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This paper describes findings from an institutional ethnography that arose out of the concerns of women living with HIV in Ontario, Canada, regarding the disclosure of their HIV status while accessing perinatal care. The enquiry traces the connections between women's experiences of perinatal care, the activities of healthcare providers delivering such care and the ruling relations that organise women's experiences and healthcare providers' activities. Focusing on HIV disclosure as a concern expressed by women, the findings make visible the day-to-day, routinised practices of healthcare providers working in perinatal care for women living with HIV, as well as the ideological discourses of 'fear of contagion' and 'AIDS hysteria' that contributed to producing the kinds of care experiences that were articulated by women. Opportunities to strengthen perinatal care policies and practices for women living with HIV are discussed. [ABSTRACT FROM AUTHOR]

Women living with HIV (WLWH) are increasingly having children yet face complex medical and psychosocial issues in the perinatal period. The HIV Mothering Study sought to understand the psychosocial experiences and needs of mothers living with HIV across Ontario, Canada. The present study was a sub-analysis of interviews conducted with WLWH during pregnancy (n = 67) and at 3 months postpartum (n = 65) and aimed to describe the health care experiences of WLWH during the perinatal period. Narrative analysis revealed positive and negative health care experiences of WLWH and highlighted how relationships with providers affected women’s experiences navigating care. Positive care experiences were characterized by effective communication, feeling a sense of belonging, being heard, and accessible care. Negative care experiences were characterized by a lack of communication, silencing of mothers’ voices and experiences, stigmatizing care, and disregard for HIV confidentiality. Implications for practice, policy, and research across individual, service, and macro systems are discussed. [ABSTRACT FROM PUBLISHER]