Factors Associated With HIV-infected Mothers' Perceptions Of And Reactions To, Infant Feeding Choices In South Africa

Tuesday, 19 August 2014
Exhibit hall (Dena'ina Center)
Moleen Zunza, MA , Stellenbosch University, Stellenbosch, South Africa
Monika Esser, MD , Stellenbosch University, Tygerberg, South Africa
Julie. A Bettinger, PhD , University of British Columbia, Vancouver, BC, Canada
Mark.F Cotton, PhD , Stellenbosch University, Tygerberg, South Africa
INTRODUCTION: As Prevention of mother-to-child transmission transitions towards universal combination antiretroviral therapy (cART), the incidence of breastfeeding is increasing and formula feeding decreasing for HIV-exposed infants in the Western Cape province of South Africa. In a prospective cohort study (the Mother-Infant Health Study) we are assessing infant feeding practices in HIV exposed infants.  This sub-study assessed HIV infected mothers’ perceptions of and reactions to feeding their infants. The aim of this study was to capture, from a phenomenological perspective, a socially constructed view of HIV infected mothers’ lived experiences regarding feeding their infants.

METHODS: Through application of Interactive Qualitative Analysis, two separate focus group discussions, a) breastfeeding mothers (n = 7) and b) formula feeding mothers (n =8) were conducted to determine factors associated with their feeding experiences. The focus group discussions were conducted in November 2013. Mothers reflected on their thoughts, beliefs, and experiences regarding feeding their infants. In depth individual interviews (n = 24) based on focus group responses were then conducted to explore the personal meaning, relevance, and life history examples of the themes with the mother. 

RESULTS: Preliminary findings revealed that the main factors comprising experiences of breastfeeding HIV positive mothers were: advice on breastfeeding, reasons for wanting to breastfeed, choosing a feeding option that could make a baby sick (HIV infected), discouragement of breastfeeding, and challenges of breastfeeding. Main factors that described HIV positive formula feeding mothers experiences were: advice on formula feeding, consideration of baby’s health, social expectations, disclosure of HIV status, making decisions about their own situation and fear of HIV transmission to their infant. 

CONCLUSIONS: Breastfeeding and formula feeding HIV positive mothers had different feeding experiences. Factors that describe HIV positive mothers’ infant feeding experiences should be explored on how they relate to each other to understand the meaning mothers attach to their feeding experiences.

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