Identifying barriers to ART initiation and adherence: An exploratory qualitative study on PMTCT in Zambia

Background Though antiretroviral therapy (ART) is widely available, HIV positive pregnant women in Zambia are less likely to start and remain on therapy throughout pregnancy and after delivery. This study sought to understand readiness to start ART among HIV pregnant women from the perspectives of both women and men in order to suggest more holistic programs to support women to continue life-long ART after delivery. Methods We conducted a qualitative study with HIV positive pregnant women before and after ART initiation, and men with female partners, to understand readiness to start lifelong ART. We conducted 28 in-depth interviews among women and 2 focus group discussions among male partners. Data were transcribed verbatim and analyzed in NVivo 12 using thematic analysis. Emerging themes from the data were organized using the social ecological framework. Results Men thought of their female partners as young and needing their supervision to initiate and stay on ART. Women agreed that disclosure and partner support were necessary preconditions to ART initiation and adherence and, expressed fear of divorce as a prominent barrier to disclosure. Maternal love and desire to look after one’s children instilled a sense of responsibility among women which motivated them to overcome individual, interpersonal and health system level barriers to initiation and adherence. Women preferred adherence strategies that were discrete, the effectiveness of which, depended on women’s intrinsic motivation. Conclusion The results support current policies in Zambia to encourage male engagement in ART care. To appeal to male partners, messaging on ART should be centered on emphasizing the importance of male involvement to ensure women remain engaged in ART care. Programs aimed at supporting postpartum ART adherence should design messages that appeal to both men’s role in couples’ joint decision-making and women’s maternal love as motivators for adherence.

Exacavating the Memory of Slavery in Léonora Miano’s La Saison de l’ombre (2013) and Toni Morrison’s Beloved (1988)

Regarded as a state of servitude through which an individual or a group of persons is compelled to work their guts out without any possibility to get compensated or rewarded, slavery, for some centuries, had been implemented under various forms from one country to another. From the antiquity to the twentieth century, thralldom had been a profitable business that gangrened the African continent. Thus being, African and African American thinkers shoulder the mission to dust archives and lift the curtain of history to retell and re-narrate the episode of drudgery; among them Leonoa Miano and Toni Morrison. The purpose of this article is to examine the trauma of slavery from a comparative, matrifocal, and Afrocentric perspective so as to highlight commonalities and differences between Leonora Miano’s La Saison de l’ombre and Toni Morrison’s Beloved. Inspired by the infamous history of slavery, these two award-winning novels not only conjure up the ordeal of slavery, but they also catalyze its haunting memory for the sake of healing, so that both characters and readers could be cleansed off its tantalizing grip and achieve catharsis and redemption. To this end, La Saison de l’ombre and Beloved are woven around feminine counter-narratives that exhibit counter-memories which are often glossed over or overlooked in both African and Euro-American phallocentric official narratives. Whereas La Saison de l’ombre spotlights the Africans’ role in the process of slavery, Beloved highlights the tragedy of a maternal love in a context of bondage. Through a comparative approach, we have spotlighted the whole process of slavery, from the captivity in Africa to enslavement in America.

Achille tra le rose (negli anni di Napoleone). Femminilizzazione del guerriero nella Penthesilea di Heinrich von Kleist

The hypothesis I advance in this article is that the character of Achilles in Heinrich von Kleist’s Penthesilea embodies the Object of desire of the female protagonist, the queen of the Amazons. By the word “Object”, I mean the interiorised and imaginary representation Penthesilea phantasises within herself about an otherwise unknown “thing” desired which finally takes the feminine features of a tender and harmless boy wearing crowns and garlands of roses, an “Achilles among the roses”, as it were – the word “rose” being both the anagram of “eros” and the emblem of the female sex. In the course of the analysis, I argue that this “mirage” of Penthesilea, the “thing desired”, is the projection of the “Thing itself”, maternal love, which, being unredeemedly lost to her, turns into a persecutory ghost. My understanding of von Kleist’s Penthesilea is not rooted in Freudian and Lacanian psychoanalysis, but both in the historical and political context in which the tragedy of the queen of the Amazon was conceived and in the transcendental and idealistic philosophy of the Subject.

