Creating continuity out of the disruption of a diagnosis of HIV during pregnancy

AIM: To understand the uniqueness of the experience of testing HIV positive from the perspective of pregnant women.

BACKGROUND: As more people learn of their HIV diagnosis through routine screening processes, it is timely to reflect on the impact of receiving an unexpected positive result.

DESIGN: A prospective qualitative study.

METHODS: This paper draws on the case studies of four women who were participating in a larger prospective qualitative study of reproductive decision-making, pregnancy and childbirth following HIV diagnosis. Multiple interviews were conducted following diagnosis during pregnancy, and, after the birth of their babies. Thematic data analysis was undertaken.

RESULTS: Drawing on Becker's theory of disruption, we document the 'sudden disjuncture' of their antenatal diagnosis and the embodied emotional struggle the women engaged in to create continuity in their lives. A diagnosis of HIV disrupted the women's biographies in terms of their health, relationships and social identity. As pregnant women, the threat of HIV was experienced most significantly in relation to their unborn child. However, their narratives also revealed how a diagnosis of HIV in the context of pregnancy, whilst traumatic, provided a focus for regaining continuity in their lives, as the baby became a metaphor for hope and orientation toward the future.

CONCLUSIONS: As HIV testing becomes more 'routine', the findings of this study serve to remind health professionals that a positive diagnosis continues to constitute a major trauma to individuals and families.

RELEVANCE TO CLINICAL PRACTICE: We propose that appropriately educated nursing and midwifery staff could facilitate the 'meaning making' process that is required for newly diagnosed HIV positive persons to find a subjective sense of well-being in their lives.

Ruling out a massive asymptotic giant-branch star as the progenitor of supernova 2005cs

We calculate the predicted UBVRIJHK absolute magnitudes for models of supernova progenitors and apply the result to the case of supernova 2005cs. We agree with previous results that the initial mass of the star was low, around 6 to 8 M-circle dot. However, such stars are thought to go through a second dredge-up to become asymptotic giant branch (AGB) stars. We show that had this occurred to the progenitor of 2005cs it would have been observed in JHK pre-explosion images. The progenitor was not detected in these bands and therefore we conclude that it was not an AGB star. Furthermore, if some AGB stars do produce supernovae they will have a clear signature in pre-explosion near-infrared images. Electron-capture supernovae are thought to occur in AGB stars, hence the implication is that 2005cs was not an electron-capture supernova but was the collapse of an iron core.