BOX 1—

Operational Definition of Coding Categories for “What Matters Most” and Structural Vulnerability

Category	Operational Definition
Cultural capabilities that “matter most” to womanhood (“what matters most”)	Participating in the activities or capabilities that determine “personhood” (or “womanhood”) in Botswana by achieving full status as a woman including (but not limited to) being a mother, which involves bearing, raising, and caring for children; caring for and respecting her husband; and ensuring the well-being of the household.
How “what matters most” shapes HIV stigma	The ways in which the stigma of being identified as having HIV, via attributions of promiscuity and immorality, exerts its effects by threatening the capabilities that determine “full womanhood” in Botswana, including (but not limited to) being a mother, caring for her husband, and ensuring the well-being of the household. Includes core mechanisms that enabled culturally based stigma to persist, and ways in which these mechanisms impaired antiretroviral therapy adherence.
How achieving “what matters most” protects against HIV stigma	The ways in which achieving cultural capabilities can protect against HIV stigma; in other words, how HIV stigma can be potentially mitigated if a woman with HIV in Botswana fulfills the capabilities of being a “good mother” (including, but not limited to, bearing and raising children in culturally endorsed ways). Includes other ways in which stigma and attributions of promiscuity were contested outside of motherhood.
Structural vulnerability (health care policies reinforcing vulnerabilities)	The ways in which health care policies can inadvertently reinforce and intensify the marginalization associated with HIV identification to locate women differentially within disadvantaged hierarchical positions, either in the health care system or society at large. This includes the internalization of attributed devalued status via behaviors and self-concept.