Coping, Resilience, and Support	Self-care and for caring others	Treatment adherence
		Changes in sexuality: protecting others from HIV
		Negotiating sex
		Family planning	Planned pregnancy
			Accidental/passive pregnancy
			Avoiding recommendations
			Child HIV + because of destiny
	Creating empowering environments
	Humanized healthcare providers
	Partner support
	Hope	Medical improvement as a hope
		Motherhood is a hope and being a mother is reason to keep fighting HIV
		A new life: second opportunity, another chance
	Personal Choices
	Protection of higher power/spiritual forces