Managing everyday life: social service use by mothers with HIV infection

Abstract

This research focused on the service use of HIV-positive mothers. My aim was to explore service use from the perspective of users and potential users of voluntary and statutory social services for people with illY infection. This approach was prompted by the assumption I thought to underlie much of the much of the literature on illY services, namely, that once a need had been identified and a relevant service provided, and adequately publicised, it would be used.

I decided to adopt a case study approach focused on Edinburgh. The city, with its relatively high prevalence of HIV infection and density of social services, provided an excellent location for a contextualised exploration of service use. To deepen my knowledge of this context, and prepare for interviews with HIV-positive mothers, I first interviewed ten service providers including funders and representatives of statutory and voluntary, child-centred and adult-focused services.

My concern to explore the social processes, attitudes and experiences underlying the use and non-use of services informed my choice of qualitative methods. The study is primarily based on in-depth, semi-structured interviews with 12 women, who had lived with illY infection for between seven and 12 years. To reflect the unpredictability of living with a chronic condition interspersed with acute episodes, I decided to interview the respondents twice over the course of some months.

Drawing on the high level of intermediate analysis completed between the two interviews, the second interviews were also used to explore recurrent themes raised in the first interviews further, and to map the chronology of each respondent's service use against other important life events.

My findings attest to the importance of exploring chronic illness and service use in the context of wider social, familial and caring relationships, as well as socioeconomic circumstances. I focus on the relationship between service use and a continuing process of post-diagnosis identity reconstruction. My analysis of this process relates not only to the diagnosis itself, but explores several other sources of, or influences on, post-diagnosis identity construction, and the inter-relationships between them. These include motherhood, work, intimate relationships, informal support and participation in service decision-making. The theoretical and policy implications of these findings for the development of services are also addressed.