Autism ‘Super Mums’: Affectivity as a Political Capital in Special Mothering and Autism Advocacy

From the refrigerator mother theory to more recent comparisons to ‘warrior-heroes’, mothers of children with autism spectrum disorders have been historically categorised as emotionally remarkable. Drawing on my ethnographic fieldwork in Portugal, I explore in this article how mothers politically mobilise emotions, characteristics, and acts usually associated with good mothering, such as maternal love, dedication, and sacrifice. While these socially expected phenomena have been addressed as instruments of the relegation of women to motherhood and care labour, I propose a novel look at the value of affectivity in discourses and practices of care and advocacy. I argue that mothers strategically embody and employ their affectivity as political capital to validate their role as expert caregivers and advocates, creating new opportunities to access leading positions within the autism advocacy movement.

Maternal Love in Willa Cather’s Shadows on the Rock (1931)

Maternity is the primary obsession that haunts Cecile’s character in Willa Cather’s Shadows on the Rock (1931). Unable to decide what to go for, Cecile finds it impossible to leave without having Jacques, a person whom she has been taking care of and compensating him with the care he really needs. His mother could not provide him with the motherly love that Jacques needs as a little child like any other children of his age. Therefore, Cecile undertakes the maternal responsibility and provides him with the attention that he lacks from his mother. The relationship between Cecile and Jacques is a mother and child relationship. We understand this theme throughout the whole novel and through multiple examples and situations we encounter when reading the novel. It is a huge responsibility that Cecile takes and shoulders as she performs this difficult role into giving the maximum maternal care to a little child.

Love, maternal love, romantic love, depressive love: a psychoanalytic perspective

This article presents a history of ideas about the origins of love as a universal human experience, beginning with Freud's formulations and expanding concepts in the light of findings about the role of attachment and love in the earliest relationship between mother and baby. Conceptualisations based on the work of Klein, Winnicott, and Bion are linked to recent findings from neuroscience to arrive at a more complex conceptualisation of the origins and role of love for mothers, fathers, children and adults.

Identifying Barriers to Disclosure to Overcome Barriers to ART Initiation: An explanatory qualitative study on PMTCT in Zambia

BackgroundThough antiretroviral therapy (ART) is widely available, HIV positive pregnant women in Zambia are less likely to start and remain on therapy throughout pregnancy and after delivery. This study sought to understand readiness to start ART among HIV pregnant women from the perspectives of both women and men in order to suggest more holistic programs to support women to continue life-long ART after delivery.MethodsWe conducted a qualitative study with HIV positive pregnant women before and after ART initiation, and men with female partners, to understand readiness to start lifelong ART. We conducted a total of 28 in-depth interviews among women and 2 focus group discussions among male partners. Data was transcribed verbatim and analyzed in NVivo 12 using thematic analysis. Emerging themes from the data were organized using the social ecological framework.ResultsMen thought of their female partners as young and needing their supervision to initiate and stay on ART. Women agreed that disclosure and partner support were necessary preconditions to ART initiation and adherence and expressed fear of divorce as a prominent barrier to disclosure. Maternal love and desire to look after one’s children instilled a sense of responsibility among women which motivated them to overcome individual, interpersonal and health system level barriers to initiation and adherence. Women preferred adherence strategies that were discrete, the effectiveness of which, depended on women’s intrinsic motivation.ConclusionThe results support current policies in Zambia to encourage male engagement in ART care. To appeal to male partners, messaging on ART should be centered on emphasizing the importance of male involvement to ensure women remain engaged in ART care. Programs aimed at supporting postpartum ART adherence should design messages that appeal to both men’s role in couples’ joint decision-making and women’s maternal love as motivators for adherence.