Culturally sensitive care

Culture can impact on communication styles, health beliefs and attitudes towards health care. For example, in some cultures, particularly African, choosing not to breastfeed or to have a caesarean section can arouse suspicion. Alternatively, for some HIV positive women, choosing to become pregnant, as is the accepted cultural norm for women in some cultures, provides protection from suspicion. Experiences of HIV in pregnancy may differ with cultural differences due to variation in beliefs, customs and possible language barriers. The following are some examples.

Here Sue talks about the implications of the culture in her home country: how people would think about her being HIV positive, the dishonour to her family, the neccessity to keep her HIV status a secret and therefore the impact on her ability to access treatment if she returned home....

Different cultural values and behaviours e.g. the high rate of breastfeeding in African cultures, can lead to anxiety for the woman who has to answer to friends and family why she is bottle feeding. In Africa, bottlefeeding and collection of free formula can stigmatise the woman as HIV positive, therefore pressure from family and friends may impact on adherence to advice on avoidance of breastfeeding.

Rachel demonstrates the personal turmoil of trying to produce a believable cover story to explain why they are bottlefeeding their baby...

Every attempt should be made to optimize understanding of information, facilitate enquiry and provide literature by utilising interpreters/interpreting services which the woman/man feels comfortable with.

Overall, consideration needs to be given to beliefs, customs and language barriers to provide culturally sensitive reproductive care in the context of HIV and optimize physical, mental and emotional health outcomes.

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