A Longitudinal Qualitative Study of Infant-Feeding Decision Making and Practices among HIV-Positive Women in South Africa

Abstract

This study examined the challenges that HIV-positive women face at different stages of early infant feeding using a longitudinal, qualitative design. The study explored factors influencing infant-feeding decision-making and behavior of HIV-positive mothers and identified characteristics of women and their environments that contributed to success in maintaining exclusivity of their infant feeding practices. The study was undertaken at 3 sites in South Africa. Participants consisted of a purposive sample of 27 women who had a positive HIV test result during antenatal care and were intending to either exclusively breast-feed or exclusively formula-feed their infants. Women were interviewed once antenatally and at 1, 4, 6, and 12 wk postpartum. Just under one-half of the women who initiated breast-feeding maintained exclusivity and over two-thirds of the women who initiated formula-feeding maintained exclusivity. Key characteristics of women who achieved success in exclusivity included the ability to resist pressure from the family to introduce other fluids and to recall key messages on mother-to-child transmission risks and mixed feeding. Among women who maintained exclusive breast-feeding, a strong belief in the benefits of breast-feeding and a supportive home environment was important. For women using formula milk, having resources such as electricity, a kettle, and flask made feeding at night easier. Support for infant feeding that extends beyond the antenatal period is important to enable mothers to cope with new challenges and pressures at critical times during the early postpartum period.

The infant-feeding practices of mothers enrolled in the prevention of mother-to-child transmission of HIV programme at a primary health care clinic in the Mpumalanga province, South Africa

“…The studies revealed that non-adherence was common among the mothers because of challenges relating to the individual mother, the family, the community, socio-economic factors, cultural factors and health care system constraints. 11,12,13 The studies were mostly done in rural and peri-urban areas in the Western Cape, Eastern Cape and KwaZulu-Natal provinces. Doherty et al 12 reported studies at three PMTCT of HIV sites in the three provinces whereby interviews with 27 HIV-infected mothers during the postpartum period revealed that just under half of the mothers who intended breast-feeding maintained exclusivity and over two-thirds of the mothers who initiated formula feeding maintained exclusivity.…”

“…11,12,13 The studies were mostly done in rural and peri-urban areas in the Western Cape, Eastern Cape and KwaZulu-Natal provinces. Doherty et al 12 reported studies at three PMTCT of HIV sites in the three provinces whereby interviews with 27 HIV-infected mothers during the postpartum period revealed that just under half of the mothers who intended breast-feeding maintained exclusivity and over two-thirds of the mothers who initiated formula feeding maintained exclusivity. Bland et al 13 found among 1 253 HIV-infected mothers in KwaZulu Natal that 78% of mothers who intended EBF were able to adhere in the first postnatal week, and 42% who intended ERF were able to adhere.…”

Suporte social de gestantes com HIV: revisão narrativa

“…13 24 Uma das fontes de suporte social instrumental mencionada [16][17][18][19] são os PPTVs, os quais utilizaram uma abordagem centrada na família e dessa forma, contribuíram para divulgação do estado sorológico, e para a adesão aos antirretrovirais. Nesta perspectiva 13,19,23 destaca-se a importância da participação de mulheres em PPTV, as quais realizaram a divulgação de seu diagnóstico e receberam apoio dos seus familiares.…”

“…Participação em programas de prevenção 13,16,[18][19][20][23][24][25][26][27][28] Acolhimento da equipe de saúde 11,16,21,24 Educação em saúde 20 Conforto das condições de saúde 24 Divulgação do estado sorológico [16][17][18][19] Aderir às medidas de profilaxia da TV 11,[16][17][18][19] Repercussões na saúde sexual 13 Deus e a fé 15,24,27 Divulgação do estado sorológico 29 Motivação para aceitar o diagnóstico e o tratamento 24 repercussões na saúde sexual: consideraram-se com maior capacidade para negociar o planejamento familiar, além do uso de preservativo, e solicitar ao companheiro que realizasse o teste de anticorpos do HIV.…”

Living with HIV in regional Queensland: social ties, care and support in managing a long-term complex chronic illness

“…Its application in the field of health research remains, however, limited. QLR has been used to explore "the prospect of dying; journeys to the diagnosis of cancer and living with haemodialysis" [40, page 2], to explore experiences of symptoms in cancer patients [40] and in people living with HIV [25,[145][146][147][148][149]]. The latter is described in more detail.…”