Knowing but not knowing: providing maternity care in the context of HIV/AIDS in rural Zimbabwe.

Individual interviews with 25 nurses and midwives revealed their experiences with providing maternity care in rural Zimbabwe. These first-hand accounts especially illuminate the complexities of providing maternity care in the context of HIV/AIDS. The caregivers described feeling troubled by knowing statistics about the magnitude and high prevalence of HIV (from official sources and the media) while they witnessed the increase in disease and the deaths of women, children and colleagues around them. They expressed frustration with a lack of information regarding the HIV status of their female patients - a situation exacerbated by HIV stigma and poor healthcare organisation. The social relationships between the caregivers and women in the study area sometimes meant that the caregivers did not effectively apply universal precautions, such as use of gloves during births. The situation described by the caregivers emphasises that contextual factors must be addressed to meet the increased demands and challenges of providing maternal healthcare in endemic HIV/AIDS countries such as Zimbabwe.