Dr. Jessica Jerome will undertake anthropological research on how culture affects reproductive decision-making among mothers with HIV in Fortaleza, Brazil. An HIV-positive woman carries a significant (~20 to 30%) probability of transmitting infection to a newborn. With appropriate treatment, this rate can be cut in half. Even where this treatment is free and readily available, there are instances where women opt not to pursue prophylaxis. Prior research based in the United States indicates that multiple cultural factors influence a woman's decisions. However, little attention has yet been paid to how different cultural contexts might affect this behavior. The hypothesis of the proposed study is that the cultural norms in Northeastern Brazil surrounding maternal sentiment, social networks, and the Universal HIV treatment program established in Brazil in 1996, will all strongly inform women's reproductive and medical decision-making.
In order to test this hypothesis, the researcher will travel to Brazil for two summers of research. She will conduct in-depth, semi-structured interviews with women in Fortaleza, Brazil, who have borne one or more children after knowledge of a positive HIV diagnosis. The results of these interviews will then be compared with the findings of a prior study, conducted by the PI and four other authors, on a cohort of HIV positive mothers in Chicago, Illinois. By providing in-depth, qualitative data about HIV positive women's motivations to bear children and receive medical treatment in Fortaleza, Brazil, the study will make an important contribution to the growing body of literature on how cultural norms and values shape the choices that women make during important life events. This comparative study of reproductive and medical decision-making among Brazilian and American women with HIV and could also lead to more culturally appropriate, and thus more effective, treatment options. The research will also engage undergraduate students from St. John's College, Santa Fe, through development of research seminars connected to this project and by taking an undergraduate student to Brazil as a research assistant. The research thus will help to develop the social science research curriculum in an undegraduate institution, which qualifies the project as one promoting Research in Undergraduate Institutions (RUI).
