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Table 3 Meta-themes, themes, and subthemes

From: Motherhood and decision-making among women living with HIV in developed countries: a systematic review with qualitative research synthesisMaternidad y toma de decisiones en mujeres que viven con el VIH en países desarrollados: una revisión sistemática con síntesis de investigación cualitativa

Meta-themes Themes Sub-themes
Shattered Identity Womanhood I’m shocked
I don’t feel like a woman anymore
Permanence of HIV
Loss of normality
Broken plans
Reduced sexual desire
Motherhood Becoming mothers as a route to normality
Missed mothering opportunities
Motherhood as a social responsibility
Motherhood as a personal desire (value and identity)
Barriers, Inequities, and Misinformation System barriers External barriers preventing access to care
Clinician barriers Negative support from healthcare providers
They never asked me if I want to have a baby
Coercion and concealment
Inadequate information Need for information
Weighing the different options
Individual barriers Knowing about HIV
Knowing about conception methods
Incorrect beliefs about HIV and pregnancy
Uncertainty and fears Fear of transmission
Fear of birth defects
Fear of leaving children alone
Family barriers Lack of familial support
HIV-related stigma Stigmatizing and stereotyping
Self-isolating and internalizing stigma
Fear to disclose, will be rejected
Gender-based inequalities I just want to be loved
Unequal power in relationships
Socioeconomic barriers Unstable situation
Coping, Resilience, and Support Self-care and for caring others Treatment adherence
Changes in sexuality: protecting others from HIV
Negotiating sex
Family planning Planned pregnancy
Accidental/passive pregnancy
Avoiding recommendations
Child HIV + because of destiny
Creating empowering environments
Humanized healthcare providers
Partner support
Hope Medical improvement as a hope
Motherhood is a hope and being a mother is reason to keep fighting HIV
A new life: second opportunity, another chance
Personal Choices
Protection of higher power/spiritual forces