Preventing Mother-to-Child HIV Transmission Among South African Adolescents

Abstract

Although prevention of mother-to-child HIV transmission (PMTCT) programs are predicated on maternal behavior change, little is known about sociocultural factors affecting maternal—child care practices in this arena. The authors used narrative methods (key informant workshops, questionnaires, focus groups, and case study analysis) to explore how sociocultural context shapes adolescent mothers' ability to adhere to programmatic recommendations in rural and urban South Africa. The study aims were to understand the extent to which mothers' decisions are borne out in PMTCT-related practices and to identify contextual elements that affect the link between individual resolutions and action. The results revealed rural adolescents as less likely than urbanites to successfully implement most PMTCT-related practices. HIV stigma, family decision making, and cultural norms surrounding infant feeding hampered mothers' efforts to implement practices that would decrease the risk for infant infection. Barriers to behavior change were analyzed along four domains: history, culture, gender, and power. Methodological aspects and programmatic implications are discussed.

Rethinking HIV/AIDS Disclosure Among Women Within the Context of Motherhood in South Africa

“…In South Africa, most women discover their HIV status during routine antenatal testing, which is available through programs such as prevention of mother-to-child transmission. 38 These women are then faced with the pressure of having to disclose not only to their partners 39 but also to family members, 40 particularly female elders who often manage pregnancy and childbirth. After childbirth, the female elders tend to look after the young mother, ensuring that she adheres to traditional caring and feeding practices.…”

Project Masihambisane: a cluster randomised controlled trial with peer mentors to improve outcomes for pregnant mothers living with HIV

“…WLH's experience of HIV-related stigma is often associated with poor antenatal and postnatal adherence to HIV-related regimens and healthy lifestyles [ 7 , 8 ]. Having a peer for support at the time of diagnoses who also introduces and supports health regimens (e.g., ARV medication adherence, exclusive breastfeeding) can be emotionally powerful [ 9 ].…”

Exclusive breastfeeding policy, practice and influences in South Africa, 1980 to 2018: A mixed-methods systematic review

“…Four studies were conducted in the first period [92–95], three led by the sociologist Gill Seidel in KZN. Most studies were conducted during Period 2 (n = 14) [96–108] and Period 3 (n = 11) [53, 63, 109–117], highlighting the increased value placed on qualitative inquiry. In Period 4, five studies using qualitative methods were published on the influences on infant feeding in South Africa [118–122].…”

“…This is relevant in terms of recall bias and how mothers may have described feeding influences. Health workers, particularly counsellors, were included in nine qualitative studies [53, 93, 94, 96–99, 108, 111]. Five studies included family members, usually fathers or grandmothers [53, 96, 97, 111, 112].…”

“…A total of 21 (61.8%) studies used interviews for data collection, with group discussions being the second most popular form of data collection (15/34), often with a mixture of the two. Novel [93–95] and participatory [108] methods were used in a few instances. Qualitative data were analyzed in a number of ways, with variations of thematic, content, and framework analyses the most common.…”