Fasting during pregnancy is an enigma: why would a woman restrict her food intake during a period of increased nutritional need? Relative to the costs to healthy individuals who are not pregnant, the physiological costs of fasting in pregnancy are amplified, with intrauterine death being one possible outcome. Given these physiological costs, the question arises as to the socioecological factors that give rise to fasting during pregnancy. There has been little formal research regarding the emic perceptions and socioecological factors associated (...) with such fasting. This study therefore took an emic approach and investigated the types of fasts that are common in pregnancy, women’s perceptions of the consequences of fasting, and the socioecological models of pregnancy fasting in three Indian communities. This cross-sectional study took place in Bhubaneshwar, Odisha state, and Mysore, Karnataka state, among two populations of Hindu women and one population of Muslim women (_N_ = 85). In total, 64% of women fasted in prior pregnancies. Findings revealed variation in the number and types of fasts that are common in pregnancy across the three communities. Each community reported differences in positive and negative consequences of fasting, with varied emphasis on reproductive health, religiosity, and general health and well-being. Finally, quantitative analyses indicated that the best-fitting model for fasting during pregnancy was religiosity, and the poorest-fitting models were resource scarcity and general health. This study provides insight into motivations for such fasting and highlights the need to investigate the relationship between supernatural beliefs and maternal–fetal protection further, as well as social functions of pregnancy fasting within the family and community. (shrink)

HIV stigma and fears surrounding the disease pose a challenge for public health interventions, particularly those that target pregnant women. In order to reduce stigma and improve the lives of vulnerable populations, researchers have recognized a need to integrate different types of support at various levels. To better inform HIV interventions, the current study draws on social-ecological and evolutionary theories of reproduction to predict stigma and fear of contracting HIV among pregnant women in South India. The aims of this study (...) were twofold: compare the social-ecological model to a modified maternal-fetal protection model and test a combined model that included strong predictors from each model. The study took place in 2008–2011 in Mysore District, Karnataka, India. Using data from a cross-sectional survey and biological indicators of health, we statistically modeled social-ecological variables representing individual, interpersonal, and community/institutional levels. Participants were 645 pregnant women. The social-ecological and combined models were the best-fitting models for HIV-related stigma, and the combined model was the best fit for HIV-related fear. Our findings suggest that combining reproductive life history factors along with individual, interpersonal, and community/institutional factors are significant indicators of HIV-related stigma and fear. Results of this study support a multifaceted approach to intervention development for HIV-related stigma and fear. The combined model in this study can be used as a predictive model for future research focused on HIV stigma and fear, with the intent that dual consideration of social-ecological and evolutionary theories will improve public health communication efforts. (shrink)